Transition from mild cognitive impairment to normal cognition: Determining the predictors of reversion with multi‐state Markov models

Abstract

Introduction. The theoretical framework of the Alzheimer's disease continuum considers transition between stages in a unidirectional manner. Here we examine the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) and explore a set of potential variables associated with this phenomenon. Methods. A total of 985 Spanish community‐dwelling individuals aged 70 years and over at baseline were monitored for 5 years. During this time, 173 MCI and 36 dementia cases were identified. Multi‐state Markov models were performed to characterize transitions between states through the dementia continuum. Results. The rate of reversion from MCI to NC was 11%. There were significant non‐modifiable (age, socioeconomic status, or apolipoprotein E) and modifiable factors (cognitive training or absence of affective symptoms) associated with reversion. Discussion. Overall, our results highlight that the likelihood of progression from MCI to dementia is very similar to that of reversion from MCI to NC.