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Sample records for cognitive impairment mci

  1. Mild Cognitive Impairment (MCI)

    Science.gov (United States)

    Mild cognitive impairment (MCI) Overview Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It ...

  2. Neuropathology of mild cognitive impairment (MCI)

    International Nuclear Information System (INIS)

    Murayama, Shigeo; Saito, Yuko

    2007-01-01

    Described are retrospective pathological studies on mild cognitive impairment (MCI) of brain specimens in the brain bank of authors' institute and current clinical studies of outpatients for screening of MCI based on those pathological findings. The study projects, aided by Ministry of Health, Labour and Welfare (MHLW) from 2003 and from 2007, have aimed to develop the optimal way for prophylaxis of dementia. In the former autopsy, about 10% of the elderly dead registered in the institute are found to have pathological changes of the clinical dementia rating 0.5, in whom the early Alzheimer disease (AD), Lewy body dementia, argentaffin granular disease and neurofibrillary tangle dominant disease are involved in a similar ratio to each other. Clinically, new patients with memory complaint are first screened by neurological tests involving CT, and then those with suspicious dementia undergo the second screening (2-day hospitalization) involving MRI with VSRAD (Voxel-based Specific Regional Analysis System for AD), ECD single photon emission computed tomography (SPECT) with eZis (easy Z-score imaging system), myocardial scintigraphy with homovanillic acid (HVA)/m-iodobenzylguanidine (MIBG), and if necessary, PET with fluorodeoxyglucose (FDG), PIB (Pittsburgh Compound B, an amyloid prove) and/or 11 C-CFT and 11 C-raclopride. Further, new patients with suspicious Parkinson disease undergo the screening (3-day) of various tests involving MRI with voxel-based morphometry and VSRAD, cerebral blood flow ECD SPECT with eZis and MIBG myocardial scintigraphy. It is concluded that AD is the most important subject in MCI and systemic diseases can also affect the cognitive ability as well. (R.T.)

  3. Designing for Mild Cognitive Impairment (MCI): A Design Anthropological Perspective.

    Science.gov (United States)

    Collier, Guy; Kayes, Nicola; Reay, Stephen; Bill, Amanda

    2017-01-01

    This paper will present a design anthropological perspective on an ongoing project called 'Living Well with Mild Cognitive Impairment (MCI)'. The project explores how people with MCI (and their families) manage and respond to changes in their memory and thinking. One of the primary aims of this project is to design an online resource that will support people to 'Live Well' within the context of possible cognitive decline. The resource was originally proposed to function as a kind of online community, where users could both share and learn about home-grown strategies for managing the cognitive changes associated with MCI in everyday life. Much of this project has been guided by the methodological approach of design anthropology, which encourages project researchers and stakeholders to critically examine underlying assumptions and conceptual frameworks, which in this case revolve around the disputed MCI category. In this paper we will provide some background to the Living Well project before highlighting a number of key insights attained from design anthropology.

  4. Awareness of deficits in mild cognitive impairment and Alzheimer's disease: do MCI patients have impaired insight

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...... heterogeneity in the clinical presentation of awareness. The results demonstrate that subjective memory problems should not be a mandatory prerequisite in suspected dementia or MCI, which makes reports from informants together with thorough clinical interview and observation central when assessing suspected...

  5. Cognitive profiles in Mild Cognitive Impairment (MCI patients associated with Parkinson′s disease and cognitive disorders

    Directory of Open Access Journals (Sweden)

    Michele Pistacchi

    2015-01-01

    Full Text Available Background: Mild cognitive impairment (MCI is rapidly becoming one of the most common clinical manifestations affecting the elderly and represents an heterogeneous clinical syndrome that can be ascribed to different etiologies; the construct of MCI in Parkinson′s disease (PD (MCI-PD is more recent but the range of deficits is still variable. Early recognition and accurate classification of MCI-PD could offer opportunities for novel therapeutic interventions to improve the natural pathologic course. Objective: To investigate the clinical phenotype of amnestic mild cognitive impairment (aMCI and in patients with PD and MCI (MCI-PD. Materials and Methods: Seventy-three patients with aMCI and in 38 patients with MCI-PD were enrolled. They all underwent Mini-mental State Examination (MMSE, the Rey auditory-verbal learning test and the immediate visual memory (IVM item of the Mental Deterioration Battery, the Rey auditory-verbal learning test included the Rey-immediate (Rey-I, and the delayed recall of the word list (Rey test deferred, Rey-D. The Geriatric Depression Scale (GDS was used for mood assessment. Results: The results of the Rey-I and Rey-D and of the IVM item showed statistically significant differences between the aMCI and the MCI-PD group. The mean Rey-I and Rey-D score was significantly lower as well as the IVM score was higher in patients with aMCI than in those with MCI-PD, aMCI patients showed greater impairment in long-term memory, whereas more aMCI than MCI-PD patients had preserved attention, computation, praxis, and conceptualization. Conclusions: Our findings demonstrate that the cognitive deficit profile is specific for each of the two disorders: Memory impairment was a typical feature in aMCI patients while MCI-PD patients suffered from executive functions and visuospatial attention deficits.

  6. The Test Your Memory for Mild Cognitive Impairment (TYM-MCI).

    Science.gov (United States)

    Brown, Jeremy M; Lansdall, Claire J; Wiggins, Julie; Dawson, Kate E; Hunter, Kristina; Rowe, James B; Parker, Richard A

    2017-12-01

    To validate a short cognitive test: the Test Your Memory for Mild Cognitive Impairment (TYM-MCI) in the diagnosis of patients with amnestic mild cognitive impairment or mild Alzheimer's disease (aMCI/AD). Two hundred and two patients with mild memory problems were recruited. All had 'passed' the Mini-Mental State Examination (MMSE). Patients completed the TYM-MCI, the Test Your Memory test (TYM), MMSE and revised Addenbrooke's Cognitive Examination (ACE-R), had a neurological examination, clinical diagnostics and multidisciplinary team review. As a single test, the TYM-MCI performed as well as the ACE-R in the distinction of patients with aMCI/AD from patients with subjective memory impairment with a sensitivity of 0.79 and specificity of 0.91. Used in combination with the ACE-R, it provided additional value and identified almost all cases of aMCI/AD. The TYM-MCI correctly classified most patients who had equivocal ACE-R scores. Integrated discriminant improvement analysis showed that the TYM-MCI added value to the conventional memory assessment. Patients initially diagnosed as unknown or with subjective memory impairment who were later rediagnosed with aMCI/AD scored poorly on their original TYM-MCI. The TYM-MCI is a powerful short cognitive test that examines verbal and visual recall and is a valuable addition to the assessment of patients with aMCI/AD. It is simple and cheap to administer and requires minimal staff time and training. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Predicting Stability of Mild Cognitive Impairment (MCI): Findings of a Community Based Sample

    NARCIS (Netherlands)

    Ellendt, S.; Vobeta, B.; Kohn, N.; Wagels, L.; Goerlich, K.S.; Drexler, E.; Schneider, F.; Habel, U.

