scholarly journals Episodic Memory and Hippocampal Volume Predict 5-Year Mild Cognitive Impairment Conversion in Healthy Apolipoprotein ε4 Carriers

2020 ◽  
Vol 26 (7) ◽  
pp. 733-738
Author(s):  
Margaret Abraham ◽  
Michael Seidenberg ◽  
Dana A. Kelly ◽  
Kristy A. Nielson ◽  
John L. Woodard ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Exploratory Study ◽  
Medial Temporal Lobe ◽  
Neuropsychological Testing ◽  
Verbal Learning ◽  
Interval Data ◽  
Hippocampal Volume ◽  
Cognitively Intact

AbstractObjective:The Apolipoprotein (APOE) ε4 allele increases the risk for mild cognitive impairment (MCI) and dementia, but not all carriers develop MCI/dementia. The purpose of this exploratory study was to determine if early and subtle preclinical signs of cognitive dysfunction and medial temporal lobe atrophy are observed in cognitively intact ε4 carriers who subsequently develop MCI.Methods:Twenty-nine healthy, cognitively intact ε4 carriers (ε3/ε4 heterozygotes; ages 65–85) underwent neuropsychological testing and MRI-based measurements of medial temporal volumes over a 5-year follow-up interval; data were converted to z-scores based on a non-carrier group consisting of 17 ε3/ε3 homozygotes.Results:At follow-up, 11 ε4 carriers (38%) converted to a diagnosis of MCI. At study entry, the MCI converters had significantly lower scores on the Mini-Mental State Examination, Rey Auditory Verbal Learning Test (RAVLT) Trials 1–5, and RAVLT Immediate Recall compared to non-converters. MCI converters also had smaller MRI volumes in the left subiculum than non-converters. Follow-up logistic regressions revealed that left subiculum volumes and RAVLT Trials 1–5 scores were significant predictors of MCI conversion.Conclusions:Results from this exploratory study suggest that ε4 carriers who convert to MCI exhibit subtle cognitive and volumetric differences years prior to diagnosis.

scholarly journals Predicting Early Mild Cognitive Impairment With Free Recall: The Primacy of Primacy

2019 ◽  
Vol 35 (2) ◽  
pp. 133-142 ◽  
Author(s):  
Deborah Talamonti ◽  
Rebecca Koscik ◽  
Sterling Johnson ◽  
Davide Bruno
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Serial Position ◽  
Verbal Learning ◽  
Binary Logistic Regression ◽  
Roc Curves ◽  
Consensus Conference ◽  
Position Effects ◽  
Cognitively Intact

Abstract Objectives Serial position effects have been found to discriminate between normal and pathological aging, and to predict conversion from Mild Cognitive Impairment (MCI) to Alzheimer’s disease (AD). Different scoring methods have been used to estimate the accuracy of these predictions. In the current study, we investigated delayed primacy as predictor of progression to early MCI over established diagnostic memory methods. We also compared three serial position methods (regional, standard and delayed scores) to determine which measure is the most sensitive in differentiating between individuals who develop early MCI from a baseline of cognitively intact older adults. Method Data were analyzed with binary logistic regression and with receiver-operating characteristic (ROC). Baseline serial position scores were collected using the Rey’s Auditory Verbal Learning Test and used to predict conversion to early MCI. The diagnosis of early MCI was obtained through statistical algorithm and consequent consensus conference. One hundred and ninety-one participants were included in the analyses. All participants were aged 60 or above and cognitively intact at baseline. Results The binary logistic regression showed that delayed primacy was the only predictor of conversion to early MCI, when compared to total and delayed recall. ROC curves showed that delayed primacy was still the most sensitive predictor of progression to early MCI when compared to other serial position measures. Conclusions These findings are consistent with previous studies and support the hypothesis that delayed primacy may be a useful cognitive marker of early detection of neurodegeneration.

