The Destiny of Multiple Domain Amnesic Mild Cognitive Impairment: Effect of Alternative Neuropsychological Definitions and Their Adjunctive Role in Respect of Memory Impairment

Author(s):  
Chiara Piccininni ◽  
Davide Quaranta ◽  
Guido Gainotti ◽  
Giordano Lacidogna ◽  
Valeria Guglielmi ◽  
...  

Abstract Objective Mild cognitive impairment is the main risk factor of dementia. Previous evidence has claimed that subjects with memory disturbances associated with impairment of other cognitive domains (multiple domain amnesic MCI) are at the highest risk of developing dementia. To date, a shared definition of amnesic MCI multiple domain (aMCI-MD) is still lacking. Method 163 subjects with aMCI were enrolled and followed-up for 2 years. They underwent a baseline comprehensive neuropsychological battery. The cut-off point for each test was set at 1, 1.5, and 2 SD below the mean obtained in normative studies; aMCI-MD was defined as the occurrence of abnormal scores on at least one, two, or three tests not assessing memory. The Episodic Memory Score (EMS), that measures the severity of memory impairment, was determined. Logistic regressionand Cox’s proportional hazard risk models were carried out. The adjunctive effect of the definitions of aMCI-MD on the severity of memory impairment was assessed. Results Fifty-four subjects progressed to dementia. Only restrictive definitions of aMCI-MD (at least three tests below 1.5 SD; at least two tests below 2 SD) predicted conversion to dementia in both logistic regression and survival analysis. None of the conditions showed a significant adjunctive effect on the EMS. Conclusions The predictive effect of impairment in tests assessing cognitive domains other than memory depends on its psychometric definition. The use of a restrictive definition would be of some usefulness, but the adjunctive effect of such a definition on an integrated analysis of memory impairment may be questionable.

2016 ◽  
Vol 41 (3-4) ◽  
pp. 199-209 ◽  
Author(s):  
Nadeshda Andrejeva ◽  
Maren Knebel ◽  
Vasco Dos Santos ◽  
Janna Schmidt ◽  
Christina Josefa Herold ◽  
...  

Background/Aims: Mild cognitive impairment (MCI) is a frequent syndrome in the older population, which involves an increased risk to develop Alzheimer's disease (AD). The latter can be modified by the cognitive reserve, which can be operationalized by the length of school education. MCI can be differentiated into four subtypes according to the cognitive domains involved: amnestic MCI, multiple-domain amnestic MCI, non-amnestic MCI and multiple-domain non-amnestic MCI. While neurocognitive deficits are a constituent of the diagnosis of these subtypes, the question of how they refer to the cognitive reserve still needs to be clarified. Methods: We examined neuropsychological deficits in healthy controls, patients with MCI and patients with mild AD (n = 485) derived from a memory clinic. To reduce the number of neuropsychological variables, a factor analysis with varimax rotation was calculated. In a second step, diagnostic groups including MCI subtypes were compared with respect to their clinical and neuropsychological characteristics including cognitive reserve. Results: Most MCI patients showed the amnestic multiple-domain subtype followed by the pure amnestic subtype, while the non-amnestic subtypes were rare. The amnestic subtype displayed a significantly higher level of cognitive reserve and higher MMSE scores than the amnestic multiple-domain subtype, which was in most cases characterized by additional psychomotor and executive deficits. Conclusions: These findings confirm earlier reports revealing that the amnestic multiple-domain subtype is the most frequent one and indicating that a high cognitive reserve may primarily prevent psychomotor and executive deficits in MCI.


2020 ◽  
Vol 17 (4) ◽  
pp. 373-381
Author(s):  
Wuhai Tao ◽  
Jinping Sun ◽  
Xin Li ◽  
Wen Shao ◽  
Jing Pei ◽  
...  

Background: Subjective Memory Impairment (SMI) may tremendously increase the risk of Alzheimer’s Disease (AD). The full understanding of the neuromechanism of SMI will shed light on the early intervention of AD. Methods: In the current study, 23 Healthy Controls (HC), 22 SMI subjects and 24 amnestic Mild Cognitive Impairment (aMCI) subjects underwent the comprehensive neuropsychological assessment and the resting-state functional magnetic resonance imaging scan. The difference in the connectivity of the Default Mode Network (DMN) and Functional Connectivity (FC) from the Region of Interest (ROI) to the whole brain were compared, respectively. Results: The results showed that HC and SMI subjects had significantly higher connectivity in the region of the precuneus area compared to aMCI subjects. However, from this region to the whole brain, SMI and aMCI subjects had significant FC decrease in the right anterior cingulum, left superior frontal and left medial superior frontal gyrus compared to HC. In addition, this FC change was significantly correlated with the cognitive function decline in participants. Conclusion: Our study indicated that SMI subjects had relatively intact DMN connectivity but impaired FC between the anterior and posterior brain. The findings suggest that long-distance FC is more vulnerable than the short ones in the people with SMI.


Author(s):  
Ramshekhar N. Menon ◽  
Feba Varghese ◽  
Avanthi Paplikar ◽  
Shailaja Mekala ◽  
Suvarna Alladi ◽  
...  

