Features Of Mild Cognitive Impairment Research Articles

Stability of Magnetoencephalography and Electroencephalography Spectral Features in Mild Cognitive Impairment

AbstractBackgroundIn mild cognitive impairment (MCI), the first neurodegenerative changes may occur years before they can be effectively detected with current clinical tools. Early pathology has been linked to synaptic dysfunction causing brain network disturbances that may be observed with electroencephalography (EEG) and magnetoencephalography (MEG). These methods are still not widely utilized in dementia risk assessment, and the stability of suggested EEG and MEG features and their correlation has not been thoroughly addressed in this patient group.MethodIn a 5‐year EU Horizon2020 project ‘AI‐Mind’, we collect EEG and simultaneous MEG data from MCI subjects, to be compiled with cognitive, genetic and plasma biomarker measures and techniques based on artificial intelligence (AI) for predicting the overall dementia risk. Here, we analyzed a subset of 31 Finnish MCI participants (20 females, age 68 ± 5; mean ± SD) from the AI‐Mind dataset to assess the stability of prominent signal features from resting‐state EEG and MEG recordings. We determined within‐session test‐retest reliability for spectral peak frequencies and relative peak power over occipital brain regions in the 8‐13 Hz range, by utilizing intraclass correlation (ICC) for subsequent 5‐min runs of EEG and MEG data in both eyes‐closed (EC) and eyes‐open (EO) conditions. In addition, we determined the consistency of the features across methods (EEG/MEG).ResultThe results indicate good (ICC>0.6) test‐retest reliability across runs for EEG (peak frequency: 0.72 (EC); relative power: 0.86 (EC) and 0.66 (EO); p<0.001) and excellent test‐retest reliability (ICC>0.75) for MEG (peak frequency: 0.83 (EC); relative power: 0.96 (EC) and 0.85 (EO); p<0.001). Consistency across EEG and MEG was excellent (peak frequency: 0.86 (EC); relative power 0.89 (EC) and 0.84 (EO); p<0.001).ConclusionElectrophysiological recordings of brain networks are emerging as a diagnostic tool for early detection of dementia. Good stability of the measured signal features is a prerequisite for a clinically feasible tool. Here, we demonstrate good or excellent stability for prominent spectral features both within and across EEG and MEG recordings.

Time-Based and Event-Based Prospective Memory in Mild Cognitive Impairment and Alzheimer's Disease Patients: A Systematic Review and Meta-analysis.

Prospective memory (PM) is the ability to remember to perform planned actions in a future moment and it is of fundamental importance for an independent and autonomous lifestyle from development to late adulthood. Deficits in episodic memory and executive functions, which are involved in PM are characteristic features of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Considering that the number of older adults is drastically increasing over the next decades, it is of great interest to understand how PM decline in healthy older adults and patients with different degree of cognitive decline. The present meta-analysis included 46 studies investigating PM performance in AD patients (17 studies) and people with MCI (24 studies); 5 studies included both clinical conditions in the same article. The 46 studies contributed a total of 63 independent samples and 129 effect sizes from 4668 participants (2115 patients and 2553 controls). Unlike previous reviews of the literature, our results with a larger and updated sample of studies confirmed lower PM abilities in AD compared to MCI and controls, although we did not observe conclusive differences between event-based and time-based PM in patients. Surprisingly, PM deficits shown by MCI and AD patients have decreased across years, in parallel to a reduction of the evidence of publication bias and an increase in the number of observations per task. We propose the use of more reliable research designs as one plausible explanation for the reduction of PM impairments.

Global assessment, cognitive profile, and characteristics of mild cognitive impairment in Parkinson's disease.

