Discriminability of Mild Cognitive Impairment Subtypes Based on Neuropsychological Test Outcomes from a Memory Clinic in Puerto Rico

Abstract Objective The aim of the study was to research test outcomes in Dementia Rating Scale-2 (DRS-2; Spanish adapted version), Montreal Cognitive Assessment (MoCA), Mini Mental Status Exam (MMSE), and Geriatric Depression Scale short form (GDS-SF), as predictors of the different Mild Cognitive Impairment (MCI) subtypes. Participants and Method Our sample constituted of 169 total participants (113 females and 56 males), with ages ranging from 44 to 88 (M = 68.20, SD = 9.59). Educational level presented by sample included 67.5% with professional degrees, 21.9% with a high school diploma, and 10.1% with less than a high school education. We conducted hierarchical logistic regression analysis to generate predicted probabilities of the cognitive tests’ total scores in identifying MCI subtypes. We tested four individual models- each utilized a different MCI subtype (amnestic MCI, single; amnestic MCI, multiple; non-amnestic MCI, single; non-amnestic MCI, multiple) as the dependent variable. The MoCA, DRS-2, MMSE, and the GDS-SF total scores were used as predictors in each analysis. Results We found statistical significance in our four regression models: χ2(1) = 46.26, p < .05 for the model with amnestic MCI, multiple; χ2 (1) = 17.62, p < .05 for the model with amnestic MCI, single; χ2(1) = 15.35, p < .05 for the model with non-amnestic MCI, multiple; and χ2(1) = 18.74, p < .05 for the model with non-amnestic MCI, single. Conclusions Overall, the results in this study suggest that the DRS-2 and the MoCA, two relatively brief and comprehensive screening instruments, are able to discriminate between individuals with varying forms of cognitive impairment. Participants in the amnestic subtypes of MCI performed significantly lower on both of these tests. Our results also suggest that MMSE better discriminates for non-amnestic subtypes. Finally, the GDS-SF suggests better discriminability between memory related cognitive impairment and emotionally related cognitive impairment.

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Self-Awareness for Memory Impairment in Amnestic Mild Cognitive Impairment: A Longitudinal Study

American Journal of Alzheimer s Disease & Other Dementias® ◽

10.1177/1533317517725812 ◽

2017 ◽

Vol 32 (7) ◽

pp. 401-407 ◽

Cited By ~ 3

Author(s):

Ilaria Cova ◽

Giulia Grande ◽

Valentina Cucumo ◽

Roberta Ghiretti ◽

Laura Maggiore ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Sex Education ◽

Memory Impairment ◽

Rating Scale ◽

Cox Regression ◽

Depression Scale ◽

Severity Index ◽

Amnestic Mild Cognitive Impairment ◽

Amnestic Mci

Aim: To assess memory impairment insight as a predictor of dementia and Alzheimer’s disease (AD) in amnestic mild cognitive impairment (MCI). Methods: To verify whether the awareness of memory impairment assessed by Geriatric Depression Scale (GDS) was associated with the risk of progression to dementia and AD in a cohort of MCI, we used a Cox regression model adjusted for age, sex, education, subtypes of amnestic MCI, Mini-Mental State Examination, Cumulative Illness Rating Scale severity index, and apolipoprotein E genotype. Results: During a follow-up of 27.7 (20.8) months, 205 (63.3%) of 324 patients with amnestic MCI progressed to dementia, including 141 to AD. No association was found in the unadjusted, partially adjusted (for sociodemographic variables), and fully adjusted multivariate Cox analysis between the awareness of memory impairment and the progression to dementia and AD. Discussion: Awareness or anosognosia of memory deficits, identified by GDS, is not useful to predict progression to dementia of patients with amnestic MCI.

