Frequency Of Mild Cognitive Impairment Research Articles

Ambroxol as a disease-modifying treatment to reduce the risk of cognitive impairment in GBA-associated Parkinson’s disease: a multicentre, randomised, double-blind, placebo-controlled, phase II trial. The AMBITIOUS study protocol

BackgroundHeterozygous mutations in the GBA gene, encoding the lysosomal enzyme β-glucocerebrosidase (GCase), are the most frequent genetic risk factor for Parkinson’s disease (PD). GBA-related PD (GBA-PD) patients have higher risk...

In the context of a deprived neighborhood, does self‐identified race cause dementia?

AbstractBackgroundAlthough accumulating evidence has shown that individual socioeconomic status affects dementia incidence, it remains unknown whether a higher degree of neighborhood disadvantage which is independent of individual socioeconomic status contributes to the excess risk of dementia among African Americans (AA).MethodIn the Monongahela‐Youghiogheny Healthy Aging Team and 15104 Senior Project, two population‐based prospective cohort studies in an economically disadvantaged Rust Belt community, 2733 participants aged 65+ years were assessed for their health history, lifestyle, and cognitive functioning. Mild cognitive impairment (MCI) or dementia was defined as Clinical Dementia Rating score ≥0.5. Each participant was assigned an Area Deprivation Index (ADI) value according to the census block group where one resided, indicating the level of neighborhood disadvantage. In cross‐sectional data, racial differences in the odds of MCI or dementia were assessed using weighted logistic regressions. Inverse probability weighting was used to balance AA and European Americans (EA) with respect to 1) ADI, 2) other confounders (age, sex, APOE*4 genotype, cardiometabolic diseases, individual socioeconomic status, health‐related behaviors, use of regular health services, functional health literacy, and air pollution [PM2.5]), and 3) ADI and other confounders.ResultThe frequency of MCI and dementia were 648 (24%) and 25 (0.9%), respectively. AA had significantly higher proportion of MCI or dementia (35% vs. 24%, p = 0.001) and higher mean ADI (96 vs. 79, p<0.0001) than EA. Being AA was associated with higher odds of MCI or dementia compared to being EA (odds ratio [OR] = 1.71, 95% confidence interval [CI] = 1.26 ‐ 2.33, unadjusted model). After balancing racial groups with respect to ADI only, the difference between AA and EA no longer reached the level of significance. When balancing all other confounders only, the OR was 1.66 (95% CI = 1.04 ‐ 2.67) and the confounders explained 5.2% of the observed disparity. After balancing both ADI and other confounders, the difference again became non‐significant (OR = 1.61, 95% CI = 0.93 ‐ 2.80) and resulted in 11.1% of the MCI or dementia disparity being explained.ConclusionA higher degree of neighborhood disadvantage may contribute to the excess risk of MCI or dementia found among AA.

Frequency and Correlates of Mild Cognitive Impairment in Myasthenia Gravis

Antibodies against acetylcholine receptors (AChRs) can also target nicotinic AChRs that are present throughout the central nervous system, thus leading to cognitive dysfunctions in patients with myasthenia gravis (MG). However, the presence of cognitive impairment in MG is controversial, and the factors that may influence this risk are almost completely unknown. In this study, the frequency of mild cognitive impairment (MCI) in MG, as well as the clinical, immunological, and behavioral correlates of MCI in MG were evaluated. A total of 52 patients with MG underwent a comprehensive assessment including motor and functional scales, serological testing, and neuropsychological and behavioral evaluation. The frequency of MCI was 53.8%, and the most impaired cognitive domains were, in order, visuoconstructive/visuospatial skills, memory, and attention. After multivariate analysis, only pyridostigmine use was inversely associated with the presence of MCI, while a trend toward a positive association between MCI and disease severity and arms/legs hyposthenia was found. Correlation analyses showed that daily doses of prednisone and azathioprine significantly correlated with depressive symptomatology, while disease severity significantly correlated with depressive symptomatology and sleep disturbance. The presence of MCI is rather frequent in MG and is characterized by multidomain amnestic impairment. Such preliminary data need further confirmation on larger case series.