Cognitive deficits are evident throughout the course of Parkinson's disease (PD), with 24% of patients experiencing subtle cognitive disturbances at the time of diagnosis, and with up to 80% of patients developing PD dementia (PDD) at advanced stages of the disease PD patients with mild cognitive impairment (MCI), an at-risk phenotype of PDD, present with heterogeneous clinical characteristics that complicate the management of PD. This study aims to examine the characteristics of PD-MCI by using the Movement Disorder Society (MDS) diagnostic criteria and evaluate the validity of global cognitive scales in identifying PD-MCI. Seventy-nine (79) PD patients completed neuropsychological assessments and a comprehensive cognitive battery. PD-MCI was classified according to the level 2 MDS task force criteria. Mini-Mental State Examination (sMMSE), Montreal Cognitive Assessment (MoCA) and Parkinson's Disease Cognitive Rating Scale (PDCRS) were examined against a level 2 dichotomised PD-MCI diagnosis. Characteristics of PD-MCI were evaluated using logistic regression analysis. Twenty-seven patients met criteria for PD-MCI (34%). The MoCA and PDCRS demonstrated high validity to screen for PD-MCI. Impairments in multiple cognitive domains were observed in 77.8% of PD-MCI patients. There were significantly more males in the PD-MCI group compared to PD patients without MCI (p<0.01). PD patients with MCI exhibited impairments in the attention/working memory, executive function and memory domains. Heterogeneous cognitive characteristics in PD warrant further investigation into specific cognitive subtypes to advance understanding and effective evaluation of PD-MCI.

Characteristics of Mild Cognitive Impairment and Associated Factors in MSA Patients

Mild cognitive impairment (MCI) in multiple-system atrophy (MSA) patients is common but remains poorly characterized, and the related factors are unclear. This retrospective study included 200 consecutive patients with a clinical diagnosis of possible or probable MSA, 102 MSA patients with MCI (MSA-MCI), and 98 MSA patients with normal cognition (MSA-NC). Cognitive profiles were compared between MSA-MCI and MSA-NC patients using the MoCA. In addition, demographic as well as major motor and nonmotor symptom differences were compared between MSA-MCI and MSA-NC patients. The median MMSE score was 26 points. Overall, MSA-MCI was observed in 51% of patients, with predominant impairment in visuospatial, executive, and attention functions compared with MSA-NC patients. MSA-MCI patients were older (p = 0.015) and had a later onset age (p = 0.024) and a higher frequency of hypertension, motor onset, and MSA with the predominant parkinsonism (MSA-P) phenotype than MSA-NC patients. The positive rate of orthostatic hypotension (OH) in MSA-MCI patients was significantly decreased and depression/anxiety was significantly increased compared with MSA-NC patients (p = 0.004). Multivariate logistic analysis showed that motor onset was independently associated with MCI in MSA patients. MSA-MCI patients had impairment in visuospatial, executive, and attention functions. More prominent memory impairment was observed in MSA-P than in MSA-C patients. Motor onset was independently associated with MCI in MSA patients. MCI was commonly presented in MSA with more prominent memory impairment in MSA-P. Future follow-up studies are warranted to identify more factors that influence cognitive impairment in MSA.

Which Multivariate Multi-Scale Entropy Algorithm Is More Suitable for Analyzing the EEG Characteristics of Mild Cognitive Impairment?

So far, most articles using the multivariate multi-scale entropy algorithm mainly use algorithms to analyze the multivariable signal complexity without clearly describing what characteristics of signals these algorithms measure and what factors affect these algorithms. This paper analyzes six commonly used multivariate multi-scale entropy algorithms from a new perspective. It clarifies for the first time what characteristics of signals these algorithms measure and which factors affect them. It also studies which algorithm is more suitable for analyzing mild cognitive impairment (MCI) electroencephalograph (EEG) signals. The simulation results show that the multivariate multi-scale sample entropy (mvMSE), multivariate multi-scale fuzzy entropy (mvMFE), and refined composite multivariate multi-scale fuzzy entropy (RCmvMFE) algorithms can measure intra- and inter-channel correlation and multivariable signal complexity. In the joint analysis of coupling and complexity, they all decrease with the decrease in signal complexity and coupling strength, highlighting their advantages in processing related multi-channel signals, which is a discovery in the simulation. Among them, the RCmvMFE algorithm can better distinguish different complexity signals and correlations between channels. It also performs well in anti-noise and length analysis of multi-channel data simultaneously. Therefore, we use the RCmvMFE algorithm to analyze EEG signals from twenty subjects (eight control subjects and twelve MCI subjects). The results show that the MCI group had lower entropy than the control group on the short scale and the opposite on the long scale. Moreover, frontal entropy correlates significantly positively with the Montreal Cognitive Assessment score and Auditory Verbal Learning Test delayed recall score on the short scale.

