Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Research Article Dement Geriatr Cogn Disord 2009;28:47–55 DOI: 10.1159/000229025 Risk Factors of Transition from Normal Cognition to Mild Cognitive Disorder: The PATH through Life Study Nicolas Cherbuin a Chantal Reglade-Meslin a Rajeev Kumar a, b Patricia Jacomb a Simon Easteal c Helen Christensen a Perminder Sachdev d, e Kaarin J. Anstey a a Centre for Mental Health Research, b Department of Psychological Medicine, and c John Curtin School of Medical Research, Australian National University, Canberra, A.C.T., and d School of Psychiatry, University of New South Wales, and e Neuropsychiatric Institute, Sydney, N.S.W., Australia Introduction There is considerable evidence for an association be- tween mild cognitive disorders (MCDs) in ageing and Alzheimer’s disease (AD) [1], with many studies showing high rates ( 30%) of conversion from MCD to AD over relatively short periods of time (2–5 years) [2]. However, few studies have reported on factors predicting transition from normal cognitive ageing to clinically assessed MCD or on factors protecting individuals from such a transi- tion, and those who did generally assessed older individ- uals [3]. Based on post-mortem studies, Braak et al. [4] have shown that the neurodegenerative processes leading to AD start early in adulthood and progress over decades. It may follow that known risk factors for conversion to dementia are also predictive of conversion to MCD and, therefore, might be amenable to even earlier interven- tion. With the aim of identifying these factors in younger individuals, we investigated a community-based cohort of 60–64-year-old participants taking part in a large pro- spective longitudinal study of ageing. We expected, aside from age, cardiovascular disease [5], diabetes [6], obesity [7], head injury [8], hypercholesterolemia [9], excessive alcohol consumption [10], depression [11], smoking [12] , Key Words Mild cognitive impairment  Alcohol  Hypertension  BMI  Depression Abstract Aims: The aim of this study was to identify physical and men- tal health and lifestyle predictors of transition from normal cognition to mild cognitive disorder (MCD). Methods: A total of 2,082 individuals, aged 60–64 years, were assessed at 2 time-points 4 years apart for mild cognitive impairment (MCI) and other MCDs. Results: The main predictors of con- version to MCI and to other mild cognitive disorders were past alcohol intake, current anxiety and depression medica- tion, increased systolic blood pressure, and past smoking. Conclusion: Participants with a history of smoking or harm- ful alcohol consumption, hypertension, or who took medica- tion for anxiety or depression were at increased risk of tran- sitioning to MCI or any MCD. Strategies targeted at managing the above risk factors may have benefits in preventing mild cognitive decline in relatively healthy middle-aged individu- als living in the community. Copyright © 2009 S. Karger AG, Basel Accepted: May 15, 2009 Published online: July 23, 2009 Nicolas Cherbuin Centre for Mental Health Research, Building 63 Australian National University Canberra, A.C.T. 0200 (Australia) Tel. +61 2 6125 3858, Fax +61 2 6125 0733, E-Mail nicolas.cherbuin@anu.edu.au © 2009 S. Karger AG, Basel 1420–8008/09/0281–0047$26.00/0 Accessible online at: www.karger.com/dem