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Memory specificity training can improve working and prospective memory in amnestic mild cognitive impairment

Dementia & Neuropsychologia ◽

10.1590/1980-57642016dn11-030007 ◽

2017 ◽

Vol 11 (3) ◽

pp. 255-261 ◽

Cited By ~ 3

Author(s):

Golita Emsaki ◽

Hamid Taher NeshatDoost ◽

Mahgol Tavakoli ◽

Majid Barekatain

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Prospective Memory ◽

Brain Plasticity ◽

Depression Scale ◽

Cognitive Intervention ◽

Amnestic Mild Cognitive Impairment ◽

Control Group ◽

Memory Specificity ◽

Amnestic Mci

ABSTRACT Amnestic Mild Cognitive Impairment (MCI) is one of the cognitive profiles of aging. OBJECTIVE: In this study, Memory Specificity Training (MEST) was used as cognitive training in patients with amnestic MCI to understand the effectiveness of the intervention on memory dimensions. METHODS: Twenty patients that met the criteria for amnestic MCI were selected and randomly assigned to experimental (n=10) or control (n=10) groups. The experimental group received five sessions of training on memory specificity while the participants in the control group took part in two general placebo sessions. Participants were assessed before, immediately after, and three months after, the treatment using the Autobiographical Memory Test, the Prospective and Retrospective Memory Questionnaire, the Wechsler Memory Scale, and the Hospital Anxiety and Depression Scale. Analysis of variance was used to analyze the data. RESULTS: Results from both post-test and follow-up treatment indicated that MEST improves working and prospective memory (p<0.05). CONCLUSION: These findings support the effectiveness of MEST for MCI patients as a viable cognitive intervention. Also, the findings have implications for the role of brain plasticity in the effectiveness of this intervention.

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Usefulness of Orientation to the Year as an Aid to Case Finding of Mild Cognitive Impairment or Depression in Community-Dwelling Older Adults

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158096 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8096

Author(s):

Hanhee Bae ◽

Sunyoung Kim ◽

Byungsung Kim ◽

Miji Kim ◽

Jisoo Yang ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Short Form ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Case Finding ◽

Community Dwelling ◽

Cross Sectional

Mild cognitive impairment (MCI) and depression are common and frequently misdiagnosed in older adults in primary care. In particular, depression combined with cognitive dysfunction is associated with a higher risk of dementia. We tried to find the usefulness of orientation to time as an easy case-finding tool for suspecting MCI or depression. This cross-sectional study included 2668 community-dwelling adults aged 70–84 years from the Korean Frailty and Aging Cohort Study (mean age of 76.0 ± 3.9 years). MCI was defined based on the criteria from the National Institute on Aging and the Alzheimer’s Association; depression was defined as a score of ≥ 6 on the Geriatric Depression Scale—Short Form (GDS-SF). Time orientation to year, month, day of the week, date, and season were tested. The sensitivity for the diagnosis of each of MCI and depression was the highest for the orientation to year (MCI, 17.7%; depression, 16.0%). For the diagnosis of MCI or depression, orientation to the year had the highest sensitivity (15.5%), and the specificity, PPV, NPV was 95.5%, 67.0%, 65.5%. In conclusion, asking “what year is it?” can be helpful as an aid to case finding to suspect MCI or depression in community and primary care settings.

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CLINICAL AND DEMOGRAPHIC PREDICTORS OF MILD COGNITIVE IMPAIRMENT - CROSS-SECTIONAL STUDY

Wiadomości Lekarskie ◽

10.36740/wlek201909201 ◽

2019 ◽

Vol 72 (9) ◽

pp. 1715-1722

Author(s):

Anna Rajtar-Zembaty ◽

Andrzej Sałakowski ◽

Jakub Rajtar-Zembaty ◽

Katarzyna Olszewska ◽

Roksana Epa ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Functioning ◽

Short Form ◽

Digit Span ◽

Verbal Learning ◽

Depression Scale ◽

Effective Prevention ◽

Level Of Education ◽

Demographic Predictors

Introduction: Cognitive limitations are a serious health and social problem, which concerns elderly people. Effective prevention and treatment of cognitive dysfunction is one of the challenges of modern medicine. There is not enough consistent data in the literature to indicate to indicate the relationship between various clinical and demographic factors with cognitive functioning in different age ranges. The aim: To analyze clinical and demographic predictors of mild cognitive impairment by age group. Material and methods: The analysis included 817 participants (669 with normal cognitive function and 148 people with MCI). The evaluation of the level of depressive symptoms was measured by the Short Form Geriatric Depression Scale. All participants were screened for cognitive functioning using the Mini-Mental State Examination and Addenbrooke’s Cognitive Examination-III. Different cognitive domains were evaluated with different neuropsychological tools: the Rey Auditory Verbal Learning test, Clock Drawing test, Verbal Fluency test, Digit Span Test and Trail Making test. Results: It has been shown that independently associated with MCI ware age (OR = 1.09, 95% CI: 1.05-1.13) and level of education (OR = 0.75, 95% CI: 0.69-0.81). Depending on the age, it turned out that in the younger MCI group, age, education and depression were significant, and the age and level of education were significant in the older MCI group. Conclusions: The identification of cognitive dysfunctions is an important element of the diagnostic and therapeutic process.