Do fine motor impairments constitute a key feature of mild cognitive impairment? A systematic review and meta‐analysis

AbstractBackgroundTypical symptoms of mild cognitive impairment (MCI) include impairments in memory, executive function, and visuospatial skills. While impairments in these cognitive domains are highly apparent after MCI, impairments in motor domain are not so conspicuous. Converging evidence suggests that individuals with MCI demonstrate motor impairments in lower extremity such as reduced balance and impaired gait performance. However, the impact of MCI on upper extremity motor impairments is not well understood. In the current meta‐analysis, we examine whether fine motor impairments are a key feature of mild cognitive impairment.MethodWe performed a systematic search of electronic databases for articles published between 1990 and 2019. The meta‐analysis included studies that compared healthy older adults and adults with a clinical diagnosis of MCI on fine motor tasks such as handwriting, finger tapping, and hand dexterity.ResultTen studies with over 800 participants qualified for inclusion. Rigorous meta‐analytic techniques using random effects model, forest and funnels plots revealed a standardized mean difference effect of 0.48 (95% CI = 0.77 to 0.19, p=0.001). This moderate effect indicated deficits in fine motor control are a likely feature of MCI.ConclusionThe cumulative evidence suggests that fine motor impairments are pervasive in MCI across a range of upper extremity motor tasks. Quantitative assessment of the decline in fine motor function in MCI may be promising approach to understand the changes in motor function that occur with the onset of Alzheimer’s disease and are clearly differentiated from normal aging‐related decline.

Role of transcranial direct current stimulation (TDCS) intervention on resting state functional connectivity in early Alzheimer’s disease

AbstractBackgroundWorking memory and executive function deficits are the characteristic features of Mild Cognitive Impairment and mild Alzheimer’s Disease (mild AD). Studies exploring the alterations in working memory and executive functions show disrupted functional connectivity in Dorsolateral Pre Frontal Cortices (DLPFC) and Angular Gyrus (AG). Transcranial direct current stimulation (tDCS), by stimulating these brain regions, can alter resting‐state functional connectivity (rs‐FC) and has emerged as a safe and non‐invasive technique that has the potential to enhance neuroplasticity and cognitive improvement.MethodWe investigated the effect of anodal stimulation at the left DLPFC and cathode placed at the right supra‐orbital area to observe the rsFC changes in patients with MCI and mild AD (n=12; Age=67.58 ± 8.59 years, Gender ratio 1:1, formal years of education= 14.58±3.55 years, Hindi mental Status examination=26.91±3.1), who attended the outpatient services of Geriatric Clinic and Services, after due approval from institute ethics committee NIMHANS. The resting‐state functional magnetic resonance imaging (rsfMRI) acquisitions were performed before and after the ten sessions of tDCS, each session lasting 20 minutes. Investigations were performed on subregions of DLPFC (left Superior Frontal Gyrus (LSFG), Right SFG, left Middle Frontal Gyrus (LMFG) and Right MFG) and Angular Gyrus (Right Angular Gyrus (RAG) and Left AG), chosen a priori as seeds for the seed based FC (sbFC) analysis after correcting for the influences of age and gender using CONN 18b toolbox. Spherical masks of size 5 mm diameter were also created for the above‐mentioned seeds.ResultThe pre‐post tDCS comparisons of sbFC showed significant (FDR; p&lt;0.05) reduction of rsFC in patients with MCI and mild AD at right supramarginal gyrus, right angular gyrus, right frontal pole (for Seed‐RAG, Voxel‐ whole brain), supramarginal gyrus (for Seed‐RAG, Voxel‐ RAG), and Middle Temporal gyrus, left Temporo‐Occipital part (for Seed‐ RSFG, Voxel‐ whole brain) as shown in Figure 1 a, b, and c respectively (Refer Table 1).ConclusionThe results support that anodal stimulation using tDCS at left DLPFC may lead to the reduction of aberrantly increased functional connectivity between brain regions involved in working memory and executive functions in MCI and mild AD.

