Geriatrics and Gerontology International 2002; 2: 57–67 57 ORIGINAL ARTICLE Blackwell Science, LtdOxford, UK GGIGeriatrics and Gerontology International1444-15862001 Blackwell Science Asia Pty Ltd 22June 2002 023 Cognitive decline in old community residents Y Fujiwara et al. 10.1046/j.1444-1586.2002.00023.x Original Article5767BEES SGML Accepted for publication 28 November 2001. Correspondence: Yoshinori Fujiwara, MD, PhD, Department of Community Health, Tokyo Metropolitan Institute of Gerontology, 35–2 Sakae-cho, Itabashi-ku, Tokyo 173–0015, Japan. Email: fujiwayo@tmig.or.jp Prevalence and characteristics of older community residents with mild cognitive decline Yoshinori Fujiwara, 1 Shuichiro Watanabe, 1 Shu Kumagai, 1 Yuko Yoshida, 1 Koji Takabayashi, 1 Masahiro Morita, 2 Akihiro Hasegawa, 3 Tanji Hoshi, 3 Masayuki Yokode, 4 Toru Kita 4 and Shoji Shinkai 1 1 Department of Community Health, Tokyo Metropolitan Institute of Gerontology, 2 Department of Psychogeriatrics, Mishima Hospital, 3 Department of Urban Studies, Graduate School of Tokyo Metropolitan University, Tokyo, 4 Department of Geriatric Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan Background: Cognitive impairment is a major health issue, but epidemiological data on mild cognitive decline have been almost absent in Japan. Methods: Of all residents aged 65 years and over living in Yoita town, Niigata Prefecture, Japan in the year 2000 (n = 1673), 1544 participated in the interview survey held at commu- nity halls or at home (92.3% response). They underwent the Mini-Mental State Exami- nation (MMSE) for assessment of cognitive function and answered questionnaires comprising socio-demographic, psychological, physical and medical, and social activity items. Higher-level functional capacities were evaluated with the Tokyo Metropolitan Index of Competence (TMIG-Index of Competence). According to subject’s age and MMSE score, all subjects were classified into 3 groups: control (MMSE > 1 SD below age-specific means), mild cognitive decline (MMSE ≥ 21 and ≤ 1 SD below age-specific means), and severe cognitive decline (MMSE ≤ 20), and compared various characteristics among these groups. Results: Mean MMSE score of the subjects showed a linear decline with advancing age. Among the participants, 232 (15.2%) were classified as mild cognitive decline. Compared with the controls, the subjects with mild cognitive decline reported poorer subjective health, more depressive moods, more history of stroke, more prevalence of basic activity of daily living (BADL) disability, and lower higher-level functional capacity, even after control- ling for possible confounding factors. They also reported a low level of social activities: both participating in group activities and enjoying hobbies were less frequent. Their food intake pattern tended to be monotonous. Conclusions: Older persons with mild cognitive decline comprised a substantial propor- tion (15.2%) of the community-dwelling older population. In addition to lower cognitive function, they had lower levels of functional capacity and social activity. Keywords: community-dwelling elderly people, mild cognitive decline, mini-mental state examination. Introduction In an aged society such as that of Japan, public health policy should aim at prolonging active life expectancy in later life, rather than merely reducing mortality and morbidity. 1–5 Cognitive impairment is a major health