Cognitive impairment and small vessel disease in atrial fibrillation

Objective : to evaluate the impact of various forms of atrial fibrillation (AF) on the development of mild cognitive impairment (MCI) and cerebral small vessel disease. Patients and methods . The study included 31 patients with AF (paroxysmal form – 22 patients, permanent form – 9 patients). Arterial hypertension was diagnosed in 26 patients and diabetes mellitus in 6 patients. All patients were taking direct oral anticoagulants (DOACs). Patients underwent cognitive testing, screening ultrasound examination of the main arteries of the head and neck, MRI on a Siemens Skyra 3 T tomograph according to a protocol including diffusion tensor imaging and perfusion determination. To create a control group of healthy elderly individuals, the open database of clinical and MR data OASIS 3 was used that retrospectively evaluated more than 1000 people over a period of 30 years. Participants whose cognitive status was assessed clinically as "normal cognitive function" were selected. Results and discussion . The frequency of MCI and indicators of cognitive tests did not differ in groups of patients with permanent and paroxysmal forms of AF. The distribution of foci of hyperintense white matter, the thickness of the cerebral cortex also did not differ in patients with different forms of AF. The neuroimaging pattern of cerebral small vessel disease in AF patients without stroke was consistent with population controls. Conclusion . Prescribing DOACs to patients reduces the risk of cognitive impairment of vascular origin development due to the clear and predictable effect of this class of drugs that prevent the development of cerebral embolism.

Cognitive function in patients undergoing cystectomy for bladder cancer - results from a prospective observational study.

Background:Impaired cognitive function of bladder cancer patients plays a role in coping with the kind of urinary diversion and may impact perioperative morbidity. In this study we therefore aimed to assess the prevalence of mild cognitive impairment in patients undergoing radical cystectomy. Secondary objectives included correlation of common cognition tests, assessment of the admitting physician, and perioperative complication rates.Methods:Patients undergoing radical cystectomy for bladder cancer were prospectively screened by neuropsychological tests including cognition tests [DemTect (Dementia Detection test), MMSE (Mini-Mental State Examination), clock drawing test] prior to surgery. Besides, clinical characteristics and perioperative outcomes were documented. Frequency of mild cognitive impairment as assessed by DemTect was correlated with the results of MMSE and clock drawing test, the occurrence of anxiety and depression, the assessment of the admitting physician, and perioperative complication rates as calculated by Spearman rank correlation coefficient. Comparative analysis (parametric and nonparametric) of patient characteristics (nonpathological versus pathological DemTect suggestive of mild cognitive impairment) was performed.Results:A total of 51 patients (80% male, median age 69 years) were analyzed. DemTect was suspicious of mild cognitive impairment in 27% (14/51) of patients, whereas MMSE and clock drawing test showed pathological results only in 10/51 and 6/51 patients, respectively. We found no correlation between mild cognitive impairment and anxiety/depression status. In all, 5/20 patients (25%) with suspicious DemTect results were considered suitable for a continent diversion neobladder by the admitting physician. Suspicious DemTect results were predictive for higher perioperative complication rates (29% versus 5%). Study limitations include small sample size and missing long-term follow-up.Conclusions:Mild cognitive impairment was observed in more than a quarter of radical cystectomy patients prior to surgery. Preoperative assessment should be supplemented by neuropsychological testing such as the DemTect as mild cognitive impairment is often underestimated and associated with significantly higher perioperative complication rates.

Resting-state network connectivity in newly diagnosed drug-naïve Parkinson's disease patients with mild cognitive impairment

Background: Cognitive impairment (CI) is one of the most frequent non-motor features in Parkinson's disease (PD). The frequency of mild cognitive impairment (MCI) was reported to exceed 40% in a large cohort of newly diagnosed PD patients.

Influence of cardiovascular risk factors on arterial hypertension and mild cognitive impairment in 4602 participants of the ELITE study.