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Beyond the “C” in MCI: Noncognitive Symptoms in Amnestic and Non-amnestic Mild Cognitive Impairment

CNS Spectrums ◽

10.1017/s1092852900016175 ◽

2008 ◽

Vol 13 (1) ◽

pp. 66-72 ◽

Cited By ~ 35

Author(s):

James M. Ellison ◽

David G. Harper ◽

Yossi Berlow ◽

Lauren Zeranski

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Geriatric Depression Scale ◽

Depression Scale ◽

Behavioral Symptoms ◽

Geriatric Depression ◽

Memory Clinic ◽

Amnestic Mci ◽

Treatment Of Depression ◽

Noncognitive Symptoms

ABSTRACTIntroduction:How frequent and how clinically important are mood and behavioral symptoms among older adults with mild cognitive impairment (MCI)? Although these noncognitive behavioral symptoms (NCBS) are not represented in the diagnostic criteria for MCI, their clinical significance is increasingly recognized.Methods:To address this question, the authors identified a cohort of consecutively evaluated patients from a psychiatric hospital's outpatient memory clinic. These patients' records contained both a clinical assessment and a standardized set of evaluations including the Mini-Mental State Exam, the Neuropsychiatric Inventory (NPI), and the Geriatric Depression Scale. Using a standardized chart-review approach, the presence of any NPI-screened symptom was identified and the frequencies of specific NPI-screened symptoms were calculated for the Memory Clinic MCI cohort and for amnestic and non-amnestic MCI subgroups.Results:A total of 116 patient records were reviewed. Thirty-eight patients with MCI were identified. Twenty-two of these met criteria for amnestic MCI by Mayo Clinic criteria while 16 met criteria for non-amnestic MCI. At least one NPI-screened mood or behavioral symptom was present in 86.8% of these MCI patients. Depression/dysphoria (63.3%), apathy (60.5%), anxiety (47.4%), irritability (44.7%), and nighttime behaviors (42.1%) were the most frequent. While depression/dysphoria was distributed similarly between amnestic and non-amnestic subgroups, apathy was significantly more frequently associated with the amnestic subtype of MCI, and nighttime behaviors were more frequently associated with the non-amnestic subtype.Conclusion:Although the presence of NCBS is not required for a diagnosis of MCI, these symptoms are frequently present and constitute an important source of morbidity. Apathy and depression may be difficult to differentiate, but targeted treatment of depression may fail to address apathy. Recognizing the limitations of this preliminary study, the authors suggest that apathy may be more characteristic of amnestic MCI while nighttime behaviors may be more characteristic of non-amnestic MCI.

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Amnestic mild cognitive impairment: Diagnostic outcomes and clinical prediction over a two-year time period

Journal of the International Neuropsychological Society ◽

10.1017/s1355617706060267 ◽

2006 ◽

Vol 12 (2) ◽

pp. 166-175 ◽

Cited By ~ 66

Author(s):

H. RANDALL GRIFFITH ◽

KELLI L. NETSON ◽

LINDY E. HARRELL ◽

EDWARD Y. ZAMRINI ◽

JOHN C. BROCKINGTON ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Test Data ◽