Impaired Recognition of Facial and Vocal Emotions in Mild Cognitive Impairment

2021 ◽  
pp. 1-14
Author(s):  
Helena S. Moreira ◽  
Ana Sofia Costa ◽  
Álvaro Machado ◽  
São Luís Castro ◽  
Selene G. Vicente ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Emotion Recognition ◽  
Facial Expressions ◽  
Daily Living ◽  
Emotional Processing ◽  
Neuropsychological Testing ◽  
Nonverbal Vocalizations ◽  
Sensory Modalities ◽  
Cognitively Intact

Abstract Objective: The ability to recognize others’ emotions is a central aspect of socioemotional functioning. Emotion recognition impairments are well documented in Alzheimer’s disease and other dementias, but it is less understood whether they are also present in mild cognitive impairment (MCI). Results on facial emotion recognition are mixed, and crucially, it remains unclear whether the potential impairments are specific to faces or extend across sensory modalities, Method: In the current study, 32 MCI patients and 33 cognitively intact controls completed a comprehensive neuropsychological assessment and two forced-choice emotion recognition tasks, including visual and auditory stimuli. The emotion recognition tasks required participants to categorize emotions in facial expressions and in nonverbal vocalizations (e.g., laughter, crying) expressing neutrality, anger, disgust, fear, happiness, pleasure, surprise, or sadness. Results: MCI patients performed worse than controls for both facial expressions and vocalizations. The effect was large, similar across tasks and individual emotions, and it was not explained by sensory losses or affective symptomatology. Emotion recognition impairments were more pronounced among patients with lower global cognitive performance, but they did not correlate with the ability to perform activities of daily living. Conclusions: These findings indicate that MCI is associated with emotion recognition difficulties and that such difficulties extend beyond vision, plausibly reflecting a failure at supramodal levels of emotional processing. This highlights the importance of considering emotion recognition abilities as part of standard neuropsychological testing in MCI, and as a target of interventions aimed at improving social cognition in these patients.

scholarly journals Associations of Pulse and Blood Pressure with Hippocampal Volume by APOE and Cognitive Phenotype: The Alzheimer’s Disease Neuroimaging Initiative (ADNI)

2018 ◽  
Vol 45 (1-2) ◽  
pp. 66-78 ◽  
Author(s):  
Julius S. Ngwa ◽  
Thomas V. Fungwe ◽  
Oyonumo Ntekim ◽  
Joanne S. Allard ◽  
Sheree M. Johnson ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Blood Pressure ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Hippocampal Volume ◽  
Cognitive Status ◽  
Brain Volumes ◽  
Using Data

Background: It is increasingly evident that high blood pressure can promote reduction in global and regional brain volumes. While these effects may preferentially affect the hippocampus, reports are inconsistent. Methods: Using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), we examined the relationships of hippocampal volume to pulse pressure (PPR) and systolic (SBP) and diastolic (DBP) blood pressure according to apolipoprotein (APOE) ɛ4 positivity and cognitive status. The ADNI data included 1,308 participants: Alzheimer disease (AD = 237), late mild cognitive impairment (LMCI = 454), early mild cognitive impairment (EMCI = 254), and cognitively normal (CN = 365), with up to 24 months of follow-up. Results: Higher quartiles of PPR were significantly associated with lower hippocampal volumes (Q1 vs. Q4, p = 0.034) in the CN and AD groups, but with increasing hippocampal volume (Q1, p = 0.008; Q2, p = 0.020; Q3, p = 0.017; Q4 = reference) in the MCI groups. In adjusted stratified analyses among non-APOE ɛ4 carriers, the effects in the CN (Q1 vs. Q4, p = 0.006) and EMCI groups (Q1, p = 0.002; Q2, p = 0.013; Q3, p = 0.002; Q4 = reference) remained statistically significant. Also, higher DBP was significantly associated with higher hippocampal volume (p = 0.002) while higher SBP was significantly associated with decreasing hippocampal volume in the EMCI group (p = 0.015). Conclusion: Changes in PPR, SBP, and DBP differentially influenced hippocampal volumes depending on the cognitive and APOE genotypic categories.