    2017-01-01

    BACKGROUND: Mild Cognitive Impairment (MCI) is a risk factor for Alzheimer's disease (AD) and other forms of dementia. However, much heterogeneity concerning neuropsychological measures, prevalence and progression rates impedes distinct diagnosis and treatment implications. OBJECTIVE: Aim of the

  8. Reverters from PD-MCI to cognitively intact are at risk for future cognitive impairment: Analysis of the PPMI cohort.

    Science.gov (United States)

    Jones, Jacob D; Kuhn, Taylor P; Szymkowicz, Sarah M

    2018-02-01

    Past studies have shown that a large portion of individuals with Parkinson's disease (PD) and mild cognitive impairment (MCI) will revert to a cognitively intact (CI) status in the future. Aging studies have shown that individuals who revert from MCI to CI are at increased risk for reconverting to MCI or dementia in the future. The current study examined if individuals who revert from PD-mild cognitive impairment (PD-MCI) to CI will be at increased risk for future PD-MCI and Parkinson's disease dementia (PDD). The study utilized data from the Parkinson's Progression Markers Initiative (PPMI). The sample included 364 newly diagnosed PD participants who were followed annually for up to 4 years. Based on the first and second assessments, we identified individuals who were CI at each assessment (CI-Stable) and individuals who were PD-MCI at baseline but then reverted to CI (Reversion). Analyses examined if participants in the Reversion group were at greater risk, relative to the CI-Stable group, for cognitive impairment at future assessments. Participants in the Reversion group were at greater risk for future cognitive impairment (PD-MCI or PDD) at the 2nd, 3rd and 4th annual follow-up, relative to the CI-Stable group. The Reversion group continued to be at increased risk for future cognitive impairment when adjusting for age, gender, education, depressive symptoms, and motor severity. A large proportion of individuals with PD-MCI will not show evidence of cognitive impairment within a year. However, these "reverters" continue to be at risk for future development of cognitive impairment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Cognitive Impairment Questionnaire (CIMP-QUEST): reported topographic symptoms in MCI and dementia.

    Science.gov (United States)

    Astrand, R; Rolstad, S; Wallin, A

    2010-06-01

    The Cognitive Impairment Questionnaire (CIMP-QUEST) is an instrument based on information obtained by key informants to identify symptoms of dementia and dementia-like disorders. The questionnaire consists of three subscales reflecting impairment in parietal-temporal (PT), frontal (F) and subcortical (SC) brain regions. The questionnaire includes a memory scale and lists non-cognitive symptoms. The reliability and validity of the questionnaire were examined in 131 patients with mild cognitive impairment (MCI) or mild dementia at a university-based memory unit. Cronbach alpha for all subscales was calculated at r = 0.90. Factor analysis supported the tri-dimensionality of CIMP-QUEST's brain region-oriented construct. Test-retest reliability for a subgroup of cognitively stable MCI-patients (n = 25) was found to be r = 0.83 (P = 0.0005). The correlation between the score on the cognitive subscales (PT + F + M) and Informant Questionnaire on Cognitive Decline in the Elderly was r = 0.83 (P = 0.0005, n = 123). The memory subscale correlated significantly with episodic memory tests, the PT subscale with visuospatial and language-oriented tests, and the SC and F subscales with tests of attention, psychomotor tempo and executive function. CIMP-QUEST has high reliability and validity, and provides information about cognitive impairment and brain region-oriented symptomatology in patients with MCI and mild dementia.

  10. Cholinergic Enhancement of Brain Activation in Mild Cognitive Impairment (MCI during Episodic Memory Encoding

    Directory of Open Access Journals (Sweden)

    Shannon L Risacher

    2013-09-01

    Full Text Available Objective: To determine the physiological impact of treatment with donepezil (Aricept on neural circuitry supporting episodic memory encoding in patients with amnestic mild cognitive impairment (MCI using functional MRI (fMRI. Methods: 18 patients with MCI and 20 age-matched healthy controls (HC were scanned twice while performing an event-related verbal episodic encoding task. MCI participants were scanned before treatment and after approximately 3 months on donepezil; HC were untreated but rescanned at the same interval. Voxel-level analyses assessed treatment effects in activation profile relative to retest changes in non-treated HC. Changes in task-related connectivity in medial temporal circuitry were also evaluated, as were associations between brain activation pattern, task-related functional connectivity, task performance, and clinical measures of cognition.Results: At baseline, the MCI group showed reduced activation during encoding relative to HC in the right medial temporal lobe (MTL; hippocampal/parahippocampal and additional regions, as well as attenuated task-related deactivation, relative to rest, in a medial parietal lobe cluster. After treatment, the MCI group showed normalized MTL activation and improved parietal deactivation. These changes were associated with cognitive performance. After treatment, the MCI group also demonstrated increased task-related functional connectivity from the right MTL cluster seed region to a network of other sites including the basal nucleus/caudate and bilateral frontal lobes. Increased functional connectivity was associated with improved task performance.Conclusions: Pharmacologic enhancement of cholinergic function in amnestic MCI is associated with changes in brain activation pattern and functional connectivity during episodic memory processing which are in turn related to increased cognitive performance. fMRI is a promising biomarker for assessing treatment related changes in brain function.

  11. Advance prediction of mild cognitive impairment (MCI) using 99mTc-ECD SPECT brain blood flow imaging

    International Nuclear Information System (INIS)

    Kawasaki, Yohsuke

    2008-01-01

    Mild Cognitive Impairment (MCI) is considered as a precursor state of Alzheimer disease (AD). Single photon emission computed tomography (SPECT) brain blood flow imaging was investigated in MCI and it's relevance to the prognosis of MCI was evaluated in an attempt define the characteristics of brain blood flow imaging of MCI (amnestic MCI; aMCI) converting to AD. Ninety-two patients over 60 years old with amnesia were studied. 99m Tc-ethyl cysteinate dimer (ECD) SPECT brain blood flow examinations of the subject under drug-free conditions were conducted and imaging was analyzed according to the first clinical diagnosis. Patients given a diagnosis of MCI on the first clinical diagnosis, were examined again after 2 years and the SPECT imaging before 2 years previously was classified and analyzed. Of them, there were 35 MCI patients, converting of 13 AD patients (37.1%; aMCI), 10 MCI patients (28.6%; non-converter), 4 depression patients (11.4%; Depression type MCI (dMCI)), 1 Geriatric psychosis patient, but 7 patients dropped out. In the aMCI group, relative hypoperfusion was recognized in the posterior cingulate and the precuneus. In the dMCI group, relative hypoperfusion was recognized in the dorsolateral prefrontal cortex (DLPFC) and the anterior cingulate. In the non-converter group, relative hypoperfusion was recognized in the basal forebrain. The hypoperfusion of the precuneus in aMCI, and the hypoperfusion of the right frontal lobe (DLPFC, dorsal-anterior cingulate) in dMCI were characteristic brain blood-flow abnormalities. We believe 99m Tc-ECD SPECT brain blood flow imaging to be useful in the diagnosis of aMCI and in the early detection of depression. (author)

  12. Self-administered Gerocognitive Examination (SAGE): a brief cognitive assessment Instrument for mild cognitive impairment (MCI) and early dementia.

