Approach to the Patient with Memory Loss, Mild Cognitive Impairment, or Dementia

Author(s):  
Andrew E. Budson ◽  
Paul R. Solomon
2017 ◽  
Vol 32 (3) ◽  
pp. 145-156 ◽  
Author(s):  
Burcu Balam Yavuz ◽  
Hacer Dogan Varan ◽  
Rónán O’Caoimh ◽  
Muhammet Cemal Kizilarslanoglu ◽  
Mustafa Kemal Kilic ◽  
...  

Background: The objective of this study was to validate the Turkish version of the Quick Mild Cognitive Impairment (Q mci-TR) screen. Methods: In total, 100 patients aged ≥65 years referred to a geriatric outpatient clinic with memory loss were included. The Q mci was compared to the Turkish versions of the standardized Mini-Mental State Examination and the Montreal Cognitive Assessment (MoCA). Results: The Q mci-TR had higher accuracy than the MoCA in discriminating subjective memory complaints (SMCs) from cognitive impairment (mild cognitive impairment [MCI] or dementia), of borderline significance after adjusting for age and education ( P = .06). The Q mci-TR also had higher accuracy than the MoCA in differentiating MCI from SMC, which became nonsignificant after adjustment ( P = .15). A similar pattern was shown for distinguishing MCI from dementia. Test reliability for the Q mci-TR was strong. Conclusion: The Q mci-TR is a reliable and useful screening tool for discriminating MCI from SMC and dementia in a Turkish population.


2004 ◽  
Vol 16 (2) ◽  
pp. 129-140 ◽  
Author(s):  
Maddalena Bruscoli ◽  
Simon Lovestone

Objectives: Older people commonly present with memory loss although on assessment are not found to have a full dementia complex. Previous studies have suggested however that people with subjective and objective cognitive loss are at higher risk of dementia. We aimed to determine from the literature the rate of conversion from mild cognitive impairment to dementia.Methods: Systematic review of MedLine, PsychLit and EmBase.Results: We identified 19 longitudinal studies published between 1991 and 2001 that addressed conversion of mild cognitive impairment to dementia. Overall the rate of conversion was 10% but with large differences between studies. The single biggest variable accounting for between study heterogeneity was source of subjects, with self-selected clinic attenders having the highest conversion rate. The most important factor accounting for heterogeneity within studies was cognitive testing, with poor performance predicting conversion with a high degree of accuracy.Conclusions: These data strongly support the notion that subjective and objective evidence of cognitive decline is not normal and predicts conversion to dementia. The more stringent the measures of both variables the better the prediction of conversion. Mild cognitive impairment, appropriately diagnosed, is a good measure with which to select subjects for disease modification studies.


2021 ◽  
pp. 1-10
Author(s):  
T. Saari ◽  
E. E. Smith ◽  
Z. Ismail

ABSTRACT Objectives: To investigate conditional dependence relationships of impulse dyscontrol symptoms in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Design: A prospective, observational study. Participants: Two hundred and thirty-five patients with MCI (n = 159) or SCD (n = 76) from the Prospective Study for Persons with Memory Symptoms dataset. Measurements: Items of the Mild Behavioral Impairment Checklist impulse dyscontrol subscale. Results: Stubbornness/rigidity, agitation/aggressiveness, and argumentativeness were frequent and the most central symptoms in the network. Impulsivity, the fourth most central symptom in the network, served as the bridge between these common symptoms and less central and rare symptoms. Conclusions: Impulse dyscontrol in at-risk states for dementia is characterized by closely connected symptoms of irritability, agitation, and rigidity. Compulsions and difficulties in regulating rewarding behaviors are relatively isolated symptoms.