A Lack of Practice Effects on Memory Tasks Predicts Conversion to Alzheimer Disease in Patients With Amnestic Mild Cognitive Impairment

2020 ◽  
pp. 089198872094424
Author(s):  
Maria Stefania De Simone ◽  
Roberta Perri ◽  
Marta Rodini ◽  
Lucia Fadda ◽  
Massimo De Tollis ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Test Performance ◽  
Medial Temporal Lobe ◽  
Amnestic Mild Cognitive Impairment ◽  
Practice Effects ◽  
Large Set ◽  
Neuropsychological Evaluations

The aim of the current study was to test the accuracy of practice effects, that is, improvement in test performance due to repeated neuropsychological evaluations, in identifying patients with amnestic mild cognitive impairment (a-MCI) at greater risk of conversion to Alzheimer disease (AD). For this purpose, we conducted a longitudinal study of 54 patients diagnosed with a-MCI at the first assessment and followed-up for 4 years. During this time, 18 patients converted to AD. Baseline and 6- to 12-month follow-up performances on a large set of neuropsychological tests were analyzed to determine their diagnostic ability to predict later conversion to dementia. Results demonstrate that a lack of practice effects on episodic memory tests is an accurate prognostic indicator of late conversion to AD in a-MCI patients. In fact, even though the performance of both groups was substantially comparable at the baseline evaluation, stable a-MCI patients greatly improved their memory performance at retest after 6 to 12 months; instead, scores of converter a-MCI remained stable or decreased passing from baseline to follow-up. Standardized z-change scores on memory tasks, which were computed as a reliable measure of performance change, classified group membership with very good overall accuracy, which was higher than the classification of converter and stable a-MCIs provided by baseline or follow-up scores. We hypothesize that the lack of practice effects on memory tasks mirrors the early involvement of medial temporal lobe areas in converter a-MCI that are fundamental for the consolidation of new memory traces.

scholarly journals Cognitive impairment and psychological state in acute coronary syndrome patients: A prospective descriptive study at cardiac rehabilitation entry, completion and follow-up

2020 ◽  
pp. 147451512093310
Author(s):  
Robyn Gallagher ◽  
Anna Woolaston ◽  
Geoffrey Tofler ◽  
Adrian Bauman ◽  
Emma Zhao ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cardiac Rehabilitation ◽  
Processing Speed ◽  
Verbal Learning ◽  
Psychological State ◽  
Coronary Syndrome ◽  
Multiple Domain

Background Cognitive impairment may limit the uptake of secondary prevention in acute coronary syndrome patients, but is poorly understood, including in cardiac rehabilitation participants. Aim The aim of this study was to explore cognitive impairment in relation to psychological state in acute coronary syndrome patients over the course of cardiac rehabilitation and follow-up. Methods Acute coronary syndrome patients without diagnosed dementia were assessed on verbal learning, processing speed, executive function and visual attention, at cardiac rehabilitation entry, completion and follow-up and scores adjusted using normative data. The hospital anxiety and depression scale measured psychological state. Results Participants ( n = 40) had an average age of 66.2 (±8.22) years and were 70% men. Mild cognitive impairment occurred at cardiac rehabilitation entry in single 62.5% and multiple 22.5% domains but was significantly less prevalent by cardiac rehabilitation completion (52.5% and 15.0%) and follow-up (32.5% and 7.0%). Domains most often impaired were verbal learning (52.5%) and processing speed (25.6%), again decreasing significantly with time (verbal learning cardiac rehabilitation completion 42.5%, follow-up 22.5%; processing speed cardiac rehabilitation completion 15.0%, follow-up 15.0%). A small group of patients had persistent multiple domain cognitive impairment. At cardiac rehabilitation entry patients with cognitive impairment in processing speed, a single domain or multiple domains had more depression, and patients with cognitive impairment in executive function had more depression and anxiety. Conclusions At cardiac rehabilitation entry, mild cognitive impairment is very common in post-acute coronary syndrome patients and worse in patients who have depression or anxiety symptoms. Cognitive impairment decreases significantly by cardiac rehabilitation follow-up. A small proportion of patients has persistent, multiple domain cognitive impairment flagging potential long-term changes and the need for further investigations and cognitive rehabilitation.