In ELITE (Ernährung, Lebensstil und individuelle Information zur Verhinderung von Herzinfarkt, Schlaganfall und Demenz; german for: Nutrition, Lifestyle and Individual Information for the Prevention of Heart Attack, Stroke and Dementia) data on cardiovascular risk factors, cognitive function and quality of life are prospectively collected, which will be improved through targeted individual information. The aim is to improve the health of the participants and identify the reasons for the lack of implementation. Risk factors of 4602 participants were linked to (controlled) hypertension and mild cognitive impairment (MCI). Blood pressure was measured according to the guidelines and the DEMTECT- test was used to detect MCI. The most common risk factor was hypertension (60%). Hypertensive patients were older (56.1 and 44.7 years), had a higher BMI (28 and 24.8 kg/m), frequently physical inactive (26 and 32.4%), diabetes (9.3 and 1.3%), higher LDL (134.7 and 124.1 mg/dl), higher triglycerides (169.6 and 124.8 mg/dl) and lower HDL (57.9 and 65.5 mg/dl) compared with normotensives (P < 0.001). Controlled hypertensive patients are less common men (46.1 and 52.1%, P < 0.001), have a lower BMI (28.3 and 29.1 kg/m, P < 0.001), lower LDL (129.0 and 135.6 mg/dl, P = 0.004) and lower triglycerides (162.5 and 182.3 mg/dl, P = 0.001) compared with treated uncontrolled hypertensive patients. Antihypertensives per person (2.015; 2.017) do not differ. The prevalence of MCI is highly significantly associated with the number of risk factors. in participants without risk factors, the prevalence is 3.9%, in participants with 4 risk factors, 16.3%. In hypertensive patients, the frequency is 11.8% compared with 4.8% for normotensives (P < 0.001). The occurrence of MCI depends significantly from age, blood pressure and diabetes CONCLUSION:: The frequency of MCI is highly significantly associated with the number of cardiovascular risk factors, regardless of age. The prevalence was particularly high among hypertensive patients, which is not often described. The occurrence of MCI depends significantly from age, blood pressure and diabetes. The metabolic syndrome and lack of exercise complicate blood pressure control.

Proteasome Activity in the Plasma as a Novel Biomarker in Mild Cognitive Impairment with Chronic Tinnitus.

Background:Although the existence of proteasomes in human blood, termed circulating proteasomes (c-proteasomes), has been reported previously, their origin and pathophysiological functions remain largely unknown.Objective:Given that c-proteasome activity was significantly reduced in Alzheimer’s disease model mice and relatively high frequency of mild cognitive impairment (MCI) is accompanied by chronic tinnitus in aged patients, we examined whether c-proteasome activity in human plasma was associated with cognitive function in patients with chronic tinnitus.Methods:c-Proteasome activity in the plasma of tinnitus patients (N = 55) was measured with fluorogenic reporter substrate, suc-LLVY-AMC. To assess MCI, the Montreal Cognitive Assessment was conducted with a cut-off score of 22/23. All patients underwent audiological and psychoacoustic analyses. Levels of c-proteasomes, Aβ42, and Aβ40 were measured using ELISA, and their association with c-proteasome activity was evaluated.Results:The activity of circulating proteasomes was significantly lower in patients with chronic tinnitus and MCI (p = 0.042), whereas activities of other plasma enzymes showed little correlation. In addition, c-proteasome activity was negatively associated with the level of plasma Aβ and was directly dependent on its own concentration in the plasma of patients with chronic tinnitus.Conclusion:Our current work provides a new perspective for understanding the potential relationship between circulating proteasomes in the plasma and cognitive dysfunction, suggesting a novel, non-invasive biomarker in the context of MCI diagnosis.

The association of blood non-esterified fatty acid, saturated fatty acids, and polyunsaturated fatty acids levels with mild cognitive impairment in Chinese population aged 35–64 years: a cross-sectional study

ABSTRACT Objectives The aim of this study was to explore the correlation between blood profiles and cognitive functions or mild cognitive impairment (MCI) in the Chinese population aged 35–64 years old. Methods A cross-sectional study was performed, which recruited 675 Chinese adults aged 35–64 years old from Beijing, China. Their cognitive performance was assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), the serum lipids levels were measured by hexokinase method and colorimetric assay, and the plasma fatty acids profiles were analyzed by fast gas chromatography. Results Among the 675 participants, 84 (12.4%) had MCI. Age, years of education, saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) were associated with MMSE scores (all P < 0.05). Age, years of education, smoking, drinking, non-esterified fatty acids (NEFAs), SFAs, MUFAs, n-3 polyunsaturated fatty acids (n-3 PUFAs) and n-6/n-3 PUFAs were associated with MoCA scores (all P < 0.05). Increased age (P = 0.002) and smoking (P = 0.028) were positively associated with the prevalence of MCI, while educational level (P = 0.005) and alcohol drinking (P = 0.003) both were negatively correlated to the prevalence of MCI. Elevated serum NEFAs (P = 0.032), high plasma SFAs (P = 0.023), and excessive polyunsaturated fatty acids (PUFAs) levels (P = 0.033) were significantly associated with increased frequency of MCI. Conclusion In the Chinese population aged 35–64 years, advanced age and cigarette smoking were risk factors of MCI, whereas higher educational level and alcohol drinking were protective factors for MCI. Excessive serum or plasma levels of NEFAs, SFAs and PUFAs were associated with an increased risk of MCI.