Association of anxiety with vascular risk factors in memory clinic patients with MCI and Alzheimer’s dementia

AbstractBackgroundAnxiety is increasingly recognized as an early neuropsychiatric symptom in Alzheimer’s disease (AD) that portends faster progression. The etiology of anxiety in AD and the mechanism of this faster progression are unclear. Vascular risk factors independently associate with anxiety and dementia, and thus may play an important role in AD‐related anxiety. We aimed to study the prevalence of vascular risk factors in memory clinic patients with and without anxiety at the mild cognitive impairment (MCI) and AD dementia stages.MethodThe cohort included patients aged ≥ 65 years who were evaluated at the NYU Langone Barlow Center for Memory Evaluation and Treatment between January 1, 2015 and June 24, 2019. Analysis was limited to patients who received a diagnosis of mild cognitive impairment (MCI) or Alzheimer’s dementia (AD). At each stage, the cohort was divided into those with and without a coded diagnosis related to anxiety. Outcomes and clinical variables were based on electronic health records. Definitions for AD, MCI, anxiety, and vascular risk factors are shown in Tables 1‐2.Result2046 and 1594 patients were included in the MCI and AD cohorts, with anxiety prevalence of 26% and 20% in each cohort respectively. Characteristics of MCI and AD patients with and without anxiety are reported in Table 3. The rates of key cardio‐ and cerebrovascular risk factors were of increased frequency in anxious vs. non‐anxious patients in both MCI and AD cohorts: hypertension, hyperlipidemia, myocardial infarction, atrial fibrillation, ischemic heart disease, heart failure, and diabetes mellitus. Moreover, these differences were amplified in the dementia stage compared to the MCI stage. Peripheral vascular disease, stroke, and sleep apnea differences were unique to the dementia stage.ConclusionThese results suggest that vascular risk factors could play a critical role in the relationship between anxiety and AD. This relationship strengthens as AD progresses from prodromal to dementia stage, and also involves additional factors. Further characterization of these relationships and their mechanisms may uncover novel pathways to manage AD‐related neuropsychiatric symptoms and modify AD progression.

Animals in multidimensional space: Interpreting coordinates throughout lexical-semantic features in mild cognitive impairment and control subjects

ABSTRACT Introduction Semantic verbal fluency is a useful neuropsychological tool since it involves language and executive abilities that can be impaired in patients with neurodegenerative diseases in comparison to healthy controls. The present study explores retrieve and executive control processes using traditional quantitative and qualitative raw scores and examines the utility of multidimensional scaling combined with linear regression to provide new insights about the underlying semantic network in mild cognitive impairment and in healthy older adults. Method A total of 165 Spanish older adults, 81 patients and 84 controls, were assessed in different cognitive domains and evoked animal names in one minute. Group differences on fluency raw scores were first explored. Regressions using tests to predict groups’ fluency scores were also performed. The 12 animals that had been produced more frequently were selected to perform a multidimensional scaling analysis for each group. Four features related to animal names were extracted from normative studies and then were used as predictors in linear regression to provide an interpretation of the resulting dimensions’ coordinates. Results Patients performed worse on memory and naming and produced a shorter list of animals than controls. In controls, naming and visual memory explained a small part of variance related to the total of animals produced and to the number of switches. Both groups exhibited similar semantic maps. Conclusions Results suggest that patients’ map is influenced by words with a dense associative neighborhood that were acquired at an early age, whereas in controls none of the predictors explained dimensions.