Using informant reports to detect cognitive decline in mild cognitive impairment

2012 ◽  
Vol 24 (6) ◽  
pp. 967-973 ◽  
Author(s):  
Ruby S. M. Tsang ◽  
Keri Diamond ◽  
Loren Mowszowski ◽  
Simon J. G. Lewis ◽  
Sharon L. Naismith
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Visual Memory ◽  
Rating Scales ◽  
Verbal Learning ◽  
Cognitive Change ◽  
Neuropsychological Performance ◽  
Informant Ratings ◽  
Cognitively Intact

ABSTRACTBackground: The use of informant rating scales in older adults at risk of dementia may assist with early detection and intervention strategies. This study aims to evaluate whether informants rate greater cognitive change in patients with mild cognitive impairment (MCI) compared to cognitively intact individuals, and to determine the relationship between informant ratings of cognitive change and neuropsychological performance.Methods: One hundred and nine health-seeking older adults underwent clinical and neuropsychological assessments, and informants completed the Cambridge Behavioral Inventory-Revised (CBI-R). Patients were rated according to MCI criteria, including amnestic and non-amnestic subtypes, or as being cognitively intact. CBI-R ratings were evaluated with respect to MCI diagnosis and neuropsychological performance.Results: Compared to cognitively intact individuals, informants rated patients with MCI as having significantly more change in overall functioning (p < 0.05) as well as in specific domains of memory and orientation (p < 0.01), everyday skills (p < 0.05), and motivation (p < 0.05), even after controlling for depressive symptom severity. In further analyses, the non-amnestic MCI subgroup only had more informant-rated mood changes compared to the amnestic subgroup. In relation to neuropsychological performance, informant ratings were related to poorer visual memory, verbal learning and memory, language, and psychomotor speed, with correlations ranging from –0.19 to –0.43 (p < 0.05).Conclusions: These findings indicate that informants are sensitive to subtle early cognitive change in individuals with MCI, and that their ratings are related to objectively measured neuropsychological performance. Thus, the CBI-R may be valuable in assisting early screening and intervention processes.

Natural course of mild cognitive impairment in Parkinson disease

Neurology ◽  
2017 ◽  
Vol 88 (8) ◽  
pp. 767-774 ◽  
Author(s):  
Kenn Freddy Pedersen ◽  
Jan Petter Larsen ◽  
Ole-Bjørn Tysnes ◽  
Guido Alves
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Confidence Interval ◽  
Parkinson Disease ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neuropsychological Testing ◽  
Increased Risk ◽  
Normal Cognition

Objective:To examine the incidence, progression, and reversion of mild cognitive impairment in patients with Parkinson disease (PD-MCI) over 5 years.Methods:A population-based cohort of patients with incident PD underwent repeated neuropsychological testing of attention, executive function, memory, and visuospatial abilities at baseline (n = 178), 1 year (n = 175), 3 years (n = 163), and 5 years (n = 150). Patients were classified as PD-MCI and diagnosed with dementia according to published criteria.Results:Thirty-six patients (20.2%) fulfilled criteria for PD-MCI at baseline. Among those with normal cognition at baseline (n = 142), the cumulative incidence of PD-MCI was 9.9% after 1 year, 23.2% after 3 years, and 28.9% after 5 years of follow-up. Overall, 39.1% of patients with baseline or incident PD-MCI progressed to dementia during the 5-year study period. The conversion rate to dementia was 59.1% in patients with persistent PD-MCI at 1 year vs 7.2% in those with normal cognition during the first year (adjusted odds ratio 16.6, 95% confidence interval 5.1–54.7, p < 0.001). A total of 27.8% of patients with baseline PD-MCI and 24.2% of those with incident PD-MCI had reverted to normal cognition at study end, but the reversion rate decreased to 9.4% in those with persistent PD-MCI at 2 consecutive visits. Compared with cognitively normal patients, PD-MCI reverters within the first 3 years of follow-up were at increased risk of subsequently developing dementia (adjusted odds ratio 10.7, 95% confidence interval 1.5–78.5, p = 0.019).Conclusions:Early PD-MCI, regardless of persistence or reversion to normal cognition, has prognostic value for predicting dementia in patients with PD.

scholarly journals Retrospective Assessment of Movement Disorder Society Criteria for Mild Cognitive Impairment in Parkinson’s Disease

