Abstract
(1) Background: Early identification of mild cognitive impairment (MCI) in people reporting subjective cognitive complaints (SCC) and the study of progression of cognitive decline are important issues in dementia research. This paper examines whether empirically derived procedures predict progression from MCI to dementia. (2) Methods: At baseline, 192 participants with SCC were diagnosed according to clinical criteria as cognitively unimpaired (70), single-domain amnestic MCI (65), multiple-domain amnestic MCI (33) and multiple-domain non-amnestic MCI (24). A two-stage hierarchical cluster analysis was performed for empirical classification. Categorical regression analysis was then used to assess the predictive value of the clusters obtained. Participants were re-assessed after 36 months. (3) Results: Participants were grouped into four empirically derived clusters: Cluster 1, similar to multiple-domain amnestic MCI; Cluster 2, characterized by subjective cognitive decline (SCD) but with low scores in language and working memory; Cluster 3, with specific deterioration in episodic memory, similar to single-domain amnestic MCI; and Cluster 4, with SCD but with scores above the mean in all domains. The majority of participants who progressed to dementia were included in Cluster 1. (4) Conclusions: Cluster analysis differentiated between MCI and SCD in a sample of people with SCC and empirical criteria were more closely associated with progression to dementia than standard criteria.
Highlights
Mild cognitive impairment (MCI) is a condition characterized by cognitive impairment with minimal effects on instrumental activities of daily living (IADL)
mild cognitive impairment (MCI) is considered as a stage of the cognitive continuum, which is traditionally divided into three stages: cognitively unimpaired (CU), MCI and dementia [2]
MCI has been classified into four subtypes of cognitive impairment: single-domain amnestic MCI, which requires the presence of amnestic deficits in isolation; single-domain non-amnestic, which includes single-domain non-amnestic deficits; multidomain amnestic MCI, with deficits in multiple cognitive domains, including memory impairment; and multidomain non-amnestic MCI, characterized by deficits in multiple cognitive domains except memory [1,4,5]
Summary
Mild cognitive impairment (MCI) is a condition characterized by cognitive impairment with minimal effects on instrumental activities of daily living (IADL). The 2018 NIA-AA working group [2] updated the standard core criteria [3,4,5] for diagnosing MCI as a cognitive syndrome, as follows: (1) cognitive performance below the expected range based on population norms; (2) evidence of cognitive impairment that may. Brain Sci. 2019, 9, 314 be reported by the individual or by an observer; (3) cognitive impairment may be characterized by presentations that are not primarily amnestic; (4) neurobehavioral disturbance may be a prominent feature of the clinical presentation, e.g., changes in mood, anxiety or motivation; and (5) independent performance of daily life activities, but cognitive difficulty may result in detectable but mild functional impact on more complex activities of daily life. MCI has been classified into four subtypes of cognitive impairment: single-domain amnestic MCI (sda-MCI), which requires the presence of amnestic deficits in isolation; single-domain non-amnestic (sdna-MCI), which includes single-domain non-amnestic deficits; multidomain amnestic MCI (mda-MCI), with deficits in multiple cognitive domains, including memory impairment; and multidomain non-amnestic MCI (mdna-MCI), characterized by deficits in multiple cognitive domains except memory [1,4,5]
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