Abstract
We tested the notion that patients at high risk for progression to Alzheimer's disease (AD) display relatively isolated memory deficits by assessing the relationship between memory and fluency performances in a sample of 92 geriatric subjects with cognitive complaints and normal to mild clinical presentations. Patient groups were formed on the basis of memory test scores. Patients with normal memory scores also performed normally on fluency tests, and their fluency scores were significantly higher than those of patients with low memory performances. Patients falling between these two groups in memory abilities also displayed intermediate level fluency performances. Whereas the normal memory group performed at equivalent levels on semantic and phonemic fluency tasks, both the impaired memory group and the intermediate group displayed relatively greater weaknesses in semantic fluency. This pattern is similar to that seen in AD. Since the impaired memory patients meet criteria for Amnestic Mild Cognitive Impairment, these findings suggest that memory deficits in “pre-clinical” AD are likely to be accompanied by fluency weaknesses, with semantic fluency weaknesses predominating.
Highlights
The term Mild Cognitive Impairment (MCI) has found an ever-widening currency within the literature to denote a heightened risk for dementia in patients who are not demented at the time of their examination [41]
We found that increasing levels of memory impairment were accompanied by increasingly deficient fluency performances in patients with normal to mild clinical presentations who were referred within a geriatric clinic for neuropsychological assessment
A recent comprehensive meta-analysis revealed that this pattern predominates in Alzheimer’s disease (AD) [21]; our finding is unsurprising, and novel insofar as the question has been rarely addressed in MCI and other nuanced presentations
Summary
The term Mild Cognitive Impairment (MCI) has found an ever-widening currency within the literature to denote a heightened risk for dementia in patients who are not demented at the time of their examination [41]. Within a growing literature on states that fall between normal functioning and dementia, a debate has emerged regarding the true nature of MCI, progression rates, and eventual clinical status ([4,6,11,12,15, 16,18,23,27,30,32,42,43,46,49]) Petersen and his colleagues have refined their conception of MCI over the years to include four subtypes: Amnestic MCI Single Domain; Amnestic MCI Multiple Domain; Non-Amnestic MCI Single Domain; and NonAmnestic MCI-Multiple Domain [28,39].
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