    Science.gov (United States)

    Scharre, Douglas W; Chang, Shu-Ing; Murden, Robert A; Lamb, James; Beversdorf, David Q; Kataki, Maria; Nagaraja, Haikady N; Bornstein, Robert A

    2010-01-01

    To develop a self-administered cognitive assessment instrument to facilitate the screening of mild cognitive impairment (MCI) and early dementia and determine its association with gold standard clinical assessments including neuropsychologic evaluation. Adults aged above 59 years with sufficient vision and English literacy were recruited from geriatric and memory disorder clinics, educational talks, independent living facilities, senior centers, and memory screens. After Self-administered Gerocognitive Examination (SAGE) screening, subjects were randomly selected to complete a clinical evaluation, neurologic examination, neuropsychologic battery, functional assessment, and mini-mental state examination (MMSE). Subjects were identified as dementia, MCI, or normal based on standard clinical criteria and neuropsychologic testing. Two hundred fifty-four participants took the SAGE screen and 63 subjects completed the extensive evaluation (21 normal, 21 MCI, and 21 dementia subjects). Spearman rank correlation between SAGE and neuropsychologic battery was 0.84 (0.76 for MMSE). SAGE receiver operating characteristics on the basis of clinical diagnosis showed 95% specificity (90% for MMSE) and 79% sensitivity (71% for MMSE) in detecting those with cognitive impairment from normal subjects. This study suggests that SAGE is a reliable instrument for detecting cognitive impairment and compares favorably with the MMSE. The self-administered feature may promote cognitive testing by busy clinicians prompting earlier diagnosis and treatment.

  13. Differences in the use of everyday technology among persons with MCI, SCI and older adults without known cognitive impairment.

    Science.gov (United States)

    Malinowsky, Camilla; Kottorp, Anders; Wallin, Anders; Nordlund, Arto; Björklund, Eva; Melin, Ilse; Pernevik, Anette; Rosenberg, Lena; Nygård, Louise

    2017-07-01

    To use valid subjective reports sensible to cognitive decline is vital to identify very early signs of dementia development. Use of everyday technology (ET) has been shown to be sensitive to differentiate adults with mild cognitive impairment (MCI) from controls, but the group with subjective cognitive impairment (SCI) has not yet been examined. This study aims to investigate and compare self-perceived ability in ET use and number of ETs reported as actually used in a sample of older adults with SCI, MCI, and older adults with no known cognitive impairment, i.e. Older adults with MCI (n = 29), SCI ( n = 26), and controls (n = 30) were interviewed with the short version of the Everyday Technology Use Questionnaire (S-ETUQ) to capture self-perceived ability in ET use and number of ETs used. To generate individual measures of ability to use ET, Rasch analysis was used. The measures were then compared group-wise using ANCOVA. The numbers of ETs used were compared group-wise with ANOVA. Controls versus SCI and MCI differed significantly regarding ETs reported as used, but not SCI versus MCI. Similarly, in ability to use ET, controls versus SCI and MCI differed significantly but not SCI versus MCI. The significantly lower numbers of ETs reported as actually used and the lower ability in SCI and MCI groups compared to controls suggest that ET use is affected already in very minor cognitive decline. This indicates that self-reported ET use based on the S-ETUQ is sensitive to detect changes already in SCI.

  14. Self-awareness of cognitive efficiency: Differences between healthy elderly and patients with mild cognitive impairment (MCI).

    Science.gov (United States)

    Fragkiadaki, Stella; Kontaxopoulou, Dionysia; Beratis, Ion N; Andronas, Nikolaos; Economou, Alexandra; Yannis, George; Papanicolaou, Andrew; Papageorgiou, Sokratis G

    2016-12-01

    Self-estimation of performance implies the ability to understand one's own performance with relatively objective terms. Up to date, few studies have addressed this topic in mild cognitive impairment (MCI) patients. The aim of the present study was to compare objective measures of performance with subjective perception of specific performance on cognitive tests and investigate differences in assessment between MCI patients and healthy elderly. Thirty-five participants diagnosed with MCI (women = 16, men = 19, mean age = 65.09 years ±SD = 7.81, mean education = 12.83 years ±SD = 4.32) and 35 control subjects similar in terms of age and education (women = 20, men = 15, mean age = 62.46 years ± SD = 9.35, mean education = 14.26 ± SD = 2.84) were examined with an extended battery of neuropsychological tests. After every test they were asked to self-evaluate their performance by comparing it to what they considered as average for people of their age and educational level. This self-evaluation was reported on a scale ranging from -100 to +100. Significant differences were found in the self-assessment patterns of the two groups in memory measures of verbal and visual delayed recall, visuospatial perception, and tests of attention. MCI patients overestimated their performance on every cognitive domain while control participants underestimated their performance on measures of verbal memory. The present results indicate that accuracy of self-report is not uniform across groups and functional areas. The discrepancies in the MCI patients indicate unawareness of their memory deficits, which is contradictory to subjective memory complaints as being an important component for clinical diagnosis.

  15. Coherence and phase synchrony analyses of EEG signals in Mild Cognitive Impairment (MCI): A study of functional brain connectivity

    Science.gov (United States)

    Handayani, Nita; Haryanto, Freddy; Khotimah, Siti Nurul; Arif, Idam; Taruno, Warsito Purwo

    2018-03-01

    This paper presents an EEG study for coherence and phase synchrony in mild cognitive impairment (MCI) subjects. MCI is characterized by cognitive decline, which is an early stage of Alzheimer's disease (AD). AD is a neurodegenerative disorder with symptoms such as memory loss and cognitive impairment. EEG coherence is a statistical measure of correlation between signals from electrodes spatially separated on the scalp. The magnitude of phase synchrony is expressed in the phase locking value (PLV), a statistical measure of neuronal connectivity in the human brain. Brain signals were recorded using an Emotiv Epoc 14-channel wireless EEG at a sampling frequency of 128 Hz. In this study, we used 22 elderly subjects consisted of 10 MCI subjects and 12 healthy subjects as control group. The coherence between each electrode pair was measured for all frequency bands (delta, theta, alpha and beta). In the MCI subjects, the value of coherence and phase synchrony was generally lower than in the healthy subjects especially in the beta frequency. A decline of intrahemisphere coherence in the MCI subjects occurred in the left temporo-parietal-occipital region. The pattern of decline in MCI coherence is associated with decreased cholinergic connectivity along the path that connects the temporal, occipital, and parietal areas of the brain to the frontal area of the brain. EEG coherence and phase synchrony are able to distinguish persons who suffer AD in the early stages from healthy elderly subjects.

