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Incidence of mild cognitive impairment in the elderly population in Greece: results from the HELIAD study

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Abstract

Background

There are no published data on Mild Cognitive Impairment (MCI) incidence in people over 65 years of age in Greece, relevant literature is scarce for Southern Europe, and reported rates worldwide show great variability.

Aims

To investigate the incidence and risk factors of MCI and its subtypes in the elderly population in Greece.

Methods

The incidence cohort of the HELIAD study (Hellenic Epidemiological Longitudinal Investigation of Aging and Diet) comprised 955 individuals who received full neurological and neuropsychological evaluation on two separate occasions about three years apart.

Results

The MCI incidence rate in our cohort is 54.07 new cases per 1000 person-years, standardized by age and sex to 59.99. Each additional year of age over 65 raises the probability of novel MCI by 6.2%, while lower educational attainment more than doubles the risk for incident MCI. Apolipoprotein E-ε4 (APOE-ε4) carriage results in increased risk for MCI by more than 1.7 times. Incidence rates for amnestic MCI are slightly higher than for the non-amnestic subtype, and AD is the most common potential underlying etiology.

Discussion

The MCI incidence rate in the Greek population over 65 years of age is 54/1000 person-years. Advanced age and APOE-ε4 carriage are predisposing factors, while higher educational attainment was found to exert a protective effect.

Conclusions

MCI incidence in people over 65 years-old in Greece is consistent with reported rates around the world. Larger studies encompassing neuroimaging and cerebrospinal fluid biomarkers will hopefully shed more light on MCI epidemiology in Greece in the future.

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Data availability

Data and material are available upon written request.

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Funding

This work has been supported by the following grants: IIRG-09-133014 from the Alzheimer’s Association, 189 10276/8/9/2011 from the NSRF-EU program Excellence Grant (ARISTEIA) (which is co-funded by the European Social Fund and Greek National resources) and ΔΥ2β/οικ.51657/14.4.2009 from the Ministry for Health and Social Solidarity (Greece) (all awarded to N.S.), and funding from the Research Committee, University of Thessaly, Code 2845 (awarded to G.H.) and from the Research Committee, Aristotle University of Thessaloniki, Code 89272 (awarded to M.H.K.). Our sponsors had no influence on the choice of study design, data collection, data analysis or decision to publish.

Author information

Authors and Affiliations

  1. 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece

    George S. Vlachos, Leonidas Stefanis & Nikolaos Scarmeas

  2. Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Mary H. Kosmidis

  3. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece

    Mary Yannakoulia & Costas A. Anastasiou

  4. School of Medicine, University of Thessaly, Larissa, Greece

    Efthimios Dardiotis & Georgios Hadjigeorgiou

  5. Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus

    Georgios Hadjigeorgiou

  6. Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece

    Ioanna Tzoulaki & Andrea N. Georgiou

  7. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK

    Ioanna Tzoulaki

  8. Athens Association of Alzheimer’s Disease and Related Disorders, Maroussi, Greece

    Paraskevi Sakka

  9. Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece

    Leonidas Stefanis

  10. The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, USA

    Nikolaos Scarmeas

Authors
  1. George S. Vlachos
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Contributions

GSV participated in data collection and consensus meetings, performed the statistical analysis, and drafted the manuscript. MHK, PS and NS participated in study design, consensus meetings, and manuscript review. MY, ED and GH participated in study design and manuscript review. CAA and LS reviewed the manuscript. IT and ANG performed statistical analysis and manuscript review. All authors read and approved the final manuscript.

Corresponding author

Correspondence to George S. Vlachos.

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All procedures were approved by the Institutional Ethics Review Board of the National and Kapodistrian University of Athens and the University of Thessaly.

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Vlachos, G.S., Kosmidis, M.H., Yannakoulia, M. et al. Incidence of mild cognitive impairment in the elderly population in Greece: results from the HELIAD study. Aging Clin Exp Res 33, 2679–2688 (2021). https://doi.org/10.1007/s40520-021-01819-w

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