Characterizing mild cognitive impairment in prodromal Parkinson's disease: A community-based study in China.

ObjectiveThe International Parkinson and Movement Disorder Society (MDS) has published research criteria for prodromal Parkinson's disease (pPD), which includes cognitive impairment as a prodromal marker. However, the clinical features of mild cognitive impairment (MCI) in pPD remain unknown. Our study aimed to evaluate the frequency and clinical features of mild cognitive impairment of pPD in the elderly in China.MethodsThe cross‐sectional community‐based study recruited 2688 participants aged ≥50 years. Subjects were diagnosed with pPD according to the MDS criteria. Overall, 39 pPD and 22 healthy controls underwent comprehensive clinical and neuropsychological assessment. MCI was also diagnosed by the MDS criteria. Next, we investigated the relationship between clinical factors and cognition.ResultsAmong the 2,663 dementia‐free and Parkinson disease (PD)‐free participants, 55 met the criteria for pPD (2.1%) and 23 pPD met the criteria for MCI. Memory, attention/working memory, and executive function were the most frequent impaired domains, and amnestic MCI multidomain phenotype was the most frequent MCI subtype (69.57%) in pPD. Additionally, correlation analysis revealed that the global cognitive performance was negatively related to UPDRS‐III score (r = −0.456, p = 0.004).ConclusionMCI, specifically impairment in memory, attention/working memory, and executive domain, is present at the prodromal stage of PD. In addition, cognitive performance is correlated with motor symptoms in pPD. Our results reflect that cognitive profile, combined with motor symptoms, can help clinicians to identify individuals with pPD early, as those would be the optimal candidates for neuroprotective therapy.

Neuropsychological and brain metabolism characteristics of mild cognitive impairment in prodromal Alzheimer's disease and in prodromal synucleinopathy

Mild cognitive impairment (MCI) is an heterogenous condition that can identify patients with prodromal Alzheimer's disease (AD), but differential diagnosis may be challenging at this stage. REM sleep behavior disorder (RBD) is often associated with MCI and is considered a prodromal synucleinopathy. Aim of the study was to investigate neuropsychological and brain metabolism characteristics of MCI due to AD (MCI-AD) and MCI with RBD (MCI-RBD).

Adiponectin: a potential target for obesity-associated Alzheimer's disease.

Obesity and dementia are two growing problems worldwide. Obesity act as a crucial risk factor for various diseases including Alzheimer's disease (AD). Several preclinical studies showed that middle-age obesity can be act as a possible feature of mild cognitive impairment in later years. Some studies have also demonstrated that a high-fat diet causes AD pathology, including extracellular amyloid-beta accumulation, hyperphosphorylation of tau, and cognition impairment. The correlation and molecular mechanism related to obesity-associated AD needs to be better evaluated. Presently, obesity results in an altered expression of several hormones, growth factors, and adipokines. Multiple signaling pathways such as leptin, insulin, adiponectin, and glutamate are involved to regulate vital functions in the brain and act as neuroprotective mediators for AD in a normal state. In obesity, altered adiponectin (APN) level and its associated downstream pathway could result in multiple signaling pathway disruption. Presently, Adiponectin and its inducers or agonist are considered as potential therapeutics for obesity-associated AD. This review mainly focuses on the pleiotropic effects of adiponectin and its potential to treat obesity-associated AD.