  16. Characterizing brain patterns in conversion from mild cognitive impairment (MCI) to Alzheimer's disease

    Science.gov (United States)

    Silva R., Santiago S.; Giraldo, Diana L.; Romero, Eduardo

    2017-11-01

    Structural Magnetic Resonance (MR) brain images should provide quantitative information about the stage and progression of Alzheimer's disease. However, the use of MRI is limited and practically reduced to corroborate a diagnosis already performed with neuropsychological tools. This paper presents an automated strategy for extraction of relevant anatomic patterns related with the conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) using T1-weighted MR images. The process starts by representing each of the possible classes with models generated from a linear combination of volumes. The difference between models allows us to establish which are the regions where relevant patterns might be located. The approach searches patterns in a space of brain sulci, herein approximated by the most representative gradients found in regions of interest defined by the difference between the linear models. This hypothesis is assessed by training a conventional SVM model with the found relevant patterns under a leave-one-out scheme. The resultant AUC was 0.86 for the group of women and 0.61 for the group of men.

  17. Memory deficits for facial identity in patients with amnestic mild cognitive impairment (MCI).

    Science.gov (United States)

    Savaskan, Egemen; Summermatter, Daniel; Schroeder, Clemens; Schächinger, Hartmut

    2018-01-01

    Faces are among the most relevant social stimuli revealing an encounter's identity and actual emotional state. Deficits in facial recognition may be an early sign of cognitive decline leading to social deficits. The main objective of the present study is to investigate if individuals with amnestic mild cognitive impairment show recognition deficits in facial identity. Thirty-seven individuals with amnestic mild cognitive impairment, multiple-domain (15 female; age: 75±8 yrs.) and forty-one healthy volunteers (24 female; age 71±6 yrs.) participated. All participants completed a human portrait memory test presenting unfamiliar faces with happy and angry emotional expressions. Five and thirty minutes later, old and new neutral faces were presented, and discrimination sensitivity (d') and response bias (C) were assessed as signal detection parameters of cued facial identity recognition. Memory performance was lower in amnestic mild cognitive impairment as compared to control subjects, mainly because of an altered response bias towards an increased false alarm rate (favoring false OLD ascription of NEW items). In both groups, memory performance declined between the early and later testing session, and was always better for acquired happy than angry faces. Facial identity memory is impaired in patients with amnestic mild cognitive impairment. Liberalization of the response bias may reflect a socially motivated compensatory mechanism maintaining an almost identical recognition hit rate of OLD faces in individuals with amnestic mild cognitive impairment.

  18. N-acetylaspartate, choline and myoinositol concentration changes in MR spectroscopy (1H MRS) of hippocampal formation in patients with mild cognitive impairment (MCI) - preliminary study

    International Nuclear Information System (INIS)

    Pawlowska, A.; Cwikla, J.; Walecki, J.; Gabryelewicz, T.; Barcikowska, M.

    2004-01-01

    Cognitive and memory impairment are very common problems in elderly patients. Mild cognitive impairment (MCI) is known as a transitional clinical state between normal ('successful') aging and dementia. In some cases MCI may be a precursor to Alzheimer's disease (AD). Early neuronal loss and metabolic changes have been documented in previous studies in AD patients in some 'strategic ' regions of the brain, mainly in hippocampal formation. Our goal was to determine whether there are statistically significant changes in hippocampal N-acetylaspartate, choline and myoinositol levels obtained by single-voxel spectroscopy in MCI patients and normal aging and to evaluate its clinical diagnostic utility. 30 patients with MCI and 15 cognitively normal elderly subjects underwent proton MR spectroscopy at 1.5 T system. MR spectra were obtained from anterior and posterior part of hippocampal formation bilaterally, using the point-resolved spectroscopy sequence. Metabolite ratios of NAA/H 2 O, Cho/H 2 O and mI/H 2 O were calculated from the peak height measurements. Relative to the control group, patients with MCI demonstrated elevated mI/H 2 O and Cho/H 2 O ratios in both hippocampal formations. The most significant increase was observed in mI/H 2 O ratio in anterior part of left hippocampus and in Cho/H 2 O ratio in posterior part of right hippocampus, in MCI patients vs.cognitively normal elderly. There were no significant differences between mean NAA/H 2 O ratios measured in hippocampal formation in both groups. Proton MRS may be used as valuable additional tool in the evaluation of regional metabolic changes in patients with MCI. Increase of mI and Cho levels in hippocampal formation may be an early sign of cognitive impairment in elderly subjects that can be measured using MRS. (author)

  19. Mild cognitive impairment (MCI) - the novel trend of targeting Alzheimer's disease in its early stages - methodological considerations.

    Science.gov (United States)

    Pater, C

    2011-11-01

    While much uncertainty exists in the estimates of the global burden of Alzheimer's disease and about the potential impact of various interventions, there is a widespread acceptance of the fact that the steady increase in the incidence and prevalence of the condition worldwide is becoming a massive public health problem as well as a huge economic burden for all healthcare systems and societies. These heavy demands are further compounded by the poor quality of life of the affected individuals, of their families and of their caregivers. The epidemic proportion of Alzheimer's disease has triggered relentless attempts for development of treatment approaches during the past two decades by a multitude of pharmaceuticals and biotech companies. Commercial development of the acetylcholinesterase inhibitors has, until recently, virtually dominated the field and, although efficacy has been demonstrated for five different products, the longterm clinical results suggested that alternate approaches were warranted. Disease modifying strategies targeting the β- amyloid plaques (e.g., decreasing β-amyloid formation through β- and γ-secretase inhibition, diminishing β-amyloid aggregation through anti-aggregants or enhancement of β-amyloid clearance through active/passive immunization), targeting the neurofibrillary tangles through inhibition of tau protein hyperphosphorilation or, more recently, by increasing mitochondrial permeability, all these potential treatment modalities are facing major methodological challenges during the conduct of a myriad of clinical trials meant to bring the novel therapies to the market. Failure of more than 400 products tested in more than 800 clinical trials to date, with many of these failures occurring in late stage development (phase III) have triggered a paradigm shift toward targeting of the early stages of cognitive deficiencies (mild cognitive impairment- MCI) and a refinement of the investigative methodologies. The great heterogeneity of

  20. Female patients dosimetry in brain exams with PET/CT scan for diagnosis of Mild Cognitive Impairment (MCI)

    International Nuclear Information System (INIS)

    Santana, P.C.; Mamede, M.; Carvalho, F.M.V.; Mourao, A.P.

