Mild Cognitive Impairment: A Neuropsychological Perspective

CNS Spectrums ◽  
2008 ◽  
Vol 13 (1) ◽  
pp. 56-64 ◽  
Author(s):  
Aaron P. Nelson ◽  
Margaret G. O'Connor
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Neuropsychological Testing ◽  
Intellectual Ability ◽  
Transitional State ◽  
Visuospatial Skills

ABSTRACTMild cognitive impairment (MCI) is a clinical diagnosis in which deficits in cognitive function are evident but not of sufficient severity to warrant a diagnosis of dementia. For the majority of patients, MCI represents a transitional state between normal aging and mild dementia, usually Alzheimer's disease. Multiple subtypes of MCI are now recognized. In addition to presentations featuring memory impairment, symptoms in other cognitive domains (eg, executive function, language, visuospatial) have been identified. Neuropsychological testing can be extremely useful in making the MCI diagnosis and tracking the evolution of cognitive symptoms over time. A comprehensive test battery includes measures of baseline intellectual ability, attention, executive function, memory, language, visuospatial skills, and mood. Informant-bassed measures of neuropsychiatric symptoms, behaviors, and competency in instrumental activity are also included. Careful assessment can identify subtle deficits that may otherwise elude detection, particularly in individuals of superior baseline intellectual ability. As we move closer to disease-modifying therapy for Alzheimer's disease, early identification becomes critical for identifying patients who have an opportunity to benefit from treatment.

Mild cognitive impairment in primary care: a clinical review

2018 ◽  
Vol 94 (1117) ◽  
pp. 647-652 ◽  
Author(s):  
Georges Assaf ◽  
Maria Tanielian
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Review ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
Neuropsychiatric Symptoms ◽  
Evidenced Based

Dementia is projected to become a global health priority but often not diagnosed in its earlier preclinical stage which is mild cognitive impairment (MCI). MCI is generally referred as a transition state between normal cognition and Alzheimer’s disease. Primary care physicians play an important role in its early diagnosis and identification of patients most likely to progress to Alzheimer’s disease while offering evidenced-based interventions that may reverse or halt the progression to further cognitive impairment. The aim of this review is to introduce the concept of MCI in primary care through a case-based clinical review. We discuss the case of a patient with MCI and provide an evidence-based framework for assessment, early recognition and management of MCI while addressing associated risk factors, neuropsychiatric symptoms and prognosis.

scholarly journals Working Memory and Executive Function Decline across Normal Aging, Mild Cognitive Impairment, and Alzheimer’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Anna-Mariya Kirova ◽  
Rebecca B. Bays ◽  
Sarita Lagalwar
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Executive Dysfunction ◽  
Normal Aging ◽  
Future Research ◽  
Neurological Differences

Alzheimer’s disease (AD) is a progressive neurodegenerative disease marked by deficits in episodic memory, working memory (WM), and executive function. Examples of executive dysfunction in AD include poor selective and divided attention, failed inhibition of interfering stimuli, and poor manipulation skills. Although episodic deficits during disease progression have been widely studied and are the benchmark of a probable AD diagnosis, more recent research has investigated WM and executive function decline during mild cognitive impairment (MCI), also referred to as the preclinical stage of AD. MCI is a critical period during which cognitive restructuring and neuroplasticity such as compensation still occur; therefore, cognitive therapies could have a beneficial effect on decreasing the likelihood of AD progression during MCI. Monitoring performance on working memory and executive function tasks to track cognitive function may signal progression from normal cognition to MCI to AD. The present review tracks WM decline through normal aging, MCI, and AD to highlight the behavioral and neurological differences that distinguish these three stages in an effort to guide future research on MCI diagnosis, cognitive therapy, and AD prevention.