Mild Cognitive Impairment in Patients with Early-Onset Parkinson's Disease

Background/Aims: Few studies have described mild cognitive impairment (MCI) and cognitive characteristics in early-onset Parkinson's disease (EOPD). This study describes attention/working memory, language, memory, visuospatial abilities, executive function, and frequency of MCI and dementia in EOPD. Methods: Eighty-one EOPD patients were administered neuropsychological tests and the Beck Depression Inventory. Scores were compared with age/education-appropriate norms and were correlated to years of disease progression and severity of motor symptoms. The frequency of MCI and dementia was determined by the Movement Disorder Society criteria. Results: Thirty-one percent of patients met the MCI criteria, but none had dementia. Commonly affected domains were memory, visuospatial, and executive function. Cognitive dysfunction was not explained by depression or severity of motor symptoms. Conclusion: One third of EOPD patients presented with MCI, which was not associated with the same risk factors as reported in late-onset Parkinson's disease. MCI could have a different prognostic value in EOPD.

Hypothyroidism and Risk of Mild Cognitive Impairment in Elderly Persons

An association of clinical and subclinical hypothyroidism with mild cognitive impairment (MCI) has not been established. To evaluate the association of clinical and subclinical hypothyroidism with MCI in a large population-based cohort. A cross-sectional, population-based study was conducted in Olmsted County, Minnesota. Randomly selected participants were aged 70 to 89 years on October 1, 2004, and were without documented prevalent dementia [CORRECTED]. A total of 2050 participants were evaluated and underwent in-person interview, neurologic evaluation, and neuropsychological testing to assess performance in memory, attention/executive function, and visuospatial and language domains. Participants were categorized by consensus as being cognitively normal, having MCI, or having dementia according to published criteria. Clinical and subclinical hypothyroidism were ascertained from a medical records linkage system. Association of clinical and subclinical hypothyroidism with MCI. Among 1904 eligible participants, the frequency of MCI was 16% in 1450 individuals with normal thyroid function, 17% in 313 persons with clinical hypothyroidism, and 18% in 141 individuals with subclinical hypothyroidism. After adjusting for covariates (age, educational level, sex, apolipoprotein E ε4, depression, diabetes mellitus, hypertension, stroke, body mass index, and coronary artery disease) we found no significant association between clinical or subclinical hypothyroidism and MCI (odds ratio [OR], 0.99 [95% CI, 0.66-1.48] and 0.88 [0.38-2.03], respectively). No effect of sex interaction was seen on these effects. In stratified analysis, the odds of MCI with clinical and subclinical hypothyroidism among men was 1.02 (95% CI, 0.57-1.82) and 1.29 (0.68-2.44) and, among women, was 1.04 (0.66-1.66) and 0.86 (0.37-2.02), respectively. In this population-based cohort of elderly people, neither clinical nor subclinical hypothyroidism was associated with MCI. Our findings need to be validated in a separate setting using the published criteria for MCI and confirmed in a longitudinal study.

Prevalence of Mild Cognitive Impairment Subtypes in Patients with Parkinson’s Disease – Comparison of two Modes of Classification

Early detection of dementia in Parkinson’s disease is becoming increasingly important. The goal of this study was to establish prevalence of mild cognitive impairment subtypes in Parkinson’s disease using two different modes of mild cognitive impairment classification. Categorizing patients into mild cognitive impairment subtypes according to the minimum mode of mild cognitive impairment classification revealed the following results: three patients (2.5 %) were categorized as cognitively healthy, whereas 117 patients (97.5 %) met the criteria for mild cognitive impairment. When categorizing patients according to the mean mode of mild cognitive impairment classification, 41.7 % of the patients were categorized as cognitively healthy, whereas 58.3 % met the criteria for mild cognitive impairment. Frequency of mild cognitive impairment varies substantially, depending on how impairment is defined.