Rating Scale ◽

Function Analysis ◽

Neuropsychological Test ◽

Amnestic Mild Cognitive Impairment ◽

Prognostic Information ◽

Wechsler Memory Scale ◽

Time Period

Amnestic mild cognitive impairment (MCI) has been defined as a precursor to Alzheimer's disease (AD), although it is sometimes difficult to identify which persons with MCI will eventually convert to AD. We sought to predict MCI conversion to AD over a two-year follow-up period using baseline demographic and neuropsychological test data from 49 MCI patients. Using a stepwise discriminant function analysis with Dementia Rating Scale (DRS) Initiation/Perseveration and Wechsler Memory Scale, third edition (WMS-III) Visual Reproduction Percent Retention scores, we correctly classified 85.7% of the sample as either AD converters or MCI nonconverters, with 76.9% sensitivity and 88.9% specificity. Adding race, the presence of vascular risk factors, or cholinesterase inhibitor use to the analysis did not greatly change the classification rates obtained with neuropsychological test data. Examining neuropsychological test cutoff scores revealed that DRS Initiation/Perseveration scores below 37 and Visual Reproduction Percent Retention scores below 26% correctly identified AD converters with 76.9% sensitivity and 91.7% specificity. These results demonstrate that commonly administered neuropsychological tests identify persons with MCI at baseline who are at risk for conversion to AD within 1–2 years. Such methods could aid in identifying MCI patients who might benefit from early treatment, in providing prognostic information to patients, and identifying potential clinical trial participants. (JINS, 2006,12, 166–175.)

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Elucidating the risk factors for progression from amyloid-negative amnestic mild cognitive impairment to dementia

Current Alzheimer Research ◽

10.2174/1567205017666201130094259 ◽

2020 ◽

Vol 17 ◽

Author(s):

Hyung-Ji Kim ◽

Jae-Hong Lee ◽

E-nae Cheong ◽

Sung-Eun Chung ◽

Sungyang Jo ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Amnestic Mild Cognitive Impairment ◽

Amyloid Pet ◽

Clinical Progression ◽

Amnestic Mci

Background: Amyloid PET allows for the assessment of amyloid β status in the brain, distinguishing true Alzheimer’s disease from Alzheimer’s disease-mimicking conditions. Around 15–20% of patients with clinically probable Alzheimer’s disease have been found to have no significant Alzheimer’s pathology on amyloid PET. However, a limited number of studies had been conducted this subpopulation in terms of clinical progression. Objective: We investigated the risk factors that could affect the progression to dementia in patients with amyloid-negative amnestic mild cognitive impairment (MCI). Methods: This study was a single-institutional, retrospective cohort study of patients over the age of 50 with amyloidnegative amnestic MCI who visited the memory clinic of Asan Medical Center with a follow-up period of more than 36 months. All participants underwent brain magnetic resonance imaging (MRI), detailed neuropsychological testing, and fluorine-18[F18]-florbetaben amyloid PET. Results: During the follow-up period, 39 of 107 patients progressed to dementia from amnestic MCI. In comparison with the stationary group, the progressed group had a more severe impairment in verbal and visual episodic memory function and hippocampal atrophy, which showed an Alzheimer’s disease-like pattern despite the lack of evidence for significant Alzheimer’s disease pathology. Voxel-based morphometric MRI analysis revealed that the progressed group had a reduced gray matter volume in the bilateral cerebellar cortices, right temporal cortex, and bilateral insular cortices. Conclusion: Considering the lack of evidence of amyloid pathology, clinical progression of these subpopulation may be caused by other neuropathologies such as TDP-43, abnormal tau or alpha synuclein that lead to neurodegeneration independent of amyloid-driven pathway. Further prospective studies incorporating biomarkers of Alzheimer’s diseasemimicking dementia are warranted.

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Donepezil for mild cognitive impairment in Parkinson’s disease

Scientific Reports ◽

10.1038/s41598-021-84243-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Kyoungwon Baik ◽

Seon Myeong Kim ◽

Jin Ho Jung ◽

Yang Hyun Lee ◽

Seok Jong Chung ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Treatment Group ◽

Outcome Measures ◽

Rating Scale ◽

Secondary Outcome ◽

Control Group ◽

Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

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Repetition Priming in Individuals with Amnestic Mild Cognitive Impairment and Alzheimer’s Dementia: a Systematic Review and Meta-Analysis

Neuropsychology Review ◽

10.1007/s11065-021-09504-5 ◽

2021 ◽

Author(s):

Liselotte De Wit ◽

Vitoria Piai ◽

Pilar Thangwaritorn ◽

Brynn Johnson ◽

Deirdre O’Shea ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Repetition Priming ◽

Meta Analysis ◽

Healthy Older Adults ◽

Amnestic Mci ◽

Standard Mean Difference ◽

Priming Paradigm

AbstractThe literature on repetition priming in Alzheimer’s disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.

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