To investigate sociodemographic and medical predictors of incident mild cognitive impairment (MCI) and subsequent course of MCI at follow-up, including sustained MCI diagnosis, classification as cognitively normal, and progression to dementia.

Within a community-based cohort, diagnoses of MCI were made with a published algorithm. Diagnosis of dementia was based on clinical consensus. Cox regressions estimated hazard ratios of incident MCI associated with several predictors. Modified Poisson regressions estimated relative risks associated with predictors of diagnostic status at follow-up after incidence.

Among 2,903 cognitively normal participants at baseline, 752 developed MCI over an average of 6.3 (SD 4.5) years (incidence rate 56 per 1,000 person-years). Presence of APOE 4 and higher medical burden increased risk of incident MCI, while more years of education, more leisure activities, and higher income decreased this risk. Of the incident MCI cases, after an average of 2.4 years of follow-up, 12.9% progressed to dementia, 9.6% declined in functioning and did not meet the algorithmic criteria for MCI but did not meet the clinical criteria for dementia, 29.6% continued to meet MCI criteria, and 47.9% no longer met MCI criteria. Multidomain MCI, presence of APOE 4, depressive symptoms, and antidepressant use increased the risk of progression to dementia.

This community-based study showed that almost half of the individuals with incident MCI diagnoses were classified as cognitively normal at follow-up. Predictors of incident MCI demonstrably differed from those of subsequent MCI course; these findings can refine expectations for cognitive and functional course of those presenting with MCI.

旨在调查轻度认知障碍 (MCI) 事件和后续 MCI 随访过程的社会人口学和医学预测因素，包括持续的 MCI 诊断、认知正常分类和痴呆进展。

在基于社区的队列中，MCI 的诊断是使用已发布的算法进行的。痴呆症的诊断基于临床共识。Cox 回归估计了与多个预测因素相关的 MCI 事件的风险比。修正泊松回归估计了与发病后随访时诊断状态预测因素相关的相对风险。

在 2,903 名基线认知正常的参与者中，752 名参与者在平均 6.3 (SD 4.5) 年的时间里出现 MCI（发病率为每 1,000 人年 56 人）。APOE 4的存在和较高的医疗负担增加了发生 MCI 的风险，而更长的教育年限、更多的休闲活动和更高的收入则降低了这种风险。在发生 MCI 的病例中，经过平均 2.4 年的随访，12.9% 进展为痴呆，9.6% 功能下降，不符合 MCI 算法标准，但不符合痴呆临床标准，29.6% 继续发展达到 MCI 标准，47.9% 不再符合 MCI 标准。多域 MCI、 APOE 4的存在、抑郁症状和抗抑郁药物的使用会增加进展为痴呆的风险。

这项基于社区的研究表明，几乎一半的 MCI 诊断患者在随访时被归类为认知正常。事件 MCI 的预测因子明显不同于后续 MCI 过程的预测因子；这些发现可以改善对 MCI 患者认知和功能过程的预期。