Mild Cognitive Impairment and Driving Cessation: A 3-Year Longitudinal Study

2017 ◽  
Vol 44 (1-2) ◽  
pp. 63-70 ◽  
Author(s):  
Michael H. Connors ◽  
David Ames ◽  
Michael Woodward ◽  
Henry Brodaty
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Significant Proportion ◽  
Medication Use ◽  
Significant Morbidity ◽  
Dementia Diagnosis ◽  
Driving Cessation ◽  
Memory Clinics ◽  
And Function

Background/Aims: Driving cessation is associated with significant morbidity in older people. People with mild cognitive impairment (MCI) may be at particular risk of this. Very little research has examined driving in this population. Given this, we sought to identify predictors of driving cessation in people with MCI. Methods: One hundred and eighty-five people with MCI were recruited from 9 memory clinics around Australia. People with MCI and their carers reported their driving status and completed measures of cognition, function, neuropsychiatric symptoms, and medication use at regular intervals over a 3-year period. Results: Of the 144 people still driving at baseline, 50 (27.0%) stopped driving during the study. Older age, greater cognitive and functional impairment, and greater decline in cognition and function at 6 months predicted subsequent driving cessation. Twenty-nine of the 50 people (58%) who stopped driving were diagnosed with dementia during the study; all except one of whom ceased driving after their dementia diagnosis. Conclusion: A significant proportion of people diagnosed with MCI stop driving over the following 3 years. This cannot be entirely attributed to developing dementia. Easily assessable characteristics - such as age, cognition, and function - and changes in these measures over 6 months predict driving cessation.

Cerebrovascular and Neurodegenerative Pathologies in Long-Term Stable Mild Cognitive Impairment

2021 ◽  
pp. 1-15
Author(s):  
Manu J. Sharma ◽  
Brandy L. Callahan
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cerebral Amyloid Angiopathy ◽  
Neurofibrillary Tangles ◽  
Small Vessel Disease ◽  
Significant Proportion ◽  
Amyloid Angiopathy ◽  
Prodromal Phase ◽  
Cerebral Amyloid

Background: Mild cognitive impairment (MCI) is considered by some to be a prodromal phase of a progressive disease (i.e., neurodegeneration) resulting in dementia; however, a substantial portion of individuals (ranging from 5–30%) remain cognitively stable over the long term (sMCI). The etiology of sMCI is unclear but may be linked to cerebrovascular disease (CVD), as evidence from longitudinal studies suggest a significant proportion of individuals with vasculopathy remain stable over time. Objective: To quantify the presence of neurodegenerative and vascular pathologies in individuals with long-term (>5-year) sMCI, in a preliminary test of the hypothesis that CVD may be a contributor to non-degenerative cognitive impairment. We expect frequent vasculopathy at autopsy in sMCI relative to neurodegenerative disease, and relative to individuals who convert to dementia. Methods: In this retrospective study, using data from the National Alzheimer’s Coordinating Center, individuals with sMCI (n = 28) were compared to those with MCI who declined over a 5 to 9-year period (dMCI; n = 139) on measures of neurodegenerative pathology (i.e., Aβ plaques, neurofibrillary tangles, TDP-43, and cerebral amyloid angiopathy) and CVD (infarcts, lacunes, microinfarcts, hemorrhages, and microbleeds). Results: Alzheimer’s disease pathology (Aβ plaques, neurofibrillary tangles, and cerebral amyloid angiopathy) was significantly higher in the dMCI group than the sMCI group. Microinfarcts were the only vasculopathy associated with group membership; these were more frequent in sMCI. Conclusion: The most frequent neuropathology in this sample of long-term sMCI was microinfarcts, tentatively suggesting that silent small vessel disease may characterize non-worsening cognitive impairment.

Mild cognitive impairment in primary care: a clinical review

2018 ◽  
Vol 94 (1117) ◽  
pp. 647-652 ◽  
Author(s):  
Georges Assaf ◽  
Maria Tanielian
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Review ◽  
Primary Care Physicians ◽  
Early Recognition ◽  
Neuropsychiatric Symptoms ◽  
Evidenced Based

Dementia is projected to become a global health priority but often not diagnosed in its earlier preclinical stage which is mild cognitive impairment (MCI). MCI is generally referred as a transition state between normal cognition and Alzheimer’s disease. Primary care physicians play an important role in its early diagnosis and identification of patients most likely to progress to Alzheimer’s disease while offering evidenced-based interventions that may reverse or halt the progression to further cognitive impairment. The aim of this review is to introduce the concept of MCI in primary care through a case-based clinical review. We discuss the case of a patient with MCI and provide an evidence-based framework for assessment, early recognition and management of MCI while addressing associated risk factors, neuropsychiatric symptoms and prognosis.

Amyloid and tau imaging, neuronal losses and function in mild cognitive impairment

2008 ◽  
Vol 12 (S1) ◽  
pp. S61-S65 ◽  
Author(s):  
J. R. Barrio ◽  
V. Kepe ◽  
N. Satyamurthy ◽  
S. C. Huang ◽  
G. Small
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Tau Imaging ◽  
And Function

Paths to Alzheimer Prevention

2013 ◽  
Author(s):  
Margaret Lock
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Alzheimer Disease ◽  
Clinical Diagnosis ◽  
Increased Risk ◽  
Memory Clinics ◽  
Formal Recognition

This chapter looks at the adoption in the 1980s of the clinical diagnosis known as “mild cognitive impairment” (MCI). Formal recognition of MCI, the value of which continues to be debated in some circles, is the result of an exerted effort to systematically identify incipient Alzheimer disease (AD) in the clinic and is closely associated with the founding of specialist memory clinics. The chapter presents ethnographic findings of interviews with individuals who have been diagnosed with MCI. The move toward the prevention of AD represents a shift in which it is assumed that embodied risk can be made manifest in the form of biomarkers. This shift is to be accomplished by researching, standardizing, and gradually routinizing the use of several biomarkers believed to put individuals at increased risk for AD.

Depressive Neuropsychiatric Symptoms and Mild Cognitive Impairment as Part of the Diabetes Mellitus/Alzheimer's Disease Link

2021 ◽  
Author(s):  
Karla Aketzalli Hernández-Contreras ◽  
Jorge Antonio Martínez-Díaz ◽  
María Elena Hernández-Aguilar ◽  
Deissy Herrera-Covarrubias ◽  
Fausto Rojas-Durán ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms
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