Depressive Neuropsychiatric Symptoms and Mild Cognitive Impairment as Part of the Diabetes Mellitus/Alzheimer's Disease Link

2021 ◽  
Author(s):  
Karla Aketzalli Hernández-Contreras ◽  
Jorge Antonio Martínez-Díaz ◽  
María Elena Hernández-Aguilar ◽  
Deissy Herrera-Covarrubias ◽  
Fausto Rojas-Durán ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms

scholarly journals Detection of mild cognitive impairment and early stage dementia with an audio-recorded cognitive scale

2013 ◽  
Vol 25 (8) ◽  
pp. 1325-1333 ◽  
Author(s):  
Margaret C. Sewell ◽  
Xiaodong Luo ◽  
Judith Neugroschl ◽  
Mary Sano
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Verbal Memory ◽  
Early Stage ◽  
Neuropsychological Testing ◽  
Area Under The Curve ◽  
Cognitive Domain ◽  
Screening Measures

ABSTRACTBackground: Physicians often miss diagnosis of mild cognitive impairment (MCI) or early dementia and screening measures can be insensitive to very mild impairments. Other cognitive assessments may take too much time or be frustrating to seniors. This study examined the ability of an audio-recorded scale, developed in Australia, to detect MCI or mild Alzheimer's disease (AD) and compared cognitive domain-specific performance on the audio-recorded scale to in-person battery and common cognitive screens.Method: Seventy-six patients from the Mount Sinai Alzheimer's Disease Research Center were recruited. Patients were aged 75 years or older, with clinical diagnosis of AD or MCI (n = 51) or normal control (n = 25). Participants underwent in-person neuropsychological testing followed by testing with the audio-recorded cognitive screen (ARCS).Results: ARCS provided better discrimination between normal and impaired elderly individuals than either the Mini-Mental State Examination or the clock drawing test. The in-person battery and ARCS analogous variables were significantly correlated, most in the 0.4 to 0.7 range, including verbal memory, executive function/attention, naming, and verbal fluency. The area under the curve generated from the receiver operating characteristic curves indicated high and equivalent discrimination for ARCS and the in-person battery (0.972 vs. 0.988; p = 0.23).Conclusion: The ARCS demonstrated better discrimination between normal controls and those with mild deficits than typical screening measures. Performance on cognitive domains within the ARCS was well correlated with the in-person battery. Completion of the ARCS was accomplished despite mild difficulty hearing the instructions even in very elderly participants, indicating that it may be a useful measure in primary care settings.

scholarly journals Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease

2011 ◽  
Vol 7 (3) ◽  
pp. 300-308 ◽  
Author(s):  
Gad A. Marshall ◽  
Dorene M. Rentz ◽  
Meghan T. Frey ◽  
Joseph J. Locascio ◽  
Keith A. Johnson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Instrumental Activities

scholarly journals Frequency and subgroups of neuropsychiatric symptoms in mild cognitive impairment and different stages of dementia in Alzheimer's disease

2017 ◽  
Vol 30 (1) ◽  
pp. 103-113 ◽  
Author(s):  
N. Siafarikas ◽  
G. Selbaek ◽  
T. Fladby ◽  
J. Šaltytė Benth ◽  
E. Auning ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Factor Analysis ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Decline ◽  
Neuropsychiatric Symptoms ◽  
Small Sample ◽  
Psychotic Symptoms ◽  
Cross Sectional

ABSTRACTBackground:Neuropsychiatric symptoms (NPS), such as depression, apathy, agitation, and psychotic symptoms are common in mild cognitive impairment (MCI) and dementia in Alzheimer's disease (AD). Subgroups of NPS have been reported. Yet the relationship of NPS and their subgroups to different stages of cognitive impairment is unclear. Most previous studies are based on small sample sizes and show conflicting results. We sought to examine the frequency of NPS and their subgroups in MCI and different stages of dementia in AD.Methods:This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4,571 patients, we included those with MCI or AD (MCI 817, mild AD 883, moderate–severe AD 441). To compare variables across groups ANOVA or χ2-test was applied. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items to identify subgroups of NPS.Results:The frequency of any NPS was 87.2% (AD 91.2%, MCI 79.5%; p < 0.001) and increased with increasing severity of cognitive decline. The most frequent NPS in MCI was depression. Apathy was the most frequent NPS in AD across different stages of severity. The factor analysis identified three subgroups in MCI and mild AD, and a fourth one in moderate–severe AD. We labelled the subgroups “depression,” “agitation,” “psychosis,” and “elation.”Conclusions:The frequency of NPS is high in MCI and AD and increases with the severity of cognitive decline. The subgroups of NPS were relatively consistent from MCI to moderate-severe AD. The subgroup elation appeared only in moderate-severe AD.

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