    2013-01-01

    Dementia affects over 35 million people worldwide, with strong personal, social and financial impacts. Alzheimer's disease is the most common form of dementia, accounting for 60-70% of cases, affecting mostly females. Recent technological innovations, using methods of anatomical and functional neuroimaging, with particular emphasis on PET / CT (positron emission tomography with computed tomography associated), have shown excellent prospects for early diagnosis of Alzheimer's disease represented by Mild Cognitive Impairment (MCI). The use of PET / CT helps diagnosis, but the patients effective dose is higher and directly dependent on the radiopharmaceutical activity and the computed tomographic (CT) protocol used. The aim of this study was evaluated the organs absorbed doses and effective doses in 59 female patients undergoing the PET/CT diagnostic technique. For the measurements of radiation levels from the CT was used TLD100 (LiF:Mg, Ti) Rod detectors inserted in Alderson Randon ® anthropomorphic phantom, which simulates a female pattern, of 155 cm and weight 50 kg, subjected to the same clinical protocol of acquiring patients images. The effective dose resulting from the radiopharmaceutical injected activity was estimated by ICRP106 model using the weight of the patients undergoing to the procedure. The average effective dose due was (7.65 ± 2.22) mSv. The effective dose contribution to the brain and the thyroid due to CT were (2.21 ± 0.38) and (0.72 ± 0.14) mSv, respectively. The use of CT optimized protocols can assist in reducing the dose in this type of procedure. (author)

  1. Female patients dosimetry in brain exams with PET/CT scan for diagnosis of Mild Cognitive Impairment (MCI)

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    Santana, P.C.; Mamede, M.; Carvalho, F.M.V., E-mail: pridili@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil); Mourao, A.P., E-mail: apratabhz@gmail.com [Centro Federal de Educacao Tecnologica, Belo Horionte, MG (Brazil). Dept. de Engenharia Eletrica; Oliveira, P.M.C.; Silva, T.A. da, E-mail: pmco@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Dementia affects over 35 million people worldwide, with strong personal, social and financial impacts. Alzheimer's disease is the most common form of dementia, accounting for 60-70% of cases, affecting mostly females. Recent technological innovations, using methods of anatomical and functional neuroimaging, with particular emphasis on PET / CT (positron emission tomography with computed tomography associated), have shown excellent prospects for early diagnosis of Alzheimer's disease represented by Mild Cognitive Impairment (MCI). The use of PET / CT helps diagnosis, but the patients effective dose is higher and directly dependent on the radiopharmaceutical activity and the computed tomographic (CT) protocol used. The aim of this study was evaluated the organs absorbed doses and effective doses in 59 female patients undergoing the PET/CT diagnostic technique. For the measurements of radiation levels from the CT was used TLD100 (LiF:Mg, Ti) Rod detectors inserted in Alderson Randon ® anthropomorphic phantom, which simulates a female pattern, of 155 cm and weight 50 kg, subjected to the same clinical protocol of acquiring patients images. The effective dose resulting from the radiopharmaceutical injected activity was estimated by ICRP106 model using the weight of the patients undergoing to the procedure. The average effective dose due was (7.65 ± 2.22) mSv. The effective dose contribution to the brain and the thyroid due to CT were (2.21 ± 0.38) and (0.72 ± 0.14) mSv, respectively. The use of CT optimized protocols can assist in reducing the dose in this type of procedure. (author)

  2. The epidemiology of mild cognitive impairment (MCI and Alzheimer’s disease (AD in community-living seniors: protocol of the MemoVie cohort study, Luxembourg

    Directory of Open Access Journals (Sweden)

    Perquin Magali

    2012-07-01

    Full Text Available Abstract Background Cognitive impairment and Alzheimer’s disease (AD are increasingly considered a major public health problem. The MemoVie cohort study aims to investigate the living conditions or risk factors under which the normal cognitive capacities of the senior population in Luxembourg (≥ 65 year-old evolve (1 to mild cognitive impairment (MCI – transitory non-clinical stage – and (2 to AD. Identifying MCI and AD predictors undeniably constitutes a challenge in public health in that it would allow interventions which could protect or delay the occurrence of cognitive disorders in elderly people. In addition, the MemoVie study sets out to generate hitherto unavailable data, and a comprehensive view of the elderly population in the country. Methods/design The study has been designed with a view to highlighting the prevalence in Luxembourg of MCI and AD in the first step of the survey, conducted among participants selected from a random sample of the general population. A prospective cohort is consequently set up in the second step, and appropriate follow-up of the non-demented participants allows improving the knowledge of the preclinical stage of MCI. Case-control designs are used for cross-sectional or retrospective comparisons between outcomes and biological or clinical factors. To ensure maximal reliability of the information collected, we decided to opt for structured face to face interviews. Besides health status, medical and family history, demographic and socio-cultural information are explored, as well as education, habitat network, social behavior, leisure and physical activities. As multilingualism is expected to challenge the cognitive alterations associated with pathological ageing, it is additionally investigated. Data relative to motor function, including balance, walk, limits of stability, history of falls and accidents are further detailed. Finally, biological examinations, including ApoE genetic polymorphism are

  3. 18F PET with florbetapir for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI).

    Science.gov (United States)

    Martínez, Gabriel; Vernooij, Robin Wm; Fuentes Padilla, Paulina; Zamora, Javier; Bonfill Cosp, Xavier; Flicker, Leon

    2017-11-22

    18 F-florbetapir uptake by brain tissue measured by positron emission tomography (PET) is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using amyloid biomarkers tests like 18 F-florbetapir. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18 F-florbetapir to predict the progression from MCI to Alzheimer's disease dementia (ADD) or other dementias has not yet been systematically evaluated. To determine the DTA of the 18 F-florbetapir PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of dementia (non-ADD), or any form of dementia at follow-up. This review is current to May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group's specialised register of dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any relevant studies and systematic reviews, and

  4. 18F-FDG PET diagnostic and prognostic patterns do not overlap in Alzheimer's disease (AD) patients at the mild cognitive impairment (MCI) stage

    International Nuclear Information System (INIS)

    Morbelli, Silvia; Bauckneht, Matteo; Buschiazzo, Ambra; Nieri, Alberto; Sambuceti, Gianmario; Pagani, Marco; De Carli, Fabrizio

