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Five-Year Trajectory of Mild Cognitive Impairment: Insights from a Primary Care Memory Clinic

Published online by Cambridge University Press:  29 September 2025

Linda Lee Open the ORCID record for Linda Lee [Opens in a new window] ,
Aaron Jones Open the ORCID record for Aaron Jones [Opens in a new window] ,
Tejal Patel ,
Loretta M. Hillier Open the ORCID record for Loretta M. Hillier [Opens in a new window] ,
Ruchi Parikh ,
Catherine Lee ,
Zahinoor Ismail ,
Frank Molnar  and
Howard Chertkow
Linda Lee*
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, ON, Canada and Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
Aaron Jones
Affiliation:
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
Tejal Patel
Affiliation:
School of Pharmacy, University of Waterloo, Waterloo, ON, Canada, and Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
Loretta M. Hillier
Affiliation:
GERAS Centre for Aging Research, Hamilton Health Sciences, Hamilton, ON, Canada
Ruchi Parikh
Affiliation:
Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
Catherine Lee
Affiliation:
Centre for Family Medicine Family Health Team, Kitchener, ON, Canada
Zahinoor Ismail
Affiliation:
University of Calgary, Hotchkiss Brain Institute and O’Brien Institute for Public Health, Calgary, AB, Canada
Frank Molnar
Affiliation:
Division of Geriatrics, University of Ottawa, The Ottawa Hospital, and Regional Geriatric Program of Eastern Ontario, Ottawa, ON, Canada
Howard Chertkow
Affiliation:
Baycrest Academy for Research and Education, Toronto, ON, Canada
*
Corresponding Author: Linda Lee, Department of Family Medicine, McMaster University Centre for Family Medicine Family Health Team, 10 B Victoria Street, South Kitchener, ON, Canada N2G 1C5, Tel: (519) 783-0023 Fax: (519) 783-0033 (lee.linda.lw@gmail.com).
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Abstract

Background

The trajectory of Mild Cognitive Impairment (MCI) to dementia within primary care is not well understood.

Objective

We investigated the 5-year trajectory of patients initially diagnosed with MCI, evaluated their risk of developing dementia considering age, sex, and Montreal Cognitive Assessment (MoCA) test scores and determined the annual conversion rate from MCI to dementia for patients assessed in a MINT (Multispecialty Interprofessional Team) memory clinic.

Methods

We conducted a longitudinal cohort study using a retrospective chart review of 751 patients assessed within a MINT memory clinic in Ontario, Canada. The conversion rate from MCI to dementia was estimated with the Kaplan-Meier method. Cox regression examined time to dementia diagnosis and the association between baseline MoCA scores and dementia risk.

Findings

The observed 5-year conversion rate from MCI to dementia was 28.0%, though with limited follow-up data. Accounting for missing data, the estimated 5-year conversion rate was 48.8% (39.5%, 59.2%) with an average annual rate of 9.8%. Each one-point increase in MoCA score at initial visit was associated with a 10% lower rate of conversion to dementia (aHR: 0.90, 95%CI: 0.85-0.96).

Discussion

Findings highlight the profile of patients assessed in MINT clinics, cognitive trajectory of those diagnosed with MCI, and the importance of primary care-based memory clinics in early detection and intervention.

Résumé

Résumé

Nous avons mené une étude de cohorte longitudinale à partir d’une analyse rétrospective des dossiers de 751 patients évalués dans une clinique de la mémoire multidisciplinaire et interprofessionnelle (MINT) en Ontario, au Canada. Le taux de conversion du trouble cognitif léger (TCL) en démence a été estimé à l’aide de la méthode de Kaplan–Meier. Une régression de Cox a permis d’examiner le délai préalable au diagnostic de démence et l’association entre les scores initiaux au test Montreal Cognitive Assessment (MoCA) et le risque de démence. Le taux de conversion du TCL en démence observé sur 5 ans était de 28.0%, mais les données de suivi étaient limitées. En tenant compte des données manquantes, le taux de conversion estimé sur 5 ans était de 48.8% (39.5%, 59.2%), avec un taux annuel moyen de 9.8%. Chaque augmentation d’un point du score MoCA lors de la première visite était associée à une réduction de 10% du taux de conversion en démence (RRI ajusté: 0.90, IC à 95%: 0.85–0,96). Les résultats mettent en évidence le profil des patients évalués dans les cliniques MINT, la trajectoire cognitive des personnes ayant reçu un diagnostic de TCL et l’importance des cliniques de la mémoire en soins primaires pour le dépistage précoce et l’intervention.

Keywords

primary carememory clinicsdementiamild cognitive impairmentdisease trajectorysoins primairescliniques de la mémoiredémencetrouble cognitif légertrajectoire cognitive

Information

Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 44 , Issue 4 , December 2025 , pp. 542 - 551
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Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Canadian Association on Gerontology

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