2010 ◽  
Vol 16 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rachell Kingsbury ◽  
Nancy A. Pachana ◽  
Michael Humphreys ◽  
Gerry Tehan ◽  
Gerard J.A. Byrne

AbstractThe current study investigated the ability of CogniScreen to differentiate older adults with mild cognitive impairment (MCI) from those reporting symptoms of depression. Participants included 140 community-based adults (30 MCI, 15 self-rated depressed, and 95 typical older adults) aged 50–89 years. Intergroup comparisons performed using receiver operating characteristic (ROC) analyses suggest tasks within CogniScreen are sensitive to clinically significant memory loss. Data provided partial support for some CogniScreen tasks to also differentiate individuals with MCI from those who are depressed. Results suggest CogniScreen may be potentially useful in screening older adults for early cognitive decline.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Massimiliano Castellazzi ◽  
Simone Patergnani ◽  
Mariapina Donadio ◽  
Carlotta Giorgi ◽  
Massimo Bonora ◽  
...  

AbstractDementia is a neurocognitive disorder characterized by a progressive memory loss and impairment in cognitive and functional abilities. Autophagy and mitophagy are two important cellular processes by which the damaged intracellular components are degraded by lysosomes. To investigate the contribution of autophagy and mitophagy in degenerative diseases, we investigated the serum levels of specific autophagic markers (ATG5 protein) and mitophagic markers (Parkin protein) in a population of older patients by enzyme-linked immunosorbent assay. Two hundred elderly (≥65 years) outpatients were included in the study: 40 (20 F and 20 M) with mild-moderate late onset Alzheimer’s disease (AD); 40 (20 F and 20 M) affected by vascular dementia (VAD); 40 with mild cognitive impairment (MCI); 40 (20 F and 20 M) with “mixed” dementia (MD); 40 subjects without signs of cognitive impairment were included as sex-matched controls. Our data indicated that, in serum samples, ATG5 and Parkin were both elevated in controls, and that VAD compared with AD, MCI and MD (all p < 0.01). Patients affected by AD, MD, and MCI showed significantly reduced circulating levels of both ATG5 and Parkin compared to healthy controls and VAD individuals, reflecting a significant down-regulation of autophagy and mitophagy pathways in these groups of patients. The measurement of serum levels of ATG5 and Parkin may represent an easily accessible diagnostic tool for the early monitoring of patients with cognitive decline.


Author(s):  
Chiara Piccininni ◽  
Davide Quaranta ◽  
Guido Gainotti ◽  
Giordano Lacidogna ◽  
Valeria Guglielmi ◽  
...  

Abstract Objective Mild cognitive impairment is the main risk factor of dementia. Previous evidence has claimed that subjects with memory disturbances associated with impairment of other cognitive domains (multiple domain amnesic MCI) are at the highest risk of developing dementia. To date, a shared definition of amnesic MCI multiple domain (aMCI-MD) is still lacking. Method 163 subjects with aMCI were enrolled and followed-up for 2 years. They underwent a baseline comprehensive neuropsychological battery. The cut-off point for each test was set at 1, 1.5, and 2 SD below the mean obtained in normative studies; aMCI-MD was defined as the occurrence of abnormal scores on at least one, two, or three tests not assessing memory. The Episodic Memory Score (EMS), that measures the severity of memory impairment, was determined. Logistic regressionand Cox’s proportional hazard risk models were carried out. The adjunctive effect of the definitions of aMCI-MD on the severity of memory impairment was assessed. Results Fifty-four subjects progressed to dementia. Only restrictive definitions of aMCI-MD (at least three tests below 1.5 SD; at least two tests below 2 SD) predicted conversion to dementia in both logistic regression and survival analysis. None of the conditions showed a significant adjunctive effect on the EMS. Conclusions The predictive effect of impairment in tests assessing cognitive domains other than memory depends on its psychometric definition. The use of a restrictive definition would be of some usefulness, but the adjunctive effect of such a definition on an integrated analysis of memory impairment may be questionable.


2012 ◽  
Vol 8 (4S_Part_15) ◽  
pp. P543-P543
Author(s):  
Fábio Porto ◽  
Livia Spíndola ◽  
Maira Oliveira ◽  
Patricia Capucho ◽  
Cláudia Porto ◽  
...  

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