Normal Cognitive Aging and Mild Cognitive Impairment: Drawing the Fine Line

2013 ◽  
Vol 23 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Valarie B. Fleming
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Diagnostic Category ◽  
Speech Language Pathologists ◽  
Fine Line ◽  
Pathological Aging ◽  
Assessment And Treatment

Mild cognitive impairment (MCI) is a transitional diagnostic category between normal cognitive aging and dementia. Speech-language pathologists (SLPs) have a role in the management of MCI, particularly the assessment and treatment of cognitive-communicative impairments related to MCI. The difficulty lies in distinguishing between normal cognitive aging and pathological aging. SLPs will need to be equipped with knowledge regarding the neurobiological, cognitive, and cognitive-communicative changes occurring in both normal and pathological aging, specifically the alterations arising in MCI.

What explains variations in the clinical use of mild cognitive impairment (MCI) as a diagnostic category?

2008 ◽  
Vol 20 (4) ◽  
pp. 697-709 ◽  
Author(s):  
Tiago Moreira ◽  
Julian C. Hughes ◽  
Thomas Kirkwood ◽  
Carl May ◽  
Ian McKeith ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Clinical Practice ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Diagnostic Category ◽  
Clinical Use ◽  
Structured Interviews ◽  
Clinical Culture ◽  
Diagnosis Of Dementia ◽  
Dementia Research

ABSTRACTBackground: Mild cognitive impairment (MCI) is proposed to describe the transitional stage between normal cognitive aging and dementia. It has had significant impact in the field of dementia research, but it remains controversial whether or not it should be used as a diagnostic category in clinical practice.Methods: Semi-structured interviews were carried out with international experts (N = 37) in the field of dementia research and practice. These interviews explored the advantages and difficulties of using MCI as a clinical diagnosis.Results: There is wide variation in the clinical use of MCI. This variation depends on institutional factors and two types of cultural factors: (a) clinical culture, and (b) the “evidential culture” – how research and guidelines figure in clinical practice.Conclusion: The study shows the importance of combining values-based practice with evidence-based practice in the early diagnosis of dementia.

scholarly journals EEG Measures of Value-Directed Strategic Processing in Older Adults With and Without Mild Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 292-293
Author(s):  
Lydia Nguyen ◽  
Shraddha Shende ◽  
Daniel Llano ◽  
Raksha Mudar
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Spectral Power ◽  
Group Differences ◽  
Cognitive Resources ◽  
Alpha Power ◽  
Strategic Processing ◽  
Unique Word

Abstract Value-directed strategic processing is important for daily functioning. It allows selective processing of important information and inhibition of irrelevant information. This ability is relatively preserved in normal cognitive aging, but it is unclear if mild cognitive impairment (MCI) affects strategic processing and its underlying neurophysiological mechanisms. The current study examined behavioral and EEG spectral power differences between 16 cognitively normal older adults (CNOA; mean age: 74.5 ± 4.0 years) and 16 individuals with MCI (mean age: 77.1 ± 4.3 years) linked to a value-directed strategic processing task. The task used five unique word lists where words were assigned high- or low-value based on letter case and were presented sequentially while EEG was recorded. Participants were instructed to recall as many words as possible after each list to maximize their score. Results revealed no group differences in recall of low-value words, but individuals with MCI recalled significantly fewer high-value words and total number of words relative to CNOA. Group differences were observed in theta and alpha bands for low-value words, with greater synchronized theta power for CNOA than MCI and greater desynchronized alpha power for MCI than CNOA. Collectively, these findings demonstrate that more effortful neural processing of low-value words in the MCI group, relative to the CNOA group, allowed them to match their behavioral performance to the CNOA group. Individuals with MCI appear to utilize more cognitive resources to inhibit low-value information and might show memory-related benefits if taught strategies to focus on high-value information processing.

scholarly journals Sex-dependent Pathological Aging Effect on Caudate Functional Connectivity in Mild Cognitive Impairment

2021 ◽  
Author(s):  
Zhengshi Yang ◽  
Jessica Z.K. Caldwell ◽  
Jeffrey L. Cummings ◽  
Aaron Ritter ◽  
Jefferson W. Kinney ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Connectivity ◽  
Aging Effect ◽  
Analysis Of Covariance ◽  
Aging Effects ◽  
Mixed Effect ◽  
Effect Analysis ◽  
Pathological Aging ◽  
Age Related

