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)

scholarly journals Test the Best: Classification Accuracies of Four Cognitive Rating Scales for Parkinson’s Disease Mild Cognitive Impairment

2020 ◽  
Vol 35 (7) ◽  
pp. 1069-1077
Author(s):  
Adela Fendrych Mazancova ◽  
Evžen Růžička ◽  
Robert Jech ◽  
Ondrej Bezdicek
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Rating Scales ◽  
Rating Scale ◽  
Screening Tools ◽  
Cutoff Score ◽  
Neuropsychological Battery ◽  
Mattis Dementia Rating Scale

Abstract Objective A progressive cognitive impairment is one of the frequent non-motor symptoms during Parkinson’s disease (PD) course. A short and valid screening tool is needed to detect an incipient cognitive deficit at the mild cognitive impairment stage in Parkinson’s disease (PD–MCI). Method The present study aims to evaluate the classification accuracies of four cognitive screenings: Montreal Cognitive Assessment (MoCA), Mattis Dementia Rating Scale second edition (DRS–2), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) in a cohort of PD patients (PD–MCI, n = 46; and Parkinson’s disease with normal cognition, PD-NC, n = 95) and Controls (n = 66). All subjects underwent a standard neuropsychological battery as recommended by the International Parkinson and Movement Disorder Society and underwent all four screening tools. Results In the detection of PD-MCI versus PD-NC, the MoCA showed a sensitivity of 84% and a specificity of 66% with a screening cutoff score at ≤25 points. The MoCA’s AUC was 86% (95% CI 78.7–93.1). In the detection of PD-MCI versus Controls, the FAB displayed 84% sensitivity and 79% specificity with a cutoff ≤16 points, to screen. The FAB’s AUC was 87% (79.0–95.0). Conclusions Our results show that the MoCA is the most discriminative tool for screening MCI in the PD population.

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 A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints

2013 ◽  
Vol 5 (3) ◽  
pp. 16 ◽  
Author(s):  
Fábio Henrique De Gobbi Porto ◽  
Lívia Spíndola ◽  
Maira Okada De Oliveira ◽  
Patrícia Helena Figuerêdo Do Vale ◽  
Marco Orsini ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Neuropsychological Testing ◽  
Area Under The Curve ◽  
Screening Tests ◽  
Elderly Subjects ◽  
Subjective Memory ◽  
Delayed Recall ◽  
Memory Complaints

It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.

scholarly journals Mild cognitive impairment: prevalence and incidence according to different diagnostic criteria

2003 ◽  
Vol 182 (5) ◽  
pp. 449-454 ◽  
Author(s):  
Anja Busse ◽  
Jeannette Bischkopf ◽  
Steffi G. Riedel-Heller ◽  
Matthias C. Angermeyer
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Longitudinal Study ◽  
Diagnostic Criteria ◽  
Community Sample ◽  
Neuropsychological Testing ◽  
Incidence Rates ◽  
Prevalence Rates ◽  
Case Definitions ◽  
Increased Risk

BackgroundAlthough mild cognitive impairment is associated with an increased risk of developing dementia, there has been little work on its incidence and prevalence.AimsTo report age-specific prevalence, incidence and predictive validities for four diagnostic concepts of mild cognitive impairment.MethodA community sample of 1045 dementia-free individuals aged 75 years and over was examined by neuropsychological testing in a three-wave longitudinal study.ResultsPrevalence rates ranged from 3% to 20%, depending on the concept applied. The annual incidence rates applying different case definitions varied from 8 to 77 per 1000 person-years. Rates of conversion to dementia over 2.6 years ranged from 23% to 47%.ConclusionsMild cognitive impairment is frequent in older people. Prevalence, incidence and predictive validities are highly dependent on the diagnostic criteria applied.

The Modified Telephone-Administered Minnesota Cognitive Acuity Screen for Mild Cognitive Impairment

2018 ◽  
Vol 31 (3) ◽  
pp. 123-128 ◽  
Author(s):  
Sarah Pillemer ◽  
George D. Papandonatos ◽  
Cara Crook ◽  
Brian R. Ott ◽  
Geoffrey Tremont
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Characteristic Curve ◽  
Neuropsychological Testing ◽  
Cost Effective ◽  
Original Version ◽  
Modest Improvement ◽  
Highly Sensitive ◽  
Risk Of Progression ◽  
Administration Time

Objective: This study aimed to compare the sensitivity and specificity of a modified version of the Minnesota Cognitive Acuity Screen (MCAS-m), by adding learning and recognition memory components, to the original version MCAS to distinguish amnestic mild cognitive impairment (aMCI) from healthy controls (HCs). Methods/Design: A total of 30 individuals with aMCI and 30 HCs underwent neuropsychological testing, neurologic examination, laboratory, and brain imaging tests. Once diagnosis was confirmed, participants completed the MCAS and MCAS-m in counterbalanced order. Results: The average administration time was 12.6 minutes for the MCAS and 13.5 minutes for the MCAS-m. Receiver operating characteristic curve analyses showed that the MCAS-m demonstrated 97% sensitivity and 97% specificity for distinguishing between aMCI and HC versus 97% and 87%, respectively, for the original MCAS in this sample. Conclusions: Both the MCAS and the MCAS-m were highly sensitive when distinguishing between normal cognition and aMCI; however, the MCAS-m demonstrated a 10% increase in specificity compared to the original version. Improved specificity is particularly relevant to screening in larger community samples with lower base rates of MCI than clinic populations. This modified screening measure presents a brief and cost-effective tool for identifying MCI. Given the risk of progression from aMCI to Alzheimer disease dementia (AD), the MCAS-m represents a modest improvement in telephone-administered methods for the early detection of AD.

Comparison of the Mini-Mental State Examination and Computerized Brief Cognitive Screening Test as Cognitive Screening Tools in Patients with Mild Cognitive Impairment

2021 ◽  
Vol 18 ◽  
Author(s):  
Che-Sheng Chu ◽  
I-Chen Lee ◽  
Chuan-Cheng Hung ◽  
I-Ching Lee ◽  
Chi-Fa Hung ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Normal Control ◽  
Internal Consistency ◽  
Mental State ◽  
Screening Test ◽  
Mini Mental State Examination ◽  
Cognitive Screening ◽  
Validity And Reliability ◽  
State Examination

Background: The aim of this study was to establish the validity and reliability of the Computerized Brief Cognitive Screening Test (CBCog) for early detection of cognitive impairment. Method: One hundred and sixty participants, including community-dwelling and out-patient volunteers (both men and women) aged ≥ 65 years, were enrolled in the study. All participants were screened using the CBCog and Mini-Mental State Examination (MMSE). The internal consistency of the CBCog was analyzed using Cronbach’s α test. Areas under the curves (AUCs) of receiver operating characteristic analyses were used to test the predictive accuracy of the CBCog in detecting mild cognitive impairment (MCI) in order to set an appropriate cutoff point. Results: The CBCog scores were positively correlated with the MMSE scores of patients with MCI-related dementia (r = 0.678, P < .001). The internal consistency of the CBCog (Cronbach’s α) was 0.706. It was found that the CBCog with a cutoff point of 19/20 had a sensitivity of 97.5% and a specificity of 53.7% for the diagnosis of MCI with education level ≥ 6 years. The AUC of the CBCog for discriminating the normal control elderly from patients with MCI (AUC = 0.827, P < 0.001) was larger than that of the MMSE for discriminating the normal control elderly from patients with MCI (AUC= 0.819, P < .001). Conclusion: The CBCog demonstrated to have sufficient validity and reliability to evaluate mild cognitive impairment, especially in highly educated elderly people.

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