Rural–urban differences in the prevalence and characteristics of mild cognitive impairment in independent community‐dwelling older adults in Taiwan

AbstractBackgroundTaiwan is among one of rapidly aging countries and cognitive impairment increases exponentially with age among older adults. Mild Cognitive Impairment (MCI) bears an increased risk of developing dementia later and may represent an early disease stage that is amenable to preventive strategies. There is currently no epidemiological data about the prevalence of MCI in Taiwan.MethodThe data was from the baseline assessment of a community‐based prospective cohort study conducted in one rural and one urban areas of New Taipei City in Taiwan between 2017‐2019. Four hundred and seventy individuals aged 65 years and older, independently living in the community, were recruited and underwent a battery of neuropsychological tests assessing cognitive domains of attention, memory and executive function. Diagnosis of MCI was ascertained through an expert consensus panel based on 2011 NIA‐AA criteria.ResultMean age of participants was 71.1± 5.5 years. Participants from the rural area were older (72.6 vs. 70.6 years), had poorer education (5.5 vs. 8.7 years), higher body mass index (25. 9 vs. 24.6 kg/m2), and higher percentage of hypertension (54.5 vs. 43.6%) The prevalence of MCI was 45/122 (36.6 %) in the rural area and 40/348 (11.5 %) in the urban areas, for a overall 85/470 (18.1 %). The rural area had a significantly higher prevalence of MCI (age‐ ,sex‐, and education‐adjusted odds ratio [OR] = 2.86, 95 % CI: 1.68–4.86) than the urban area. There was no differences in the distribution of subtypes of MCI in two areas. In the rural area, only poorer education was associated higher prevalence OR of MCI whereas in the urban area, being male, poorer education, and higher geriatric depressive scale were associated higher prevalence OR of MCI.ConclusionThe prevalence of MCI was much higher in the rural area relative to the urban area. Different factors were associated with the prevalence of MCI in the rural and urban areas. This regional difference suggests preventive strategies or programs against cognitive impairment should be tailored and modified according to the urbanicity of an area.

Investigating the relationship between neuropsychiatric symptoms and cognition in mild cognitive impairment and Alzheimer’s disease patients undergoing an exercise‐primed transcranial direct current stimulation clinical trial (The EXPRESS Study)

AbstractBackgroundNeuropsychiatric symptoms (NPS) are common features of Mild Cognitive Impairment (MCI) and Alzheimer’s disease (AD), and are associated with poorer cognition. Transcranial direct current stimulation (tDCS), a non‐invasive type of brain stimulation, has been investigated for the treatment of some NPS in a few small AD studies, but with negative results for apathy and depression. Priming the brain with an excitatory intervention, such as exercise, may elicit greater changes if applied prior to tDCS. Using data from an ongoing blinded study, we aimed to evaluate the relationship between NPS and cognition in MCI and mild AD.MethodMCI or mild AD participants were enrolled in a two‐week, randomized, blinded clinical trial investigating the effects of exercise‐primed tDCS for cognition using the Montreal Cognitive Assessment (MoCA). NPS were measured using the Neuropsychiatric Inventory (NPI) subscales. A Pearson’s correlation determined the relationship between NPI scores and the MoCA at baseline in patients who received exercise‐primed tDCS or tDCS alone. A repeated measures analysis of variance compared changes in NPI scores between the two treatment groups over time. As the study is ongoing, the treatment groups have been randomly coded as Group 1 and Group 2 to avoid unblinding.ResultAt baseline, participants (N=13) were 76.5±7.2 years of age, MoCA score= 20.9±3.6, 53% female, and 53% MCI. Nine (69.2%) participants reported having at least one NPS (NPI Score ≥ 1). Apathy (46.2%), sleep disturbances (38.5%), agitation (30.8%), and anxiety (30.8%) were the most prevalent NPS. At baseline, only anxiety was negatively correlated with MoCA scores (r=‐0.57, p=0.041; Figure 1). There were no significant differences between treatment groups on anxiety scores over time (F(1,10)= 2.4, p=0.16). However, after controlling for baseline MoCA scores, there was a significantly greater reduction on anxiety scores in Group 1 (‐0.83±1.3) compared to Group 2 over time (0±0; F(1,9)= 5.3, p=0.047).ConclusionRecruitment is ongoing (total N=30). Only anxiety was associated with poorer cognition at baseline. There were differences between treatment groups on anxiety scores over time, after controlling for baseline MoCA scores. It remains to be seen, after unblinding, whether the group with reduction in anxiety was receiving the primed intervention.