Characterizing mild cognitive impairment in incident Parkinson disease

To describe the frequency of mild cognitive impairment (MCI) in Parkinson disease (PD) in a cohort of newly diagnosed incident PD cases and the associations with a panel of biomarkers. Between June 2009 and December 2011, 219 subjects with PD and 99 age-matched controls participated in clinical and neuropsychological assessments as part of a longitudinal observational study. Consenting individuals underwent structural MRI, lumbar puncture, and genotyping for common variants of COMT, MAPT, SNCA, BuChE, EGF, and APOE. PD-MCI was defined with reference to the new Movement Disorder Society criteria. The frequency of PD-MCI was 42.5% using level 2 criteria at 1.5 SDs below normative values. Memory impairment was the most common domain affected, with 15.1% impaired at 1.5 SDs. Depression scores were significantly higher in those with PD-MCI than the cognitively normal PD group. A significant correlation was found between visual Pattern Recognition Memory and cerebrospinal β-amyloid 1-42 levels (β standardized coefficient = 0.350; p = 0.008) after controlling for age and education in a linear regression model, with lower β-amyloid 1-42 and 1-40 levels observed in those with PD-MCI. Voxel-based morphometry did not reveal any areas of significant gray matter loss in participants with PD-MCI compared with controls, and no specific genotype was associated with PD-MCI at the 1.5-SD threshold. In a large cohort of newly diagnosed PD participants, PD-MCI is common and significantly correlates with lower cerebrospinal β-amyloid 1-42 and 1-40 levels. Future longitudinal studies should enable us to determine those measures predictive of cognitive decline.

Mild cognitive impairment in obstructive sleep apnea

INTRODUCTION Obstructive sleep apnea (OSA) causes sleep disruption and intermittent nocturnal hypoxemia, which can lead to daytime sleepiness and cognitive deficits. Cognitive deficits reported in individuals suffering from OSA can be severe enough to warrant a diagnosis of mild cognitive impairment (MCI). However, the frequency of MCI in individuals with OSA is unknown and factors associated with co-morbid MCI and OSA need to be investigated. Objectives: Determine the frequency and subtypes of MCI in subjects with OSA and identify demographic and clinical variables associated with co-morbid MCI and OSA. Materials and methods Fifty-one subjects with OSA (apnea- hypopnea index 10; mean age: 60.13 9.48 yrs) and 51 healthy controls (mean age: 61.82 9.49 yrs), matched for sex and education, underwent an overnight polysomnography and a comprehensive neuropsychological assessment. MCI was defined as: 1) objective evidence of cognitive decline; and 2) no major impact of cognitive deficits in activities of daily living. MCI subtypes were categorized as nonamnestic single domain, amnestic single domain, nonamnestic multiple domains and amnestic multiple domains. Group difference in the proportion of MCI was assessed using a ÷ test. Subjects with co-morbid OSA and MCI were compared to subjects with OSA alone on respiratory, demographic, questionnaire, and polysomnographic variables using Student t-tests. Results MCI was found in 37% (19/51) of OSA subjects. In contrast, only 13% (7/51) of controls had MCI ( ÷ = 7.43, dl = 1, p 0.01). Eight (42%) of the 19 patients with comorbid OSA and MCI met the criteria for nonamnestic single domain (6 with impaired attention and executive functions and 2 with impaired visuospatial abilities), two (11%) for amnestic single domain, four (21%) for nonamnestic multiple domains and five (26%) for amnestic multiple domains. Subjects with co-morbid OSA and MCI showed a lower education level (t (52) = 5.17, p 0.01) and a higher score on the vascular burden index (t (23) = -2.07, p 0.05) compared to patients with OSA alone. No difference was found between these two groups for respiratory and polysomnographic variables. Conclusion Results showed that OSA subjects have higher risk of developing MCI compared to control subjects. Nonamnestic MCI subtypes with attention/executive dysfunctions were predominant in OSA. Low education level and high vascular burden were also associated with the presence of MCI among OSA subjects. Future studies are needed to assess the effects of co- morbid MCI and OSA on the risk of converting to dementia. Acknowledgements Supported by the Canadian Institutes of Health Research and the Fonds de recherche du Quebec e Sante

