scholarly journals State of the science on mild cognitive impairment (MCI)

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 78-87 ◽  
Author(s):  
Nicole D. Anderson
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Engagement ◽  
Medial Temporal Lobe ◽  
Healthy Aging ◽  
Cognitive Screening ◽  
Symptoms Of Depression ◽  
Preclinical Ad ◽  
Positron Emission ◽  
State Of The Science

Mild cognitive impairment (MCI) represents a transitional stage between healthy aging and dementia, and affects 10–15% of the population over the age of 65. The failure of drug trials in Alzheimer’s disease (AD) treatment has shifted researchers’ focus toward delaying progression from MCI to dementia, which would reduce the prevalence and costs of dementia profoundly. Diagnostic criteria for MCI increasingly emphasize the need for positive biomarkers to detect preclinical AD. The phenomenology of MCI comprises lower quality-of-life, greater symptoms of depression, and avoidant coping strategies including withdrawal from social engagement. Neurobiological features of MCI are hypoperfusion and hypometabolism in temporoparietal cortices, medial temporal lobe atrophy particularly in rhinal cortices, elevated tau and phosphorylated tau and decreased Aβ42in cerebrospinal fluid, and brain Aβ42deposition. Elevated tau can be identified in MCI, particularly in the entorhinal cortex, using positron emission tomography, and analysis of signal complexity using electroencephalography or magnetoencephalography holds promise as a biomarker. Assessment of MCI also relies on cognitive screening and neuropsychological assessment, but there is an urgent need for standardized cognitive tests to capitalize on recent discoveries in cognitive neuroscience that may lead to more sensitive measures of MCI. Cholinesterase inhibitors are frequently prescribed for MCI, despite the lack of evidence for their efficacy. Exercise and diet interventions hold promise for increasing reserve in MCI, and group psychoeducational programs teaching practical memory strategies appear effective. More work is needed to better understand the phenomenology and neurobiology of MCI, and how best to assess it and delay progression to dementia.

scholarly journals Mild Cognitive Impairment: A Concept and Diagnostic Entity in Need of Input from Neuropsychology

2014 ◽  
Vol 20 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Mark W. Bondi ◽  
Glenn E. Smith
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scales ◽  
Neuropsychological Testing ◽  
Cognitive Screening ◽  
Neuropsychological Battery ◽  
Neuropsychological Measures ◽  
Neuropsychological Functions ◽  
Diagnostic Decision Making ◽  
State Of The Science

AbstractThis virtual issue consists of studies previously published in the Journal of the International Neuropsychological Society and selected on the basis of their content related to one of the most highly researched concepts in behavioral neurology and neuropsychology over the past decade: mild cognitive impairment (MCI). The reliance on cognitive screening measures, staging-based rating scales, and limited neuropsychological testing in diagnosing MCI across most research studies may miss individuals with subtle cognitive declines or mis-diagnose MCI in those who are otherwise cognitively normal on a broader neuropsychological battery of tests. The assembled articles highlight the perils of relying on these conventional criteria for MCI diagnosis and reveal how the reliability of diagnosis is improved when sound neuropsychological approaches are adopted. When these requirements are met, we illustrate with a second series of articles that neuropsychological measures associate strongly with biomarkers and often reflect pathology beyond or instead of typical AD distributions. The final set of articles reveal that people with MCI demonstrate mild but identifiable functional difficulties, and a challenge for neuropsychology is how to incorporate this information to better define MCI and distinguish it from early dementia. Neuropsychology is uniquely positioned to improve upon the state of the science in MCI research and practice by providing critically important empirical information on the specific cognitive domains affected by the predominant neurodegenerative disorders of late life as well as on the diagnostic decision-making strategies used in studies. When such efforts to more comprehensively assess neuropsychological functions are undertaken, better characterizations of spared and impaired cognitive and functional abilities result and lead to more convincing associations with other biomarkers as well as to prediction of clinical outcomes. (JINS, 2014, 20, 129–134)

The Relational and Item-Specific Encoding Task in Mild Cognitive Impairment and Alzheimer Disease

2016 ◽  
Vol 42 (5-6) ◽  
pp. 265-277 ◽  
Author(s):  
Amber Sousa ◽  
Jesus J. Gomar ◽  
J. Daniel Ragland ◽  
Concepcion Conejero-Goldberg ◽  
Justin Buthorn ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Psychometric Properties ◽  
Medial Temporal Lobe ◽  
Functional Competence ◽  
Neuropsychological Measures ◽  
Receiver Operating Characteristic Curves ◽  
Preclinical Ad ◽  
Relational Encoding

Background: The Relational and Item-Specific Encoding task (RISE) measures episodic memory subcomponents, including item-specific and relational encoding of to-be-remembered stimuli. These memory components are neurobiologically relevant because they may engage distinct subregions of the medial temporal lobe, perirhinal and entorhinal cortices, parahippocampus, and hippocampus. Methods: A total of 125 participants, including 84 healthy controls (HC), 22 mild cognitive impairment-diagnosed and 19 Alzheimer disease (AD)-diagnosed participants, were administered the RISE and neuropsychological measures. Stepwise linear regressions assessed prediction of functional ability from RISE d′ measures. ANOVAs and logistic regressions determined the ability of the RISE to discriminate between the diagnostic groups. In addition, the psychometric properties of the RISE were examined. Results: RISE measures predicted diagnosis with pseudo R2 values in the range of 0.25-0.30. Receiver operating characteristic curves demonstrated adequate sensitivity and specificity with areas under the curve in the range of 0.78-0.98. Memory following relational encoding was a significant predictor of everyday functional competence. The RISE had acceptable psychometric properties, with the exception of floor effects in the AD group. Conclusion: The RISE measures significantly predicted diagnosis and predicted everyday functional competence. The RISE offers unique advantages in the assessment of HC and individuals with preclinical AD.

