Varying Strength of Cognitive Markers and Biomarkers to Predict Conversion and Cognitive Decline in an Early-Stage-Enriched Mild Cognitive Impairment Sample

2015 ◽  
Vol 44 (2) ◽  
pp. 625-633 ◽  
Author(s):  
Simone C. Egli ◽  
Daniela I. Hirni ◽  
Kirsten I. Taylor ◽  
Manfred Berres ◽  
Axel Regeniter ◽  
...  
Author(s):  
A.J. Sinclair ◽  
B. Vellas

The recent addition of the Diabetes and Cognitive Decline section to JPAD marks a milestone in the history of this progressive journal as it recognises the important contribution that Diabetes makes to the aetiology of both vascular and neurodegenerative dementia syndromes (1-3). It has been observed that diabetes in the presence of hypertension leads to a more pronounced cognitive decline (4) and that at an early stage of cognitive decline (mild cognitive impairment ( MCI)), diabetes accelerates the progression of MCI to dementia (5).


BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e028441
Author(s):  
Melanie Bayly ◽  
Debra Morgan ◽  
Julie Kosteniuk ◽  
Valerie Elliot ◽  
Amanda Froehlich Chow ◽  
...  

IntroductionCaregivers of persons with dementia and mild cognitive impairment (MCI) are at risk of decreased well-being. While many interventions for caregivers exist, evidence is sparse regarding intervention timing and effectiveness at an early stage of cognitive decline. Our systematic review aims to answer the following questions: (1) Do interventions for caregivers of persons with early stage dementia or MCI affect their well-being and ability to provide care? (2) Are particular types of caregiver interventions most effective during early stage cognitive decline? (3) How does effectiveness differ when early and later interventions are directly compared? (4) Do effects of early stage caregiver intervention vary based on care recipient and caregiver characteristics (eg, sex, type of dementia)?Methods and analysisThe databases MEDLINE, EMBASE, PSYCINFO and CINAHL, as well as grey literature databases, will be searched for English language studies using search terms related to caregiver interventions and dementia/MCI. Abstracts and full texts will be screened by two independent reviewers; included studies must assess the effects of an intervention for caregivers of persons with early stage dementia or MCI on caregiver well-being or ability to provide care. Intervention, study and participant characteristics will be extracted by two independent reviewers, along with outcome data. Risk of bias will be assessed using the Cochrane risk of bias tool (for controlled trials with and without randomisation). Interventions will be grouped by type (eg, psychoeducational) and a narrative synthesis is planned due to expected heterogeneity, but a meta-analysis will be performed where possible. The Grading of Recommendations, Assessment, Development and Evaluations approach will be used to inform conclusions regarding the quality of evidence for each type of intervention.Ethics and disseminationFindings from this review will be disseminated via conferences and peer-reviewed publication, and a summary will be provided to the Alzheimer Society.PROSPERO registration numberCRD42018114960.


2012 ◽  
Vol 25 (4) ◽  
pp. 597-606 ◽  
Author(s):  
Byoung Seok Ye ◽  
Sang Won Seo ◽  
Hanna Cho ◽  
Seong Yoon Kim ◽  
Jung-Sun Lee ◽  
...  

ABSTRACTBackground: Highly educated participants with normal cognition show lower incidence of Alzheimer's disease (AD) than poorly educated participants, whereas longitudinal studies involving AD have reported that higher education is associated with more rapid cognitive decline. We aimed to evaluate whether highly educated amnestic mild cognitive impairment (aMCI) participants show more rapid cognitive decline than those with lower levels of education.Methods: A total of 249 aMCI patients enrolled from 31 memory clinics using the standard assessment and diagnostic processes were followed with neuropsychological evaluation (duration 17.2 ± 8.8 months). According to baseline performances on memory tests, participants were divided into early-stage aMCI (−1.5 to −1.0 standard deviation (SD)) and late-stage aMCI (below −1.5 SD) groups. Risk of AD conversion and changes in neuropsychological performances according to the level of education were evaluated.Results: Sixty-two patients converted to AD over a mean follow-up of 1.43 years. The risk of AD conversion was higher in late-stage aMCI than early-stage aMCI. Cox proportional hazard models showed that aMCI participants, and late-stage aMCI participants in particular, with higher levels of education had a higher risk of AD conversion than those with lower levels of education. Late-stage aMCI participants with higher education showed faster cognitive decline in language, memory, and Clinical Dementia Rating Sum of Boxes (CDR-SOB) scores. On the contrary, early-stage aMCI participants with higher education showed slower cognitive decline in MMSE and CDR-SOB scores.Conclusions: Our findings suggest that the protective effects of education against cognitive decline remain in early-stage aMCI and disappear in late-stage aMCI.


Author(s):  
Xiaojun Liu ◽  
Xiao Yin ◽  
Anran Tan ◽  
Meikun He ◽  
Dongdong Jiang ◽  
...  

Mild cognitive impairment (MCI) is an early stage of Alzheimer’s disease or other forms of dementia that occurs mainly in older adults. The MCI phase could be considered as an observational period for the secondary prevention of dementia. This study aims to assess potential differences in the risk of MCI among different elderly groups in Wuhan, China, and to further identify the most vulnerable populations using logistic regression models. A total of 622 older adults participated in this study, and the prevalence of MCI was 34.1%. We found that individuals aged 80–84 (odds ratio, OR = 1.908, 95% confidence interval, 95% CI 1.026 to 3.549) or above (OR = 2.529, 95% CI 1.249 to 5.122), and those with two chronic diseases (OR = 1.982, 95% CI 1.153 to 3.407) or more (OR = 2.466, 95% CI 1.419 to 4.286) were more likely to be diagnosed with MCI. Those with high school degrees (OR = 0.451, 95% CI 0.230 to 0.883) or above (OR = 0.318, 95% CI 0.129 to 0.783) and those with a family per-capita monthly income of 3001–4500 yuan (OR = 0.320, 95% CI 0.137 to 0.750) or above (OR = 0.335, 95% CI 0.135 to 0.830) were less likely to experience MCI. The results also showed that those aged 80 or above were more likely to present with cognitive decline and/or reduced activities of daily living (ADL) function, with the odds ratios being 1.874 and 3.782, respectively. Individuals with two, or three or more chronic diseases were more likely to experience cognitive decline and/or reduced ADL function, with odds ratios of 2.423 and 2.631, respectively. Increased risk of suffering from either MCI and/or decline in ADL functioning is strongly positively associated with older age, lower educational levels, poorer family economic status, and multiple chronic diseases. Our findings highlight that the local, regional, and even national specific MCI-related health promotion measures and interventions must target these vulnerable populations.


2018 ◽  
Vol 15 (3) ◽  
pp. 219-228 ◽  
Author(s):  
Jiri Cerman ◽  
Ross Andel ◽  
Jan Laczo ◽  
Martin Vyhnalek ◽  
Zuzana Nedelska ◽  
...  

Background: Great effort has been put into developing simple and feasible tools capable to detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very early in AD and is detectable even in the stage of mild cognitive impairment (MCI). Objective: The aim was to describe the frequency of self-reported spatial navigation complaints in patients with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD dementia and to assess whether a simple questionnaire based on these complaints may be used to detect early AD. Method: In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination and were administered a questionnaire addressing spatial navigation complaints. Responses to the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints). Results: 55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia patients were more likely to express complaints than normal controls (p's<0.050) after adjusting for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41). Conclusion: Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and aMCI and can potentially be detected by a simple and inexpensive questionnaire.


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