2015 ◽  
Vol 21 (2) ◽  
pp. 137-145 ◽  
Author(s):  
Andrea M. Loftus ◽  
Romola S. Bucks ◽  
Meghan Thomas ◽  
Robert Kane ◽  
Caitlin Timms ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Movement Disorder ◽  
Rating Scale ◽  
Neuropsychological Testing ◽  
Simulation Method ◽  
Movement Disorder Society

AbstractA Movement Disorder Society (MDS) taskforce recently proposed diagnostic criteria for Parkinson’s disease with features of mild cognitive impairment (PD-MCI). This study first examined the prevalence and nature of PD-MCI in a non-demented cohort using the MDS criteria. Using the generic Monte Carlo simulation method developed by Crawford and colleagues (2007), this study then estimated the base rate of the representative population who would demonstrate PD-MCI due to chance alone. A total of 104 participants with idiopathic PD underwent extensive motor and neuropsychological testing at baseline and 2 years later. The Unified Parkinson’s Disease Rating Scale (UPDRS) was used to assess motor symptoms of PD and a range of established neuropsychological tests was used to assess PD-MCI in accord with MDS criteria. In accord with MDS criteria, 38% of this cohort demonstrated PD-MCI at baseline and 48% at follow-up. Of the 36 participants in the multiple-domain PD-MCI subtype at time-1, 9 (25%) demonstrated no PD-MCI at follow up. Analysis revealed that approximately 13% of the representative population would demonstrate abnormally low scores for 2 of the 9 tests used, thereby meeting MDS criteria for PD-MCI. Clinicians and researchers need to approach a single diagnosis (i.e., based on one assessment) of PD-MCI with considerable caution. (JINS, 2015, 21, 137–145)

Remission of poststroke cognitive impairment no dementia: Clinical and imaging correlates

2011 ◽  
Vol 26 (S2) ◽  
pp. 1179-1179
Author(s):  
Y.K. Chen ◽  
E. Lee ◽  
G.S. Ungvari ◽  
J.Y. Lu ◽  
W.C.W. Chu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Cognitive Impairment ◽  
Hippocampal Volume ◽  
Cognitive Status ◽  
Cerebral Microbleeds ◽  
Younger Age ◽  
One Year ◽  
Cognitively Intact ◽  
Cognitive Impairment No Dementia

IntroductionCerebral microbleeds (CMBs) may contribute to cognitive deficits in stroke. Cognitive impairment that does not meet the criteria for dementia (cognitive impairment no dementia [CIND]) is common in stroke, and patients with such impairment can revert to normal cognition.ObjectiveTo investigate the association of CMBs and remission of poststroke CIND.AimTo understand the evolution of poststroke cognitive impairment no dementia (CIND) is bi-directional.Methods143 patients with CIND at three months after stroke were recruited and followed up for one year. Remission of CIND was defined as a conversion of cognitive status from CIND to cognitively intact at follow-up. MRI variables in terms of infarction, cerebral microbleeds (CMBs), and white matter hyperintensities (WMHs) and hippocampal volume were analyzed. Logistic regression was performed to find the predictors of the remission of poststroke CIND.Results30 (21.0%) out of the 143 patients converted to cognitive intact at follow-up. In univariate comparisons, subjects with remission of CIND had younger age (67.1 ± 9.5 vs.73.6 ± 7.6 years, p < 0.001) and higher education years (5.1 ± 4.0 vs.3.6 ± 4.0, p = 0.039). They also had lower WMHs volume (8.2 ± 8.2 vs. 18.6 ± 19.7 cm3, p < 0.001), lower frequency of CMBs (10.0% vs. 31.0%, p = 0.021) and lower volume of the lateral ventricle (33.3 ± 16.5 vs.42.6 ± 19.4 cm3, p = 0.017). In logistic regression, age (odds ratio [OR] = 0.913, 95%C.I. = 0.866–0.962, p = 0.001) and absence of CMBs (OR = 4.292, 95%C.I. = 1.174–15.625, p = 0.028) were significant predictors of remission of CIND.ConclusionsYounger age and absence of CMBs predict the remission of poststroke CIND.

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