Abstract Purpose To assess the pathological aging effect on caudate functional connectivity among mild cognitive impairment (MCI) participants and examine whether and how sex and amyloid contribute to this process. Materials and Methods 277 functional magnetic resonance imaging (fMRI) sessions from 163 cognitive normal (CN) older adults and 309 sessions from 139 participants with MCI were included as the main sample in our analysis. Pearson’s correlation was used to characterize the functional connectivity (FC) between caudate and each brain region, then caudate nodal strength was computed to quantify the overall caudate FC strength. Association analysis between caudate nodal strength and age was carried out in MCI and CN separately using linear mixed effect (LME) model with covariates (education, handedness, sex, Apolipoprotein E4 and intra-subject effect). Analysis of covariance was conducted to investigate sex, amyloid status and their interaction effects on aging with the fMRI data subset having amyloid status available. LME model was applied to women and men separately within MCI group to evaluate aging effects on caudate nodal strength and each region’s connectivity with caudate. We then evaluated the roles of sex and amyloid status in the associations of neuropsychological scores with age or caudate nodal strength. An independent cohort was used to validate the sex-dependent aging effects in MCI. Results The MCI group had significantly stronger age-related increase of caudate nodal strength compared to the CN group. Analyzing women and men separately revealed that the aging effect on caudate nodal strength among MCI participants was significant only for women (left: P=6.23x10−7, right: P=3.37x10−8), but not for men (P>0.3 for bilateral caudate). The aging effects on caudate nodal strength were not significantly mediated by brain amyloid burden. Caudate connectivity with ventral prefrontal cortex substantially contributed to the aging effect on caudate nodal strength in women with MCI. Higher caudate nodal strength is significantly related to worse cognitive performance in women but not in men with MCI. Conclusion Sex modulates the pathological aging effects on caudate nodal strength in MCI regardless of amyloid status. Caudate nodal strength may be a sensitive biomarker of pathological aging in women with MCI.

O1-05-04: Pain and depression in normal cognitive aging and mild cognitive impairment

2010 ◽  
Vol 6 ◽  
pp. S79-S79
Author(s):  
Tina M. Kruger ◽  
Erin Abner ◽  
Frederick A. Schmitt ◽  
Gregory A. Jicha
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging

scholarly journals Neurocognitive predictors of financial capacity across the dementia spectrum: Normal aging, mild cognitive impairment, and Alzheimer’s disease

2009 ◽  
Vol 15 (2) ◽  
pp. 258-267 ◽  
Author(s):  
MEGAN G. SHEROD ◽  
H. RANDALL GRIFFITH ◽  
JACQUELYNN COPELAND ◽  
KATHERINE BELUE ◽  
SARA KRZYWANSKI ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Control Model ◽  
Cognitive Models ◽  
Story Recall ◽  
Financial Capacity

AbstractFinancial capacity is a complex instrumental activity of daily living critical to independent functioning of older adults and sensitive to impairment in patients with amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD). However, little is known about the neurocognitive basis of financial impairment in dementia. We developed cognitive models of financial capacity in cognitively healthy older adults (n = 85) and patients with MCI (n = 113) and mild AD (n = 43). All participants were administered the Financial Capacity Instrument (FCI) and a neuropsychological test battery. Univariate correlation and multiple regression procedures were used to develop cognitive models of overall FCI performance across groups. The control model (R2 = .38) comprised (in order of entry) written arithmetic skills, delayed story recall, and simple visuomotor sequencing. The MCI model (R2 = .69) comprised written arithmetic skills, visuomotor sequencing and set alternation, and race. The AD model (R2 = .65) comprised written arithmetic skills, simple visuomotor sequencing, and immediate story recall. Written arithmetic skills (WRAT-3 Arithmetic) was the primary predictor across models, accounting for 27% (control model), 46% (AD model), and 55% (MCI model) of variance. Executive function and verbal memory were secondary model predictors. The results offer insight into the cognitive basis of financial capacity across the dementia spectrum of cognitive aging, MCI, and AD. (JINS, 2009, 15, 258–267.)

scholarly journals Distinct Subgroups of Amnestic Mild Cognitive Impairment as Identified by Soft Independent Modeling of Class Analogy

2019 ◽  
Author(s):  
Sookjaroen Tangwongchai ◽  
Itthipol Tawankanjanachot ◽  
Chavit Tunvirachaisakul ◽  
Thitiporn Supasitthumrong ◽  
Solaphat Hemrungrojn ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychological Tests ◽  
Diagnostic Category ◽  
Principal Component ◽  
Amnestic Mild Cognitive Impairment ◽  
Cognitive Profile ◽  
Support Vector ◽  
Patients At Risk ◽  
Normal Controls