ANALYSIS OF THE RELATIONSHIP DIAGNOSED MILD COGNITIVE IMPAIRMENT IN ELDERLY AND SENILE PATIENTS WITH CERTAIN FEATURES OF MEDICAL HISTORY AND DEPRESSION

Are defined frequency of mild cognitive impairment (MCI) at patients of advanced and senile age with chronic ischemia of a brain (HIGM) in comparison with frequency of existence of a depression, an education level and the place of residence and their interrelation. 100 patients with HIGM 2 age групп: 1 – advanced age (from 60 to 74 years – 48 people), 2 – senile age (from 75 to 89 years – 52 persons) are surveyed. In research didn't join: patients with Alzheimer's disease and other forms of a dementias. Diagnostics of UKN it was carried out by means of a short scale of an assessment of the mental status (MMSE). For an assessment of existence of a depression – Bek's scale. For objective justification of conclusions from results of the carried-out research the statistical analysis of primary information was used.

Assessing mild cognitive impairment among older African Americans

To examine the frequency of Mild Cognitive Impairment (MCI) in African American older adults. The study also plans to explore the specific cognitive domains of impairment as well as whether there are differences in demographics, health, and cognitive performance between MCI and normal participants. Cross-sectional. Independent-living sample of urban dwelling elders in Baltimore, Maryland. The sample consisted of 554 subjects ranging in age from 50 to 95 (Mean = 68.79 +/- 9.60). Socio-demographics and health were assessed. Several cognitive measures were administered to assess inductive reasoning, declarative memory, perceptual speed, working memory, executive functioning, language and global cognitive functioning. Approximately 22% of participants were considered MCI (i.e. 18% non-amnestic vs. 4% amnestic). A majority of the non-amnestic MCI participants had impairment in one cognitive domain, particularly language and executive function. Individuals classified as non-amnestic MCI were significantly older and had more years of education than normal individuals. The MCI groups were not significantly different than cognitively normal individuals on health factors. Individuals classified as MCI performed significantly worse on global cognitive measures as well as across specific cognitive domains than cognitively normal individuals. This study demonstrates that impairment in a non-memory domain may be an early indicator of cognitive impairment, particularly among African Americans.

Abnormal nocturnal blood pressure profile is associated with mild cognitive impairment in the elderly: the J-SHIPP study

Mild cognitive impairment (MCI), a syndrome characteristic of the transition phase between normal cognitive function and dementia, has been shown to carry the risk of progression to dementia. Dysregulation of blood pressure (BP) is thought to be an indicator of cerebrovascular damage, including cognitive impairment. Here, we investigated the possible association of circadian BP variation with MCI in community-dwelling persons exhibiting no definitive dementia. Our study enrolled 144 persons (68+/-7 years). Nocturnal BP profile was defined as dipper, with a 10-19% drop in nocturnal systolic BP; extreme dipper, >or=20% drop; non-dipper, 0-10% drop; and riser, any increase in nocturnal BP. MCI was assessed using the MCI screen, a cross-validated, staff-administered battery of tests. Subjects with MCI (n=38) were significantly older (74+/-6, 67+/-6 years, P<0.001) and had higher frequency of apolipoprotein E varepsilon4 allele (36.8, 18.9%, P=0.018). Although the ambulatory measured BP and the percent changes in nocturnal systolic BP (-10+/-12% and -12+/-8%, respectively; P=0.291) did not differ between MCI subjects and normal controls, frequency of MCI was significantly higher in the extreme dippers (32.0%), non-dippers (30.0%) and risers (50.0%) than in dippers (13.2%, P=0.018). Multiple logistic regression analysis identified a blunted nocturnal BP decline, non-dipping or increase in nocturnal BP and extreme drop in BP as potent determinants of MCI (odds ratio 3.062, P=0.039), after adjustment for possible confounding factors, including apolipoprotein E varepsilon4 genotype. Abnormal nocturnal BP profile was found to be a strong indicator of MCI in otherwise apparently healthy community-dwelling elderly persons.

