Clinical and Dynamic Features and Prognostic Value of Non-Cognitive Psychopathological Symptoms in Mild Cognitive Impairment (MCI)

Background: high prevalence of pre-dementia cognitive disorders (in particular mild cognitive impairment, MCI) in older people, unfavorable predictive value of MCI with a high risk of conversion to dementia, lack of a unified view of facultative, noncognitive psychopathological symptoms (NPS) in its syndromic structure, their clinical heterogeneity, close relationships with mild cognitive impairment syndrome is actualized by the analysis of the mutual influence of the components of MCI syndromes.The aim: to investigate clinical and dynamic features and determine the prognostic value of non-cognitive psychopathological symptoms in MCI, including various psychopathological symptoms (affective, psychotic, behavioral disorders).Patients and methods: a comparative dynamic prospective selective observational study of 264 older patients with MCI was carried out. The main study group included 189 patients with NPS; compared group made up 75 cases with MCI represented only by cognitive impairments. Repeated clinical, psychopathological and psychometric assessments (MMSE, MoCa, NPI) were performed at 12 and 24 months. Results: differences were revealed in the structure and dynamics of cognitive indicators in patients with dominance of affective, psychotic or behavioral symptoms. Patients with affective symptoms showed low scores on subtests of line drawing, phonemic fluency, and ability to verbal categorization (p < 0.05). In these individuals, with repeated measurements, the indices of delayed reproduction, retention, abstract thinking were significantly reduced in comparison with the results of the rest of the study participants (p < 0.05). Patients with psychotic symptoms showed the lowest indices of delayed reproduction, spatial-visual, speech tests, false reproductions both at the initial assessment and in the dynamics of observation (p < 0.05). But their parameters of counting, attention, working memory, “recognition” are higher in them than in representatives of other psychopathological subgroups (p < 0.05). It was found that mild cognitive impairment without psychopathological inclusions has a lower tendency to transform into dementia over a two-year follow-up period than MCI, in the structure of which non-cognitive psychopathological symptoms are present.Conclusions: non-cognitive psychopathological symptoms of MCI are heterogeneous in terms of clinical and dynamic characteristics. The structure and dynamics of cognitive indicators is different in the affective, psychotic, behavioral subgroups of patients with MCI. Individuals with affective pathology had the highest rate of MCI conversion to dementia. In patients with MCI without neuropsychiatric symptoms, a favorable course of cognitive impairment was more common than in patients with MCI with non-cognitive psychopathological symptoms.

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Diagnostic and Prognostic Value of the Combination of Two Measures of Verbal Memory in Mild Cognitive Impairment due to Alzheimer’s Disease

Journal of Alzheimer s Disease ◽

10.3233/jad-170073 ◽

2017 ◽

Vol 58 (3) ◽

pp. 909-918 ◽

Cited By ~ 14

Author(s):

Isabel Sala ◽

Ignacio Illán-Gala ◽

Daniel Alcolea ◽

Ma Belén Sánchez-Saudinós ◽

Sergio Andrés Salgado ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Verbal Memory ◽

Prognostic Value ◽

Two Measures ◽

Diagnostic And Prognostic Value

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Prognostic Value of Posteromedial Cortex Deactivation in Mild Cognitive Impairment

PLoS ONE ◽

10.1371/journal.pone.0001104 ◽

2007 ◽

Vol 2 (10) ◽

pp. e1104 ◽

Cited By ~ 53

Author(s):

Jeffrey R. Petrella ◽

Steven E. Prince ◽

Lihong Wang ◽

Caroline Hellegers ◽

P. Murali Doraiswamy

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Prognostic Value

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Frequency and subgroups of neuropsychiatric symptoms in mild cognitive impairment and different stages of dementia in Alzheimer's disease

International Psychogeriatrics ◽

10.1017/s1041610217001879 ◽

2017 ◽

Vol 30 (1) ◽

pp. 103-113 ◽

Cited By ~ 20

Author(s):

N. Siafarikas ◽

G. Selbaek ◽

T. Fladby ◽

J. Šaltytė Benth ◽

E. Auning ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Factor Analysis ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Neuropsychiatric Symptoms ◽

Small Sample ◽

Psychotic Symptoms ◽

Cross Sectional

ABSTRACTBackground:Neuropsychiatric symptoms (NPS), such as depression, apathy, agitation, and psychotic symptoms are common in mild cognitive impairment (MCI) and dementia in Alzheimer's disease (AD). Subgroups of NPS have been reported. Yet the relationship of NPS and their subgroups to different stages of cognitive impairment is unclear. Most previous studies are based on small sample sizes and show conflicting results. We sought to examine the frequency of NPS and their subgroups in MCI and different stages of dementia in AD.Methods:This was a cross-sectional study using data from a Norwegian national registry of memory clinics. From a total sample of 4,571 patients, we included those with MCI or AD (MCI 817, mild AD 883, moderate–severe AD 441). To compare variables across groups ANOVA or χ2-test was applied. We used factor analysis of Neuropsychiatric Inventory Questionnaire (NPI-Q) items to identify subgroups of NPS.Results:The frequency of any NPS was 87.2% (AD 91.2%, MCI 79.5%; p < 0.001) and increased with increasing severity of cognitive decline. The most frequent NPS in MCI was depression. Apathy was the most frequent NPS in AD across different stages of severity. The factor analysis identified three subgroups in MCI and mild AD, and a fourth one in moderate–severe AD. We labelled the subgroups “depression,” “agitation,” “psychosis,” and “elation.”Conclusions:The frequency of NPS is high in MCI and AD and increases with the severity of cognitive decline. The subgroups of NPS were relatively consistent from MCI to moderate-severe AD. The subgroup elation appeared only in moderate-severe AD.