Amnestic mild cognitive impairment (aMCI) is a condition characterized by mild deficits in episodic and semantic memory and learning. The conversion rate of aMCI to Alzheimer disease (AD) is significantly higher in aMCI than in the general population. The aim of this study is to examine whether aMCI is a valid diagnostic category or whether aMCI comprises different subgroups based on cognitive functions. We recruited 60 aMCI patients, 60 with AD and 61 healthy controls who completed neuropsychological tests of the Consortium to Establish a Registry for Alzheimer’s Disease (CERAD-NP) and biomarkers including serum anion gap (AGAP). Principal component analysis, support vector machine and Soft Independent Modeling of Class Analogy (SIMCA) showed that AD patients and controls were highly significantly discrimanted from each other, while patients with aMCI overlap considerably with normal controls. SIMCA showed that 68.3% of the aMCI patients were assigned to the control class (named: aMCI-HC), 15% to AD (aMCI-AD), while 16.6% did not belong to either class (aMCI-strangers). aMCI-HC subjects showed sings of very mild cognitive decline and impaired recall. aMCI-strangers showed signs of mild cognitive impairment with impaired fluency and naming. aMCI-AD cases showed a cognitive profile reminiscent of AD an increased AGAP levels. In conclusion, our SIMCA model may classify subjects afforded a clinical diagnosis of aMCI according to Petersen’s criteria into three clinically relevant subgroups and help in the early detection of AD by identifying aMCI patients at risk to develop AD and those that have an AD prodrome.

scholarly journals Prevalence of Neuropsychiatric Symptoms in Mild Cognitive Impairment and Normal Cognitive Aging

2008 ◽  
Vol 65 (10) ◽  
pp. 1193 ◽  
Author(s):  
Yonas E. Geda ◽  
Rosebud O. Roberts ◽  
David S. Knopman ◽  
Ronald C. Petersen ◽  
Teresa J. H. Christianson ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Neuropsychiatric Symptoms

scholarly journals Evaluating Daily Versus Global Stress Appraisals’ Sensitivity to Mild Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 598-599
Author(s):  
Eric Cerino ◽  
Stacey Scott ◽  
Ruixue Zhaoyang ◽  
Richard Lipton ◽  
Martin Sliwinski
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Aging ◽  
Daily Stressors ◽  
Stress Markers ◽  
Aging Study ◽  
Global Stress ◽  
Ecological Momentary ◽  
Cognitively Intact ◽  
Everyday Stress

Abstract Stress is an important correlate of cognitive aging that manifests in everyday life. Infrequent trait-based stress measures may not be as sensitive to mild cognitive impairment (MCI) as ecological momentary assessments (EMA). We compared EMA to global trait-based stress measures in discriminating MCI. A sample of 248 adults from the Einstein Aging Study (Mage=77.33 years, SD=5.04; 68 with MCI) were prompted to report whether a stressor occurred and to rate the severity up to four times daily for 14 days. Global perceived stress and neuroticism were assessed at baseline. Although MCI status was unrelated to stressor frequency (p>.05), individuals with MCI appraised their daily stressors as more severe than cognitively intact participants (p=.03). No MCI-related differences emerged on global stress or neuroticism assessments (ps>.05). Results suggest everyday stress markers may be more sensitive to differentiating MCI than global assessments and point toward their utility for early identification of pathological declines.

scholarly journals REACTIONS TO AMYLOID PET SCAN RESULTS AND LEVELS OF ANXIETY AND DEPRESSION AMONG CARE PARTNERS: CARE IDEAS STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S136-S136
Author(s):  
Emmanuelle Belanger ◽  
Jessica D’Silva ◽  
Courtney H Van Houtven ◽  
Megan Shepherd-Banigan ◽  
Valerie Smith ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Qualitative Content Analysis ◽  
Diagnostic Category ◽  
Pet Scan ◽  
Amyloid Pet ◽  
Loved One ◽  
Care Partners ◽  
Positive Scan

Abstract Few studies have examined caregiver reactions to their loved ones receiving the results of an Amyloid PET scan which can be indicative of Alzheimer’s disease. Therefore, we examine: 1) What are care partner’s reactions to their loved one receiving negative or positive amyloid PET scan results?, and 2) To what extent are scan results and diagnostic category (dementia vs. mild cognitive impairment) associated with care partner depressive symptoms (PHQ-2) and anxiety (STAI-6)? Using data from 1,799 care partners in the CARE IDEAS study, we applied a sequential mixed-methods design and explored the reactions of 192 care partners who answered open-ended interview questions after learning about the Amyloid PET scan results. We first conducted qualitative content analysis of transcripts from open-ended questions to explore caregivers’ emotional responses after their loved one received an Amyloid PET scan result. The qualitative data suggest that when the scan results fit care partner’s expectations, i.e. positive scan when the patient has dementia and negative scan when the patient has mild impairment, care partners report satisfaction with this information and relief, rather than shock and frustration. Adjusted logistic regression models of survey responses support this finding; having dementia and a positive scan both increased the likelihood of care partners having high levels of anxiety, and a significant interaction indicated that a positive scan was associated with high anxiety among care partners of patients with mild cognitive impairment but not dementia. Only lower education and higher impairment in everyday cognitive function were associated with high depressive symptoms.

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