    2017-01-01

    We aimed to identify the cortical regions where hypometabolism can predict the speed of conversion to dementia in mild cognitive impairment due to Alzheimer's disease (MCI-AD). We selected from the clinical database of our tertiary center memory clinic, eighty-two consecutive MCI-AD that underwent 18F-fluorodeoxyglucose (FDG) PET at baseline during the first diagnostic work-up and were followed up at least until their clinical conversion to AD dementia. The whole group of MCI-AD was compared in SPM8 with a group of age-matched healthy controls (CTR) to verify the presence of AD diagnostic-pattern; then the correlation between conversion time and brain metabolism was assessed to identify the prognostic-pattern. Significance threshold was set at p < 0.05 False-Discovery-Rate (FDR) corrected at peak and at cluster level. Each MCI-AD was then compared with CTR by means of a SPM single-subject analysis and grouped according to presence of AD diagnostic-pattern and prognostic-pattern. Kaplan-Meier-analysis was used to evaluate if diagnostic- and/or prognostic-patterns can predict speed of conversion to dementia. Diagnostic-pattern corresponded to typical posterior hypometabolism (BA 7, 18, 19, 30, 31 and 40) and did not correlate with time to conversion, which was instead correlated with metabolic levels in right middle and inferior temporal gyri as well as in the fusiform gyrus (prognostic-pattern, BA 20, 21 and 38). At Kaplan-Meier analysis, patients with hypometabolism in the prognostic pattern converted to AD-dementia significantly earlier than patients not showing significant hypometabolism in the right middle and inferior temporal cortex (9 versus 19 months; Log rank p < 0.02, Breslow test: p < 0.003, Tarone-Ware test: p < 0.007). The present findings support the role of FDG PET as a robust progression biomarker even in a naturalist population of MCI-AD. However, not the AD-typical diagnostic-pattern in posterior regions but the middle and inferior temporal

  5. 18F-FDG PET diagnostic and prognostic patterns do not overlap in Alzheimer's disease (AD) patients at the mild cognitive impairment (MCI) stage

    Energy Technology Data Exchange (ETDEWEB)

    Morbelli, Silvia; Bauckneht, Matteo; Buschiazzo, Ambra; Nieri, Alberto; Sambuceti, Gianmario [Genoa Univ. (Italy). Dept. of Health Sciences; IRCCS AOU San Martino-IST, Genoa (Italy). Nuclear Medicine Unit; Arnaldi, Dario; Picco, Agnese; Pardini, Matteo; Brugnolo, Andrea; Girtler, Nicola; Nobili, Flavio [Genoa Univ. (Italy). Clinical Neurology, Department of Neuroscience (DINOGMI); IRCCS AOU San Martino-IST, Genoa (Italy); Pagani, Marco [Institute of Cognitive Sciences and Technologies, Rome (Italy); Karolinska Hospital, Stockholm (Sweden). Department of Nuclear Medicine; Chincarini, Andrea [Istituto Nazionale di Fisica Nucleare, Genoa (Italy); De Carli, Fabrizio [National Research Council, Genoa (Italy). Institute of Bioimaging and Molecular Physiology

    2017-11-15

    We aimed to identify the cortical regions where hypometabolism can predict the speed of conversion to dementia in mild cognitive impairment due to Alzheimer's disease (MCI-AD). We selected from the clinical database of our tertiary center memory clinic, eighty-two consecutive MCI-AD that underwent 18F-fluorodeoxyglucose (FDG) PET at baseline during the first diagnostic work-up and were followed up at least until their clinical conversion to AD dementia. The whole group of MCI-AD was compared in SPM8 with a group of age-matched healthy controls (CTR) to verify the presence of AD diagnostic-pattern; then the correlation between conversion time and brain metabolism was assessed to identify the prognostic-pattern. Significance threshold was set at p < 0.05 False-Discovery-Rate (FDR) corrected at peak and at cluster level. Each MCI-AD was then compared with CTR by means of a SPM single-subject analysis and grouped according to presence of AD diagnostic-pattern and prognostic-pattern. Kaplan-Meier-analysis was used to evaluate if diagnostic- and/or prognostic-patterns can predict speed of conversion to dementia. Diagnostic-pattern corresponded to typical posterior hypometabolism (BA 7, 18, 19, 30, 31 and 40) and did not correlate with time to conversion, which was instead correlated with metabolic levels in right middle and inferior temporal gyri as well as in the fusiform gyrus (prognostic-pattern, BA 20, 21 and 38). At Kaplan-Meier analysis, patients with hypometabolism in the prognostic pattern converted to AD-dementia significantly earlier than patients not showing significant hypometabolism in the right middle and inferior temporal cortex (9 versus 19 months; Log rank p < 0.02, Breslow test: p < 0.003, Tarone-Ware test: p < 0.007). The present findings support the role of FDG PET as a robust progression biomarker even in a naturalist population of MCI-AD. However, not the AD-typical diagnostic-pattern in posterior regions but the middle and inferior temporal

  6. 18F PET with flutemetamol for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI).

    Science.gov (United States)

    Martínez, Gabriel; Vernooij, Robin Wm; Fuentes Padilla, Paulina; Zamora, Javier; Flicker, Leon; Bonfill Cosp, Xavier

    2017-11-22

    18 F-flutemetamol uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and the confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18 F-flutemetamol. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18 F-flutemetamol to predict the progression from MCI to Alzheimer's disease dementia (ADD) or other dementias has not yet been systematically evaluated. To determine the DTA of the 18 F-flutemetamol PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of dementia (non-ADD) or any form of dementia at follow-up. The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group's specialised register of dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any

  7. 18F PET with florbetaben for the early diagnosis of Alzheimer's disease dementia and other dementias in people with mild cognitive impairment (MCI).

    Science.gov (United States)

    Martínez, Gabriel; Vernooij, Robin Wm; Fuentes Padilla, Paulina; Zamora, Javier; Flicker, Leon; Bonfill Cosp, Xavier

    2017-11-22

    18 F-florbetaben uptake by brain tissue, measured by positron emission tomography (PET), is accepted by regulatory agencies like the Food and Drug Administration (FDA) and the European Medicine Agencies (EMA) for assessing amyloid load in people with dementia. Its added value is mainly demonstrated by excluding Alzheimer's pathology in an established dementia diagnosis. However, the National Institute on Aging and Alzheimer's Association (NIA-AA) revised the diagnostic criteria for Alzheimer's disease and confidence in the diagnosis of mild cognitive impairment (MCI) due to Alzheimer's disease may be increased when using some amyloid biomarkers tests like 18 F-florbetaben. These tests, added to the MCI core clinical criteria, might increase the diagnostic test accuracy (DTA) of a testing strategy. However, the DTA of 18 F-florbetaben to predict the progression from MCI to Alzheimer's disease dementia (ADD) or other dementias has not yet been systematically evaluated. To determine the DTA of the 18 F-florbetaben PET scan for detecting people with MCI at time of performing the test who will clinically progress to ADD, other forms of dementia (non-ADD), or any form of dementia at follow-up. The most recent search for this review was performed in May 2017. We searched MEDLINE (OvidSP), Embase (OvidSP), PsycINFO (OvidSP), BIOSIS Citation Index (Thomson Reuters Web of Science), Web of Science Core Collection, including the Science Citation Index (Thomson Reuters Web of Science) and the Conference Proceedings Citation Index (Thomson Reuters Web of Science), LILACS (BIREME), CINAHL (EBSCOhost), ClinicalTrials.gov (https://clinicaltrials.gov), and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) (http://www.who.int/ictrp/search/en/). We also searched ALOIS, the Cochrane Dementia & Cognitive Improvement Group's specialised register of dementia studies (http://www.medicine.ox.ac.uk/alois/). We checked the reference lists of any

