الفهرس 
MILD COGNITIVE IMPAIRMENTOnly 14 pages are availabe for public view
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Abstract
MCI is a syndrome of cognitive decline that is greater than would be expected for an individual‘s age and level of education that does not interfere with that individual‘s ability to perform activities of daily life .
Older adults with MCI have a higher risk of developing dementia, between 5% and 10% compared with cognitively healthy older adults. Individuals with a MCI progress to AD at a rate of 10% to 15% per year, compared with 1% to 2% per year in normal elderly persons.
The prevalence of MCI is estimated to be 19% among individuals age <75, and 29% in those over 85 years of age.
Amnestic MCI is particularly predictive of dementia, with rates as high as 41% after 1 year, and 64% after 2 years for amnestic MCI, Impairment of delayed recall is a strong predictor of progression to Alzheimer‘s disease
Conversion rates to dementia vary depending on the setting. Notably, in a community setting, 44% of people with MCI were shown to return to normal after 1 year
In older adults, cognition is an essential element of mental health that is important for healthy aging. Timely identification of cognitive changes, such as mild cognitive impairment (MCI), and its treatment are paramount for healthcare providers to support healthy aging and prolong independence and quality of life for older adults, their families, and care givers and may delay the progress to dementia with proper management and modification of risk factors.
The MCI group was divided into Subgroups (Amnestic n=17 and Non-amnestic n=16). In the current study, both males and females were matched regarding their age (p>0.05). Furthermore, the MCI and Control groups were matched for educational level (p>0.05).
The cases and controls were matched regarding age, gender and education. The MCI group as regarding of age had statistically significant lower FES-I scores in comparison to the control group. Both the MCI group and control group had normal office test and VNG results, except for one MCI subject who failed in condition 4 of the mCTSIB . There was a statistically significant difference in the fixation index between control group and MCI groups. However, all fixation indices were within normal ranges.
MCI group had lower scores conditions (two, three, five and six) and composite score than control group. When comparing between MCI and controls, the younger age MCI had more risk of fall in SOT (condition 3, 5, 6), and composite score. Meanwhile, the older age MCI group had more risk of fall with compare to older control group in condition (3,5,6) and composite score.
Older age MCI had more objective risk of fall in comparison to younger age MCI in SOT condition 3-6.this had a statistically significant difference in the harder SOT conditions.
Comparison between the different MCI types (amnestic and non-amnestic) as regards different SOT conditions and scores showed that Amnestic group had more risk of fall in condition6 and composite score than non-amnestic group.
In MCI subjects there was significant correlation between MME score and Condition 3, 5, 6, composite score, FES-I score. Same as in all Amnestic MCI subjects there was significant correlation between FES-I score and condition 4, 5, 6, composite score. Meanwhile, in non-amnestic MCI subjects there was significant correlation between FES-I score and condition 5, 6, composite score.
A significant difference in SOT scores (condition 2, 3, 5, 6), and composite score between MCI group and control group. This can be explained by the fact that cognitive deficits may lead to a lower multisensory integration, which reduces their functional SOT performance compared to healthy elderly subjects.
The analysis of our findings revealed poorer body balance in MCI group, in agreement with other posturography studies conducted in this population.
The analysis of static body balance in different visual conditions enabled an analysis of the impact of vision to maintain the balance in both MCI and Controls. We could observe that there was no significant difference in dynamic posturography variables between both groups in Open-eyes (OE) conditions (i.e. condition 1 and 4). However, in Closed-eyes (CE) conditions (i.e. conditions 2 and 5), a statistically significant difference was found. In other words, the MCI group needed more visual information in order to maintain balance, and the absence of visual cues resulted in higher body sway in the MCI group.It seemed that visual control is an important factor in postural control during dynamic activities. As these elderly people present with a lower somatosensory input in their lower limbs, as well as a possible change in vestibular system, their visual system gets overloaded, and visual deprivation triggers a greater change in static equilibrium.
Older age MCI had more objective risk of fall in comparison to younger age MCI in SOT condition 3-6. This had statistical significance in condition 6 and the composite scores. Older people with mild cognitive impairment have an increased risk for falls.
The Amnestic group had more risk of fall in condition 6 and composite score than Non Amnestic group. These results can be understood based on the fact that aMCI is more predictive and likely to progress to AD than naMCI.
In MCI subjects there was significant correlation between MME score and: Condition 3, 5, 6, composite score, FES-I score. MMSE the relationship between increased risk of falling and poor cognitive function, supported by previous researches. Arabic FES-I showed negative correlation with the MMSE. This agreed with previous reports that fall risk appears to increase as cognition declines, with higher risk of falling with decline in MMSE scores. This was congruent with both our subjective (FES-I) and objective (SOT) risk of fall assessment tools
Our hypotheses were confirmed, mild cognitive impairment was associated with decline in the postural stability, and the analysis of our findings revealed poorer body balance in MCI group. There was an agreement with previous posturography studies Therefore, identifying pending cognitive impairment at an early stage has become increasingly important to physicians, in order to achieve early intervention and fall prevention. Older-adult patients must be screened for mild cognitive impairment even if not clinically manifest, as early detection and intervention can improve quality of life and delay progression to dementia.