scholarly journals Clinical factors contributing to functional change over time in individuals with subjective cognitive concerns and mild cognitive impairment

2021 ◽  
Vol 17 (S6) ◽  
Author(s):  
Pinghsiu Lin ◽  
Haley LaMonica ◽  
Sharon L Naismith ◽  
Loren Mowszowski
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Change ◽  
Clinical Factors ◽  
Change Over Time ◽  
Over Time

PSYCHOMETRIC EVALUATION OF THE NEUROPSYCHOLOGICAL TEST BATTERY IN INDIVIDUALS WITH NORMAL COGNITION, MILD COGNITIVE IMPAIRMENT, OR MILD TO MODERATE ALZHEIMER’S DISEASE: RESULTS FROM A LONGITUDINAL STUDY

2018 ◽  
pp. 1-9
Author(s):  
J.E. Harrison ◽  
D.M. Rentz ◽  
H.R. Brashear ◽  
H.M. Arrighi ◽  
M.T. Ropacki ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Test ◽  
Cognitive Change ◽  
Test Battery ◽  
Change Over Time ◽  
Neuropsychological Test Battery ◽  
Over Time

Background: The Neuropsychological Test Battery (NTB) is a combination of widely used clinical neuropsychological tests measuring memory and executive function and was designed to overcome some of the limitations of the traditionally used Alzheimer’s disease Assessment Scale – Cognitive subscale (ADAS-Cog). A previously reported account indicated high levels of NTB reliability in patients with mild-to-moderate Alzheimer’s disease (AD) and mild cognitive impairment (MCI). Objectives: We examined capacity of the Neuropsychological Test Battery (NTB) and its component subtests to measure cognitive change over time. Correlations with other cognitive and functional assessments were also determined. Design, Settings, Participants: This was a multicentre, prospective, non-interventional, longitudinal cohort study involving patients with mild-to-moderate AD (n=196), MCI (n=70), or cognitively normal control participants (NC, n=75). Intervention: The NTB, as well as other Clinical Outcome Assessments including, ADAS-Cog, other cognitive measures, functional/behavioral questionnaires, health outcome questionnaires, and resource utilization tools were administered. Results: Mean change from baseline for the NTB composite score and the six individual NTB subtests showed greater reductions in performance over time in the AD and MCI groups, compared with NC group. The ADAS-Cog was found to be more sensitive to change than the NTB in all three populations. Conclusions: The NTB showed high correlation with the ADAS-Cog and appears to be a sensitive and reliable assessment tool for measuring cognitive decline in patients with mild-to-moderate AD. However, the ADAS-Cog was found to be more sensitive to change over time in both the AD and MCI populations.

Potenziamento della capacitÀ mentale? Dalla medicalizzazione della cognizione alla farmacologizzazione delle routine mental life

2012 ◽  
pp. 145-159
Author(s):  
Catherine Coveney ◽  
Jonathan Gabe ◽  
Simon Williams
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Research Agenda ◽  
Cognitive Enhancement ◽  
Early Stage ◽  
Mental Life ◽  
Medical Authority ◽  
Pharmaceutical Cognitive Enhancement ◽  
Promise Problems ◽  
Over Time

Sociological engagement with debates around the promise, problems and prospects of pharmaceutical cognitive enhancment is still at an early stage. In this paper we attempt to explore how the prospect of cognitive enhancement can be understood using existing sociological concepts of medicalisation, biomedicalisation and pharmaceuticalisation. Drawing on two case studies, that of Mild Cognitive Impairment (MCI) and the use of modafinil to enhance alertness, we discuss the idea of enhancement medicine and the use of cognitive enhancers outside of medical authority. We suggest that whilst all three of the above concepts shed important light on these developments, overlapping and converging as they do in various ways, pharmaceuticalisation provides a more precise sociological term of reference. We end with some suggestions for a research agenda for tracing and tracking trends in pharmaceutical cognitive enhancement over time.

The Transition of Mild Cognitive Impairment Over Time: An AV45- and FDG-PET Study of Reversion and Conversion Phenomena

2021 ◽  
Vol 18 ◽  
Author(s):  
Amir Ashraf-Ganjouei ◽  
Kamyar Moradi ◽  
Shahriar Faghani ◽  
AmirHussein Abdolalizadeh ◽  
Mohammadreza Khomeijani-Farahani ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Glucose Metabolism ◽  
Pet Imaging ◽  
Fdg Pet ◽  
Amyloid Β ◽  
Positron Emission ◽  
One Year ◽  
T Tau ◽  
Over Time

Background: Mild cognitive impairment (MCI) is a state between normal cognition and dementia. However, MCI diagnosis does not necessarily guarantee the progression to dementia. Since no previous study investigated brain positron emission tomography (PET) imaging of MCI-- to-normal reversion, we provided PET imaging of MCI-to-normal reversion using the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Methods: We applied comprehensive neuropsychological criteria (NP criteria), consisting of mem- ory, language, and attention/executive function domains, to include patients with a baseline diagno- sis of MCI (n=613). According to the criteria, the year 1 status of the patients was categorized into three groups (reversion: n=105, stable MCI: n=422, conversion: n=86). Demographic, neuropsycho- logical, genetic, CSF, and cognition biomarker variables were compared between the groups. Addi- tionally, after adjustment for confounding variables, the deposition pattern of amyloid-β and cere- bral glucose metabolism were compared between three groups via AV45- and FDG-PET modali- ties, respectively. Results: MCI reversion rate was 17.1% during one year of follow-up. The reversion group had the lowest frequency of APOE ε4+ subjects, the highest CSF level of amyloid-β, and the lowest CSF levels of t-tau and p-tau. Neuropsychological assessments were also suggestive of better cognitive performance in the reversion group. Patients with reversion to normal state had higher glucose metabolism in bilateral angular and left middle/inferior temporal gyri, when compared to those with stable MCI state. Meanwhile, lower amyloid-β deposition at baseline was observed in the fron- tal and parietal regions of the reverted subjects. On the other hand, the conversion group showed lower cerebral glucose metabolism in bilateral angular and bilateral middle/inferior temporal gyri compared to the stable MCI group, whereas the amyloid-β accumulation was similar between the groups. Conclusions: This longitudinal study provides novel insight regarding the application of PET imag- ing in predicting MCI transition over time.