  8. The Aerobic and Cognitive Exercise Study (ACES for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI: Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Cay Anderson-Hanley

    2018-05-01

    Full Text Available Prior research has found that cognitive benefits of physical exercise and brain health in older adults may be enhanced when mental exercise is interactive simultaneously, as in exergaming. It is unclear whether the cognitive benefit can be maximized by increasing the degree of mental challenge during exercise. This randomized clinical trial (RCT, the Aerobic and Cognitive Exercise Study (ACES sought to replicate and extend prior findings of added cognitive benefit from exergaming to those with or at risk for mild cognitive impairment (MCI. ACES compares the effects of 6 months of an exer-tour (virtual reality bike rides with the effects of a more effortful exer-score (pedaling through a videogame to score points. Fourteen community-dwelling older adults meeting screening criteria for MCI (sMCI were adherent to their assigned exercise for 6 months. The primary outcome was executive function, while secondary outcomes included memory and everyday cognitive function. Exer-tour and exer-score yielded significant moderate effects on executive function (Stroop A/C; d's = 0.51 and 0.47; there was no significant interaction effect. However, after 3 months the exer-tour revealed a significant and moderate effect, while exer-score showed little impact, as did a game-only condition. Both exer-tour and exer-score conditions also resulted in significant improvements in verbal memory. Effects appear to generalize to self-reported everyday cognitive function. Pilot data, including salivary biomarkers and structural MRI, were gathered at baseline and 6 months; exercise dose was associated with increased BDNF as well as increased gray matter volume in the PFC and ACC. Improvement in memory was associated with an increase in the DLPFC. Improved executive function was associated with increased expression of exosomal miRNA-9. Interactive physical and cognitive exercise (both high and low mental challenge yielded similarly significant cognitive benefit for adherent sMCI

  9. The Aerobic and Cognitive Exercise Study (ACES) for Community-Dwelling Older Adults With or At-Risk for Mild Cognitive Impairment (MCI): Neuropsychological, Neurobiological and Neuroimaging Outcomes of a Randomized Clinical Trial.

    Science.gov (United States)

    Anderson-Hanley, Cay; Barcelos, Nicole M; Zimmerman, Earl A; Gillen, Robert W; Dunnam, Mina; Cohen, Brian D; Yerokhin, Vadim; Miller, Kenneth E; Hayes, David J; Arciero, Paul J; Maloney, Molly; Kramer, Arthur F

    2018-01-01

    Prior research has found that cognitive benefits of physical exercise and brain health in older adults may be enhanced when mental exercise is interactive simultaneously, as in exergaming. It is unclear whether the cognitive benefit can be maximized by increasing the degree of mental challenge during exercise. This randomized clinical trial (RCT), the Aerobic and Cognitive Exercise Study (ACES) sought to replicate and extend prior findings of added cognitive benefit from exergaming to those with or at risk for mild cognitive impairment (MCI). ACES compares the effects of 6 months of an exer-tour (virtual reality bike rides) with the effects of a more effortful exer-score (pedaling through a videogame to score points). Fourteen community-dwelling older adults meeting screening criteria for MCI (sMCI) were adherent to their assigned exercise for 6 months. The primary outcome was executive function, while secondary outcomes included memory and everyday cognitive function. Exer-tour and exer-score yielded significant moderate effects on executive function (Stroop A/C; d 's = 0.51 and 0.47); there was no significant interaction effect. However, after 3 months the exer-tour revealed a significant and moderate effect, while exer-score showed little impact, as did a game-only condition. Both exer-tour and exer-score conditions also resulted in significant improvements in verbal memory. Effects appear to generalize to self-reported everyday cognitive function. Pilot data, including salivary biomarkers and structural MRI, were gathered at baseline and 6 months; exercise dose was associated with increased BDNF as well as increased gray matter volume in the PFC and ACC. Improvement in memory was associated with an increase in the DLPFC. Improved executive function was associated with increased expression of exosomal miRNA-9. Interactive physical and cognitive exercise (both high and low mental challenge) yielded similarly significant cognitive benefit for adherent sMCI

  10. Cognitive Training Using a Novel Memory Game on an iPad in Patients with Amnestic Mild Cognitive Impairment (aMCI).

    Science.gov (United States)

    Savulich, George; Piercy, Thomas; Fox, Chris; Suckling, John; Rowe, James B; O'Brien, John T; Sahakian, Barbara J

    2017-08-01

    Cognitive training is effective in patients with mild cognitive impairment but does not typically address the motivational deficits associated with older populations with memory difficulties. We conducted a randomized controlled trial of cognitive training using a novel memory game on an iPad in 42 patients with a diagnosis of amnestic mild cognitive impairment assigned to either the cognitive training (n=21; 8 hours of gameplay over 4 weeks) or control (n=21; clinic visits as usual) groups. Significant time-by-pattern-by-group interactions were found for cognitive performance in terms of the number of errors made and trials needed on the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning task (P=.044; P=.027). Significant time-by-group interactions were also found for the Cambridge Neuropsychological Test Automated Battery Paired Associates Learning first trial memory score (P=.002), Mini-Mental State Examination (P=.036), the Brief Visuospatial Memory Test (P=.032), and the Apathy Evaluation Scale (P=.026). Within-group comparisons revealed highly specific effects of cognitive training on episodic memory. The cognitive training group maintained high levels of enjoyment and motivation to continue after each hour of gameplay, with self-confidence and self-rated memory ability improving over time. Episodic memory robustly improved in the cognitive training group. "Gamified" cognitive training may also enhance visuospatial abilities in patients with amnestic mild cognitive impairment. Gamification maximizes engagement with cognitive training by increasing motivation and could complement pharmacological treatments for amnestic mild cognitive impairment and mild Alzheimer's disease. Larger, more controlled trials are needed to replicate and extend these findings. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  11. The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI).