A Meta-Analysis of Semantic Memory in Mild Cognitive Impairment

Accumulating evidence over the past decade suggests that semantic deficits represent a consistent feature of Mild Cognitive Impairment (MCI). A meta-analysis was performed to examine if semantic deficits are consistently found in patients with MCI. Studies meeting all inclusion criteria were selected for the current meta-analysis. An effect size and a weight were calculated for each study. A random effect model was performed to assess the overall difference in semantic performances between MCI patients and healthy subjects. 22 studies (476 healthy participants, 476 MCI patients, mean Mini Mental Status Examination of the MCI patients: 27.05 ± 0.58) were included in the meta-analysis. Results indicate that MCI patients systematically performed significantly worse than healthy matched controls in terms of overall semantic performance (mean effect size of 1.02; 95% CI [0.80; 1.24]). Semantic deficits are a key feature of MCI. Semantic tests should be incorporated in routine clinical assessments.

Association between altered serum lipids levels on cognitive impairment in the pre-elderly and elderly population of South India

Altered serum lipid levels are linked with varying degrees of cognitive impairment due to various mechanisms. In addition, the prevalence of mild cognitive impairment varies substantially from one region to another. The prevalence of cognitive impairment in relation to altered serum lipid levels on cognitive impairment in the pre-elderly and elderly population is of great importance. Therefore, it is important to characterize the features of mild cognitive impairment with respect to altered lipid profile. This study investigated the association between altered serum lipid levels on cognitive impairment in the pre-elderly and elderly population. The present cross-sectional study was done in 406 pre-elderly and elderly patients. The participants were subjected to demographic data collection followed by Mini-Mental State Examination (MMSE). Participants were classified into two groups: cognitively-normal (n=289) and mild cognitive impairment (117). Fasting serum lipids of the participants was estimated using venous blood samples by standard biochemical techniques. Differences in the lipid concentrations between the two groups were then compared using the Mann-Whitney U test. Significant differences were found in MMSE scores between the cognitively-normal and MCI groups (p&lt;0.05). MCI patients had a significantly lower level of high-density lipoprotein when compared to cognitively-normal participants (p&lt;0.05). In addition, the two groups showed differences in education levels attained. The cognitively-normal group had a greater number of educational years when compared to the MCI group. The study found significant differences in serum lipid concentrations between the cognitively-normal individuals and the mild cognitive impairment group. Future investigations may be needed to explore the effects exerted by lipids on cognitive functions.

Depression, Anxiety, and Apathy in Mild Cognitive Impairment: Current Perspectives.

Objective: Mild cognitive impairment (MCI) is an important risk state for dementia, particularly Alzheimer’s disease (AD). Depression, anxiety, and apathy are commonly observed neuropsychiatric features in MCI, which have been linked to cognitive and functional decline in daily activities, as well as disease progression. Accordingly, the study’s objective is to review the prevalence, neuropsychological characteristics, and conversion rates to dementia between MCI patients with and without depression, anxiety, and apathy.Methods: A PubMed search and critical review were performed relating to studies of MCI, depression, anxiety, and apathy.Results: MCI patients have a high prevalence of depression/anxiety/apathy; furthermore, patients with MCI and concomitant depression/anxiety/apathy have more pronounced cognitive deficits and progress more often to dementia than MCI patients without depression/anxiety/apathy.Conclusions and Implications: Depression, anxiety, and apathy are common in MCI and represent possible risk factors for cognitive decline and progression to dementia. Further studies are needed to better understand the role and neurobiology of depression, anxiety, and apathy in MCI.

Characteristics of Mild Cognitive Impairment in Northern Japanese Community-Dwellers from the ORANGE Registry.