scholarly journals Progression of mild cognitive impairment to dementia: a challenge to current thinking

2006 ◽  
Vol 189 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Anja Busse ◽  
Matthias C. Angermeyer ◽  
Steffi G. Riedel-Heller
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Community Sample ◽  
Neuropsychological Testing ◽  
Time Dependent ◽  
Current Thinking ◽  
Conversion Rates ◽  
Over Time ◽  
Long Term Studies

BackgroundStudies of conversion from mild cognitive impairment to dementia suggest a linear progression over time. Conversion rates during lifetime may extend to 80–90%.AimsThis study examines the time-dependent evolution from mild cognitive impairment to dementia. Current assumptions regarding yearly and lifetime conversion rates are challenged.MethodA community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing based on 6 years of observation.ResultsApproximately 60–65% of people with mild cognitive impairment develop clinical dementia during their life. Progression from mild cognitive impairment to dementia appears to be time dependent, occurring primarily within the initial 18 months.ConclusionsFurther long-term studies are needed to examine the time-dependent evolution from mild cognitive impairment to dementia and to establish age-specific conversion rates during lifetime.

scholarly journals Mutual interaction of clinical factors and specific microRNAs to predict mild cognitive impairment in patients receiving dialysis

2020 ◽  
Author(s):  
Jin-Bor Chen ◽  
Chiung-Chih Chang ◽  
Lung-Chih Li ◽  
Wen-Chin Lee ◽  
Chia-Ni Lin ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Test Performance ◽  
Roc Analysis ◽  
Neuron Specific Enolase ◽  
Mutual Interaction ◽  
Uremic Toxin ◽  
Clinical Factors ◽  
Clinical Dementia Rating ◽  
Functional Scores

Abstract Background To examine mutual interaction of various clinical factors for cognitive impairment in patients receiving dialysis. Methods A total 48 dialysis patients with subjective memory complaints in outpatient clinic were recruited from 2015 to 2017. Demographics, circulating uremic toxin concentrations, miRNA concentrations and nerve injury protein concentrations were collected and measured. Clinical dementia rating (CDR) scores was used to stratify the functional scores of the patients. Receiver operating characteristic(ROC) analysis was used to evaluate diagnostic test performance for predicting dichotomous results, cumulative ROC analysis to examine the combined contribution of clinical factors. Results CDR scale 0 included 15 patients (mean age, 59.1 years; 5 men and 10 women); CDR > 0.5 included 33 patients (mean age, 64.0 years; 18 men and 15 women). On cumulative ROC analysis, the major predictors of mild cognitive impairment were hemoglobin, age, sex, homocysteine, neuron-specific enolase and miR-486. The cumulative AUC on combining hemoglobin, age, and miR-486 was the highest (0.897, 95% confidence interval 0.806–0.988). Two dichotomized variables reached 81.82% sensitivity and 86.67% specificity, with the likelihood ratio for positive and negative results being 6.14 and 0.21, respectively. Conclusion Hemoglobin, age, and miR-486 exerts combined effects on mild cognitive impairment in patients receiving dialysis.

scholarly journals Diagnosing Mild Cognitive Impairment Among Racially Diverse Older Adults: Comparison of Consensus, Actuarial, and Statistical Methods

2021 ◽  
pp. 1-18
Author(s):  
Kathryn N. Devlin ◽  
Laura Brennan ◽  
Laura Saad ◽  
Tania Giovannetti ◽  
Roy H. Hamilton ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Statistical Methods ◽  
Latent Class ◽  
Population Based ◽  
Functional Change ◽  
Diagnostic Methods ◽  
Prognostic Indicators ◽  
Racially Diverse

Background: Actuarial and statistical methods have been proposed as alternatives to conventional methods of diagnosing mild cognitive impairment (MCI), with the aim of enhancing diagnostic and prognostic validity, but have not been compared in racially diverse samples. Objective: We compared the agreement of consensus, actuarial, and statistical MCI diagnostic methods, and their relationship to race and prognostic indicators among diverse older adults. Methods: Participants (N = 354; M age = 71; 68% White, 29% Black) were diagnosed with MCI or normal cognition (NC) according to clinical consensus, actuarial neuropsychological criteria (Jak/Bondi), and latent class analysis (LCA). We examined associations with race/ethnicity, longitudinal cognitive and functional change, and incident dementia. Results: MCI rates by consensus, actuarial criteria, and LCA were 44%, 53%, and 41%, respectively. LCA identified three MCI subtypes (memory; memory/language; memory/executive) and two NC classes (low normal; high normal). Diagnostic agreement was substantial, but agreement of the actuarial method with consensus and LCA was weaker than the agreement between consensus and LCA. Among cases classified as MCI by actuarial criteria only, Black participants were over-represented, and outcomes were generally similar to those of NC participants. Consensus diagnoses best predicted longitudinal outcomes overall, whereas actuarial diagnoses best predicted longitudinal functional change among Black participants. Conclusion: Consensus diagnoses optimize specificity in predicting dementia, but among Black older adults, actuarial diagnoses may be more sensitive to early signs of decline. Results highlight the need for cross-cultural validity in MCI diagnosis and should be explored in community- and population-based samples.

Sign in / Sign up

Export Citation Format

Share Document