Identifying mild cognitive impairment at baseline in the Ginkgo Evaluation of Memory (GEM) study

Objectives: To identify, characterize and compare the frequency of mild cognitive impairment (MCI) subtypes at baseline in a large, late-life cohort (n = 3063) recruited into a dementia prevention trial. Method: A retrospective, data-algorithmic approach was used to classify participants as cognitively normal or MCI with corresponding subtype (e.g. amnestic vs. non-amnestic, single domain vs. multiple domain) based on a comprehensive battery of neuropsychological test scores, with and without Clinical Dementia Rating (CDR) global score included in the algorithm. Results: Overall, 15.7% of cases (n = 480) were classified as MCI. Amnestic MCI was characterized as unilateral memory impairment (i.e. only verbal or only visual memory impaired) or bilateral memory impairment (i.e. both verbal and visual memory impaired). All forms of amnestic MCI were almost twice as frequent as non-amnestic MCI (10.0% vs. 5.7%). Removing the CDR = 0.5 (‘questionable dementia’) criterion resulted in a near doubling of the overall MCI frequency to 28.1%. Conclusion: Combining CDR and cognitive test data to classify participants as MCI resulted in overall MCI and amnestic MCI frequencies consistent with other large community-based studies, most of which relied on the ‘gold standard’ of individual case review and diagnostic consensus. The present data-driven approach may prove to be an effective alternative for use in future large-scale dementia prevention trials.

Cognitive Impairment in Parkinson's Disease without Dementia: Subtypes and Influences of Age

Background and PurposeCognitive impairments are common in Parkinson's disease (PD), although the severity of these impairments does not significantly impair the patient's daily activities. The aim of this study was to determine the frequency of mild cognitive impairment (MCI) of Parkinson's disease (PDMCI) and its subtypes in nondemented PD patients. We also evaluated the influence of age on the pattern of subtypes of PDMCI.MethodsA total of 141 consecutive, nondemented PD patients underwent a comprehensive neuropsychological assessment covering the five cognitive domains: attention, language, visuospatial, memory, and executive functions. PDMCI was defined as impaired performance in at least one of these five cognitive domains. The influence of age on the distribution of subtypes of PDMCI was assessed by comparing patients in two groups dichotomized according to their age at assessment (younger vs. older).ResultsFifty-seven (40.4%) of the nondemented PD patients had an impairment in at least one domain, and were therefore considered as having PDMCI. The age at assessment and age at disease onset were significantly higher in the PDMCI patients. The amnestic type of PDMCI was the most frequent, followed by the visuospatial, linguistic, executive, and attention types in that order. The frequency of PDMCI was higher for all subtypes in the older group; the domain that was influenced the most by age was executive function.ConclusionsMCI was common in PD and the subtypes were diverse. Age was found to be an important risk factor for the development of PDMCI, particularly for the executive subtype. These results indicate that the concept of MCI should be introduced in PD.

Deterioro cognitivo leve: características neuropsicológicas de los distintos subtipos

To evaluate the frequency of mild cognitive impairment (MCI) subtypes and their neuropsychological characteristics in our population, and estimate the change in this frequency according to the extension of the neuropsychological examination. Patients with diagnostic of MCI were included from 01/01/2003 to 31/12/2007. MCI was classified as MCI-amnestic type (MCI-AT), MCI-multiple domain type (MCI-MDT) and MCI-single domain non amnestic (MCI-MNOA). A neuropsychological test was considered abnormal if its result was equal or less than 1.5 standard deviations from what expected for age and educational level. The cohort was divided in short evaluation (less than 14 test, from 2003-2005) and basic-extended evaluation (equal or more than 14 test, from 2006-2007). Out of 204 patients included, 51 (26%) were classified as MCI-AT, 11 (5,4%) as MCI-MNOA and 142 (69,9%) as MCI-MDT. A higher educational level was associated with an increase in the number of MCI-MDT. The longer the evaluation, the greater was the proportion of MCI-MDT and MCI-MNOA and the lower the proportion of MCI-AT, without statistical significance. The most frequent MCI subtype was MCI-MDT. A more extended evaluation would allow a better classification of MCI subtypes and increase the number of MCI-MDT and MCI-MNOA at the expense of MCI-AT.