Mortality in Mild Cognitive Impairment
Diagnosed with DSM-5 Criteria and with
Petersen’s Criteria: A 17-Year Follow-Up in
a Community Study
Javier Santabárbara, Ph.D., Patricia Gracia-García, M.D., Ph.D.,
Guillermo Pírez, M.D., Raúl López-Antón, Ph.D.,
Concepcion De La Cámara, M.D., Ph.D., Tirso Ventura, M.D., Ph.D.,
Marina Pérez-Sastre, M.D., Elena Lobo, Ph.D., Pedro Saz, M.D., Ph.D.,
Guillermo Marcos, M.D., Ph.D., Antonio Lobo, M.D., Ph.D.
Objective: To explore the possibility that the mortality risk of mild cognitive impair-
ment (MCI) as diagnosed using Diagnostic and Statistical Manual of Mental Disorders,
Fifth Edition (DSM-5) criteria (DSM-5–MCI) will be higher than using Petersen’s cri-
teria (P-MCI) and to report the population-attributable fraction (PAF) of mortality
due to MCI. Methods: A representative community sample of 4,803 individuals aged
55 or more years was interviewed and then followed for 17 years.Standardized in-
struments were used in the assessment, including the Geriatric Mental State-
AGECAT,and research psychiatrists diagnosed P-MCI and DSM-5–MCI cases following
operationalized criteria.Mortality information was obtained from the official popu-
lation registry.Kaplan-Meier age-adjusted survival curves were built for the MCI diagnostic
groups, and Cox proportional hazards regression models were used to calculate the
hazard ratio of death in participants with MCI relative to those without.We also es-
timated the PAF of mortality due to specific MCI diagnostic groups. Results: Compared
with noncases, the mortality rate ratio was approximately double in DSM-5–MCI in-
dividuals (2.3) than in P-MCI individuals (1.2).In the multivariate statistical analysis,
a significant association between each diagnostic category and mortality was ob-
served but was only maintained in the final model in DSM-5–MCI cases (hazard ratio:
1.24).The PAF of mortality due to MCI was approximately 1% in both MCI categories.
Received January 22, 2016; revised June 27, 2016; accepted July 7, 2016. From the Department of Preventive Medicine and Public Health (JS,
MP-S, EL, GM); Department of Medicine and Psychiatry (PG-G, GP, CDLC, TV, PS,AL); Department of Psychology and Sociology (RL-A);
Psychiatry Service (PG-G, CDLC, TV), Universidad de Zaragoza, Zaragoza, Spain; Medical Records Service (GM), Hospital Clínico Universitario,
Zaragoza, Spain; Centre Assistencial Sant Joan de Déu d’Almacelles (GP), Lérida, Spain; Instituto de Investigación Sanitaria de Aragón (IIS
Aragón) (CDLC, TV, GM,AL), Zaragoza, Spain; and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (AL), Ministry
of Science and Innovation, Madrid, Spain. Send correspondence and reprint requests to ProfessorAntonio Lobo, Departamento de Psiquiatría,
Universidad de Zaragoza, Calle Domingo Miral, s/n, 50009 Zaragoza, Spain. e-mail: alobo@unizar.es
© 2016 Published by Elsevier Inc. on behalf of American Association for Geriatric Psychiatry.
http://dx.doi.org/10.1016/j.jagp.2016.07.005
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