scholarly journals Sensitive Measures of Cognition in Mild Cognitive Impairment

2021 ◽  
pp. 1-14
Author(s):  
Nathaniel Klooster ◽  
Stacey Humphries ◽  
Eileen Cardillo ◽  
Franziska Hartung ◽  
Long Xie ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Semantic Memory ◽  
Medial Temporal Lobe ◽  
Figurative Language ◽  
Neurofibrillary Tangle ◽  
Experimental Tests ◽  
Perirhinal Cortex ◽  
Cognitive Change ◽  
Preclinical Ad

Background: Sensitive measures of cognition are needed in preclinical and prodromal Alzheimer’s disease (AD) to track cognitive change and evaluate potential interventions. Neurofibrillary tangle pathology in AD is first observed in Brodmann Area 35 (BA35), the medial portion of the perirhinal cortex. The importance of the perirhinal cortex for semantic memory may explain early impairments of semantics in preclinical AD. Additionally, our research has tied figurative language impairment to neurodegenerative disease. Objective: We aim to identify tasks that are sensitive to cognitive impairment in individuals with mild cognitive impairment (MCI), and that are sensitive to atrophy in BA35. Methods: Individuals with MCI and cognitively normal participants (CN) were tested on productive and receptive experimental measures of semantic memory and experimental tests of figurative language comprehension (including metaphor and verbal analogy). Performance was related to structural imaging and standard neuropsychological assessment. Results: On the experimental tests of semantics and figurative language, people with MCI performed worse than CN participants. The experimental semantic memory tasks are sensitive and specific; performance on the experimental semantic memory tasks related to medial temporal lobe structural integrity, including BA35, while standard neuropsychological assessments of semantic memory did not, demonstrating the sensitivity of these experimental measures. A visuo-spatial analogy task did not differentiate groups, confirming the specificity of semantic and figurative language tasks. Conclusion: These experimental measures appear sensitive to cognitive change and neurodegeneration early in the AD trajectory and may prove useful in tracking cognitive change in clinical trials aimed at early intervention.

scholarly journals Rethinking and Co-Design of Beloved Board Games for People With Mild Cognitive Impairment and Their Care Partners

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 558-558
Author(s):  
Chantal Kerssens ◽  
Maribeth Gandy ◽  
Kara Cohen ◽  
Laura Levy ◽  
Cecile Janssens ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Social Engagement ◽  
Game Design ◽  
Social Activity ◽  
Positive Interactions ◽  
Older Americans ◽  
Board Games ◽  
Care Partners ◽  
Progression Of Disease

Abstract Mild cognitive impairment (MCI) affects millions of older Americans and progression to dementia is common. Although people with MCI may experience impairments, they are often highly verbal, able, and eager to uphold beloved routines. Moreover, many seek opportunities to stay active, physically and mentally, to support their brain health. Some forms of cognitive training and social engagement potentially delay the onset and progression of disease, including dementia. This 12-month project used mixed methods to co-design and test an accessible version of well-known board games for people with MCI and a care partner without MCI. The overall goal was to foster a meaningful, joyous, social activity for players with differing capabilities using adapted game mechanics to create a compelling experience for both players. Coping strategies of care partners were studied to learn ways to foster positive interactions. Findings inform recommendations for game design and clinical interventions. Part of a symposium sponsored by Technology and Aging Interest Group.

Discriminating accuracy of medial temporal lobe volumetry and fMRI in mild cognitive impairment

Hippocampus ◽  
2009 ◽  
Vol 19 (2) ◽  
pp. 166-175 ◽  
Author(s):  
Anne M. Jauhiainen ◽  
Maija Pihlajamäki ◽  
Susanna Tervo ◽  
Eini Niskanen ◽  
Heikki Tanila ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Temporal Lobe ◽  
Medial Temporal Lobe

scholarly journals Using Regional Homogeneity to Reveal Altered Spontaneous Activity in Patients with Mild Cognitive Impairment

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yumei Wang ◽  
Xiaochuan Zhao ◽  
Shunjiang Xu ◽  
Lulu Yu ◽  
Lan Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Spontaneous Activity ◽  
Healthy Aging ◽  
Early Stage ◽  
Brain Activity ◽  
Regional Homogeneity ◽  
Whole Brain ◽  
Spontaneous Brain Activity ◽  
Regional Brain Activity

Most patients with mild cognitive impairment (MCI) are thought to be in an early stage of Alzheimer’s disease (AD). Resting-state functional magnetic resonance imaging reflects spontaneous brain activity and/or the endogenous/background neurophysiological process of the human brain. Regional homogeneity (ReHo) rapidly maps regional brain activity across the whole brain. In the present study, we used the ReHo index to explore whole brain spontaneous activity pattern in MCI. Our results showed that MCI subjects displayed an increased ReHo index in the paracentral lobe, precuneus, and postcentral and a decreased ReHo index in the medial temporal gyrus and hippocampus. Impairments in the medial temporal gyrus and hippocampus may serve as important markers distinguishing MCI from healthy aging. Moreover, the increased ReHo index observed in the postcentral and paracentral lobes might indicate compensation for the cognitive function losses in individuals with MCI.

scholarly journals Increased functional connectivity within medial temporal lobe in mild cognitive impairment

Hippocampus ◽  
2012 ◽  
Vol 23 (1) ◽  
pp. 1-6 ◽  
Author(s):  
Sandhitsu R. Das ◽  
John Pluta ◽  
Lauren Mancuso ◽  
Dasha Kliot ◽  
Sylvia Orozco ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Temporal Lobe ◽  
Medial Temporal Lobe
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