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Prevalence and prognostic value of CSF markers of Alzheimer's disease pathology in patients with subjective cognitive impairment or mild cognitive impairment in the DESCRIPA study: a prospective cohort study

The Lancet Neurology ◽

10.1016/s1474-4422(09)70139-5 ◽

2009 ◽

Vol 8 (7) ◽

pp. 619-627 ◽

Cited By ~ 342

Author(s):

Pieter Jelle Visser ◽

Frans Verhey ◽

Dirk L Knol ◽

Philip Scheltens ◽

Lars-Olof Wahlund ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cohort Study ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Prognostic Value ◽

Subjective Cognitive Impairment

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PAŽINTINIŲ GEBĖJIMŲ IR APOLIPOPROTEINO E Ɛ4 GENOTIPO SĄSAJOS: SISTEMINĖ APŽVALGA

Psichologija ◽

10.15388/psichol.2012.46.815 ◽

2012 ◽

Vol 46 ◽

pp. 123-134

Author(s):

Laura Sapranavičiūtė ◽

Abdonas Tamošiūnas

Keyword(s):

Risk Factor ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Alzheimer Disease ◽

Apolipoprotein E ◽

Longitudinal Studies ◽

Cognitive Functions ◽

Prognostic Value ◽

Healthy Adults ◽

Cognitively Impaired

Senėjimo problemos kontekste pažintinių gebėjimų prastėjimas tampa vis aktualesnė tema. Yra duomenų, kad APOE ɛ4 genotipas prognozuoja prastesnius pažintinius gebėjimus. Taigi, kyla poreikis išsiaiškinti, kurie pažintinių gebėjimų komponentai ir jų pokyčiai siejasi su APOE ɛ4 genotipu. Šio straipsnio tikslas – sisteminės analizės metodu apžvelgti mokslinius tyrimus, analizavusius pažintinių gebėjimų ir APOE ɛ4 genotipo sąsajas.Ankstesnių tyrimų rezultatai atskleidžia, kad turintieji APOE ɛ4 alelį pasižymi prastesniais pažintiniais gebėjimais, palyginti su asmenimis, neturinčiais APOE ɛ4. Dauguma tyrimų įrodo, kad APOE ɛ4 genotipas susijęs su prastesne atmintimi ir vykdomosios funkcijos rezultatais. Kiek rečiau aptinkami APOE ɛ4 ir dėmesio ryšiai. O verbaliniai ir samprotavimo gebėjimai su šio geno polimorfizmu dažniausiai nesiejami. Manoma, kad APOE ɛ4 genotipas gali turėti įtakos pažintinių gebėjimų prastėjimui, tačiau lieka neaiški šio geno polimorfizmo įtaka pažintinių gebėjimų prastėjimui, pasireiškus Alzheimerio ligai.Taigi, APOE ɛ4 genotipas gali būti rizikos veiksnys, susijęs tiek su natūraliu, tiek su patologiniu pažintinių gebėjimų prastėjimu. Tačiau tolesni APOE ɛ4 genotipo ir pažintinių gebėjimų sąsajų tyrimai yra būtimi.Pagrindiniai žodžiai: pažintiniai gebėjimai, APOE ɛ4 genotipas.ASSOCIATIONS BETWEEN COGNITIVE FUNCTIONS AND APOLIPOPROTEIN E Ɛ4 GENOTYPE: SYSTEMIC REVIEWLaura Sapranavičiūtė, Abdonas TamošiūnasSummaryDeterioration of cognitive functions is becoming more and more important issue in context of aging. So there is the growing interest in studies looking for the risk factors of deterioration of cognitive functions. Apolipoprotein E is a plasma protein whose major function is lipids transportation. APOE ɛ4 allele of the Apolipoprotein E gene is known as a risk factor of Alzheimer disease. Previous researchers stated, that APOE ɛ4 also might be related to cognitive performance in normal aging. However results of previous studies are quit confusing: different studies established various associations between APOE ɛ4 and specific cognitive functions. Moreover, longitudinal studies failed to establish prognostic value of APOE ɛ4 genotype to different levels of cognitive functions deterioration. So the purpose of this study is to review prospective, observational, cohort studies that had researched association between APOE ɛ4 and cognitive functions using systematic analysis method.The weight of evidence suggests that APOE ɛ4 is associated with cognitive functions in healthy adults. APOE ɛ4 carriers are likely to have lower level of cognitive functions. Associations between specific cognitive functions and APOE ɛ4 genotype are quit confusing. The most consistent finding was a negative relationship between APOE ɛ4 genotype and performance of memory and executive functioning. Presence of APOE ɛ4 and attention test results was less likely to be associated. Reasoning and verbal abilities were mostly not connected to APOE ɛ4 genotype. Associations between APOE ɛ4 and cognitive function differ in the groups of healthy adults, adults with mild cognitive impairment or Alzheimer disease. There were established that APOE ɛ4 is associated with cognitive functions in cognitively impaired population. People with mild cognitive impairment or Alzheimer disease more often tended to be APOE ɛ4 carriers in comparison with people who are not cognitively impaired. Longitudinal studies revealed different links between APOE ɛ4 and cognitive functions. Although APOE ɛ4 might be a risk factor of deterioration of cognitive functions in healthy and impaired cognitive functions groups. Yet prognostic value of APOE ɛ4 in deterioration of cognitive functions in Alzheimer population is confusing.The current review suggests that APOE ɛ4 has an effect on cognitive functions. It might be a risk factor for deterioration of cognitive functions in healthy adults and cognitively impaired population. However further researches are needed to establish specific associations between APOE ɛ4 genotype and different cognitive functions in healthy adults and disease populations.Keywords: cognitive functions, APOE ɛ4 genotype.

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