<b><i>Background/Aims:</i></b> In a linguistically diverse country such as India, challenges remain with regard to diagnosis of early cognitive decline among the elderly, with no prior attempts made to simultaneously validate a comprehensive battery of tests across domains in multiple languages. This study aimed to determine the utility of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB) in the diagnosis of mild cognitive impairment (MCI) and its vascular subtype (VaMCI) in 5 Indian languages. <b><i>Methods:</i></b> Literate subjects from 5 centers across the country were recruited using a uniform process, and all subjects were classified based on clinical evaluations and a gold standard test protocol into normal cognition, MCI, and VaMCI. Following adaptation and harmonization of the ICMR-NCTB across 5 different Indian languages into a composite Z score, its test performance against standards, including sensitivity and specificity of the instrument as well as of its subcomponents in diagnosis of MCI, was evaluated in age and education unmatched and matched groups. <b><i>Results:</i></b> Variability in sensitivity-specificity estimates was noted between languages when a total of 991 controls and 205 patients with MCI (157 MCI and 48 VaMCI) were compared due to a significant impact of age, education, and language. Data from a total of 506 controls, 144 patients with MCI, and 46 patients with VaMCI who were age- and education-matched were compared. Post hoc analysis after correction for multiple comparisons revealed better performance in controls relative to all-cause MCI. An optimum composite Z-score of −0.541 achieved a sensitivity of 81.1% and a specificity of 88.8% for diagnosis of all-cause MCI, with a high specificity for diagnosis of VaMCI. Using combinations of multiple-domain 2 test subcomponents retained a sensitivity and specificity of &#x3e;80% for diagnosis of MCI. <b><i>Conclusions:</i></b> The ICMR-NCTB is a “first of its kind” approach at harmonizing neuropsychological tests across 5 Indian languages for the diagnosis of MCI due to vascular and other etiologies. Utilizing multiple-domain subcomponents also retains the validity of this instrument, making it a valuable tool in MCI research in multilingual settings.


2021 ◽  
pp. 1-10
Author(s):  
T. Saari ◽  
E. E. Smith ◽  
Z. Ismail

ABSTRACT Objectives: To investigate conditional dependence relationships of impulse dyscontrol symptoms in mild cognitive impairment (MCI) and subjective cognitive decline (SCD). Design: A prospective, observational study. Participants: Two hundred and thirty-five patients with MCI (n = 159) or SCD (n = 76) from the Prospective Study for Persons with Memory Symptoms dataset. Measurements: Items of the Mild Behavioral Impairment Checklist impulse dyscontrol subscale. Results: Stubbornness/rigidity, agitation/aggressiveness, and argumentativeness were frequent and the most central symptoms in the network. Impulsivity, the fourth most central symptom in the network, served as the bridge between these common symptoms and less central and rare symptoms. Conclusions: Impulse dyscontrol in at-risk states for dementia is characterized by closely connected symptoms of irritability, agitation, and rigidity. Compulsions and difficulties in regulating rewarding behaviors are relatively isolated symptoms.


Medicine ◽  
2020 ◽  
Vol 99 (31) ◽  
pp. e20105 ◽  
Author(s):  
Xiang-Lian Zhou ◽  
Li-Na Wang ◽  
Jie Wang ◽  
Ling Zhou ◽  
Xin-Hua Shen

NeuroImage ◽  
2007 ◽  
Vol 36 (2) ◽  
pp. 289-297 ◽  
Author(s):  
Sang Won Seo ◽  
Kiho Im ◽  
Jong-Min Lee ◽  
Yun-Hee Kim ◽  
Sung Tae Kim ◽  
...  

2006 ◽  
Vol 21 (5-6) ◽  
pp. 284-290 ◽  
Author(s):  
F. Ribeiro ◽  
A. de Mendonça ◽  
M. Guerreiro

2012 ◽  
Vol 31 (1) ◽  
pp. 101-111 ◽  
Author(s):  
Yanyong Liu ◽  
Haji Akber Aisa ◽  
Chao Ji ◽  
Nan Yang ◽  
Haibo Zhu ◽  
...  

Aging-associated cognitive impairment is an important health care issue since individuals with mild cognitive impairment are more likely to develop Alzheimer’s disease. In the present study, the protective effect of Gossypium herbaceam extracts (GHE) on learning and memory impairment associated with aging were examined in vivo using Morris water maze and step through task. Furthermore, the antioxidant activity and neuroprotective effect of GHE was investigated with methods of histochemistry and biochemistry. These data showed that oral administration with GHE at the doses of 35, 70, and 140 mg/kg exerted an improved effect on the learning and memory impairment in aged rats. Subsequently, GHE afforded a beneficial action on eradication of free radicals without influence on the activity of glutathione peroxidase and superoxide dismutase. GHE treatment enhanced the expression levels of nerve growth factor. Meanwhile, proliferation of neural progenitor cells was elevated in hippocampus after treatment with GHE. Taken together, neurogenic niche improvement could be involved in the mechanism underlying neuroprotection of GHE against aging-associated cognitive impairment. These findings suggested that GHE might be a potential agent as cognitive-enhancing drugs that delay or halt mild cognitive impairment progression to Alzheimer’s disease or treatment of aging-associated cognitive impairment.


Sign in / Sign up

Export Citation Format

Share Document