A gradually increasing prevalence of mild cognitive impairment (MCI) is recognized in the super-aging society that Japan faces, and early detection and intervention in community-dwellers with MCI are critical issues to prevent dementia. Although many previous studies have revealed MCI/non-MCI differences in older individuals, information on the prevalence and characteristics of MCI in rural older adults is limited. The aim of this study was to investigate differential characteristics between older adults with and without MCI. The investigation was conducted over one year from 2018 to 2019. Participants were recruited from Akita in northern Japan. Neuropsychological assessments were applied to classify MCI, including the National Center for Geriatrics and Gerontology Functional Assessment Tool (NCGG-FAT) and the Touch panel-type Dementia Assessment Scale (TDAS) based on the Alzheimer’s disease assessment scale. Our samples consisted of 103 older adults divided into 54 non-MCI and 49 MCI. The MCI group had lower scores of all cognitive items. Our results showed that individuals with MCI had significantly slower walking speed (WS) and worse geriatric depression scale (GDS) compared to non-MCI. In addition, WS was significantly associated with some cognitive items in non-MCI, but not in MCI. Finally, we showed that predictive variables of MCI were WS and GDS. Our study provides important information about MCI in rural community-dwellers. We suggest that older adults living in a super-aging society should receive lower limb training, and avoiding depression in older adults through interaction of community-dwellers may contribute to preventing the onset of MCI.

Mild cognitive impairment associated with eventual Lewy body disease pathology: Clinical characterization of 75 patients

The clinical characteristics of mild cognitive impairment (MCI) associated with underlying Lewy body disease (LBD) pathology are still being defined. The Mayo Alzheimer’s Disease Research Center database was queried to identify all patients who were diagnosed with MCI from 1996 to 2018, followed prospectively, underwent autopsy, and limbic- or neocortical-predominant LBD was present. The key demographic and clinical features were characterized. Seventy-five patients were identified, of whom 55 (73%) were male, mean education was 15 ± 3 years, baseline MMSE score was 26 ± 2, and all had a CDR score of 0.5. The pathologic findings were neocortical-predominant LBD in 40 and limbic-predominant LBD in 35, with 32 (43%) having coexisting Alzheimer’s disease pathology. The mean age or duration ± SD in years for key features were as follows: onset of cognitive decline 71 ± 9, onset of REM sleep behavior disorder (RBD, n = 45) 63 ± 14, age of MCI diagnosis 73 ± 8, age of dementia diagnosis 75 ± 8, duration from MCI to dementia diagnosis 2 ± 1, age at death 81 ± 8, and duration from dementia diagnosis to death 6 ± 4. At MCI diagnosis, the coexisting features were: RBD 53%, mild parkinsonism 31%, cognitive fluctuations 23%, and visual hallucinations 20%; 19% had none of these present. Of the 70 who developed dementia, 80% met criteria for clinically probable DLB. The absence of many core features in the MCI phase and variable development of these features in the dementia-predominant phenotype of LBD underscores the need for biomarkers which are sensitive and specific to LBD pathology, particularly in the MCI phase.

Memorability of photographs in subjective cognitive decline and mild cognitive impairment: Implications for cognitive assessment

IntroductionImpaired long-term memory is a defining feature of mild cognitive impairment (MCI). We tested whether this impairment is item specific, limited to some memoranda, whereas some remain consistently memorable. MethodsWe conducted item-based analyses of long-term visual recognition memory. Three hundred ninety-four participants (healthy controls, subjective cognitive decline [SCD], and MCI) in the multicentric DZNE-Longitudinal Cognitive Impairment and Dementia Study (DELCODE) were tested with images from a pool of 835 photographs. ResultsWe observed consistent memorability for images in healthy controls, SCD, and MCI, predictable by a neural network trained on another healthy sample. Looking at memorability differences between groups, we identified images that could successfully categorize group membership with higher success and a substantial image reduction than the original image set. DiscussionIndividuals with SCD and MCI show consistent memorability for specific items, while other items show significant diagnosticity. Certain stimulus features could optimize diagnostic assessment, while others could support memory.