    Science.gov (United States)

    Flak, Marianne M; Hernes, Susanne S; Chang, Linda; Ernst, Thomas; Douet, Vanessa; Skranes, Jon; Løhaugen, Gro C C

    2014-05-03

    Mild cognitive impairment (MCI) is a condition characterized by memory problems that are more severe than the normal cognitive changes due to aging, but less severe than dementia. Reduced working memory (WM) is regarded as one of the core symptoms of an MCI condition. Recent studies have indicated that WM can be improved through computer-based training. The objective of this study is to evaluate if WM training is effective in improving cognitive function in elderly patients with MCI, and if cognitive training induces structural changes in the white and gray matter of the brain, as assessed by structural MRI. The proposed study is a blinded, randomized, controlled trail that will include 90 elderly patients diagnosed with MCI at a hospital-based memory clinic. The participants will be randomized to either a training program or a placebo version of the program. The intervention is computerized WM training performed for 45 minutes of 25 sessions over 5 weeks. The placebo version is identical in duration but is non-adaptive in the difficulty level of the tasks. Neuropsychological assessment and structural MRI will be performed before and 1 month after training, and at a 5-month folllow-up. If computer-based training results in positive changes to memory functions in patients with MCI this may represent a new, cost-effective treatment for MCI. Secondly, evaluation of any training-induced structural changes to gray or white matter will improve the current understanding of the mechanisms behind effective cognitive interventions in patients with MCI. ClinicalTrials.gov NCT01991405. November 18, 2013.

  12. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.

    Science.gov (United States)

    Ciesielska, Natalia; Sokołowski, Remigiusz; Mazur, Ewelina; Podhorecka, Marta; Polak-Szabela, Anna; Kędziora-Kornatowska, Kornelia

    2016-10-31

    Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

  13. Comparison of the quick mild cognitive impairment (Qmci) screen and the SMMSE in screening for mild cognitive impairment.

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2012-09-01

    differentiating mild cognitive impairment (MCI) from normal cognition (NC) is difficult. The AB Cognitive Screen (ABCS) 135, sensitive in differentiating MCI from dementia, was modified to improve sensitivity and specificity, producing the quick mild cognitive impairment (Qmci) screen.

  14. Mild Cognitive Impairment and Progession to Dementia: New Findings

    Science.gov (United States)

    ... David C. Spencer, MD Steven Karceski, MD Mild cognitive impairment and progression to dementia New findings John C.S. ... exami- nations showed that 534 persons had mild cognitive impairment, or MCI (see About MCI, following sec- tion). ...

  15. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study

    Directory of Open Access Journals (Sweden)

    Erik Hessen

    2017-02-01

    Full Text Available Background/Aims: In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1 baseline cerebrospinal fluid biomarkers and (2 a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Methods: Eighty-one patients (mean age 61 years were recruited from university memory clinics and followed up for 6 years. Results: Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% (n = 4 developed dementia. Regression analysis revealed that low levels of Aβ42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Conclusions: Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

  16. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study.

    Science.gov (United States)

    Hessen, Erik; Eckerström, Marie; Nordlund, Arto; Selseth Almdahl, Ina; Stålhammar, Jacob; Bjerke, Maria; Eckerström, Carl; Göthlin, Mattias; Fladby, Tormod; Reinvang, Ivar; Wallin, Anders

    2017-01-01

    In the quest for prevention or treatment, there is a need to find early markers for preclinical dementia. This study observed memory clinic patients with subjective cognitive impairment (SCI) and normal cognitive function at baseline. The primary aim was to address SCI as a potential risk factor for cognitive decline. The secondary aim was to address a potential relation between (1) baseline cerebrospinal fluid biomarkers and (2) a decline in memory performance over the first 2 years of follow-up, with a possible cognitive decline after 6 years. Eighty-one patients (mean age 61 years) were recruited from university memory clinics and followed up for 6 years. Eighty-six percent of the cohort remained cognitively stable or improved, 9% developed mild cognitive impairment, and only 5% ( n = 4) developed dementia. Regression analysis revealed that low levels of Aβ 42 at baseline and memory decline during the first 2 years predicted dementia. When combined, these variables were associated with a 50% risk of developing dementia. Cognitive stability for 86% of the cohort suggests that SCI is predominantly a benign condition with regard to neuropathology. The low number of individuals who developed dementia limits the generalizability of the results and discussion of progression factors.

  17. Meta-Analysis of Social Cognition in Mild Cognitive Impairment.

    Science.gov (United States)

    Bora, Emre; Yener, Görsev G

    2017-07-01

    Social cognitive abilities are impaired in Alzheimer disease and other dementias. Recent studies suggested that social cognitive abilities might be also impaired in mild cognitive impairment (MCI). Current meta-analysis aimed to summarize available evidence for deficits in theory of mind (ToM) and emotion recognition in MCI. In this meta-analysis of 17 studies, facial emotion recognition and ToM performances of 513 individuals with MCI and 693 healthy controls were compared. Mild cognitive impairment was associated with significant impairments falling in the medium effect sizes range in ToM ( d = 0.63) and facial emotion recognition ( d = 0.58). Among individual emotions, recognition of fear and sadness were particularly impaired. There were no significant between-group differences in recognition of disgust, happiness, and surprise. Social cognitive deficits were more severe in multidomain MCI. There is a need for longitudinal studies investigating the potential role of social cognitive impairment in predicting conversion to dementia.

  18. Performance of a sample of patients with Mild Cognitive Impairment (MCI), Alzheimer's Disease (AD) and healthy elderly on a lexical decision test (LDT) as a measure of pre-morbid intelligence

    OpenAIRE

    Serrao, Valéria Trunkl; Brucki, Sônia Maria Dozzi; Campanholo, Kenia Repiso; Mansur, Letícia Lessa; Nitrini, Ricardo; Miotto, Eliane Correa

    2015-01-01

    Objective: The objective of this study was to describe the performance of healthy elderly patients with aging-related pathologies (MCI) and patients with AD on a lexical decision test. Methods: The study included 38 healthy elderly subjects, 61 MCI and 26 AD patients from the Neurology Department of the Hospital das Clinicas, Behavioral and Cognitive Neurology Group. The neuropsychological instruments included the episodic memory test (RAVLT), subtests from the WAIS-III (Matrix Reasoning and...

  19. Including persistency of impairment in mild cognitive impairment classification enhances prediction of 5-year decline.

    Science.gov (United States)

    Vandermorris, Susan; Hultsch, David F; Hunter, Michael A; MacDonald, Stuart W S; Strauss, Esther

    2011-02-01

    Although older adults with Mild Cognitive Impairment (MCI) show elevated rates of conversion to dementia as a group, heterogeneity of outcomes is common at the individual level. Using data from a prospective 5-year longitudinal investigation of cognitive change in healthy older adults (N = 262, aged 64-92 years), this study addressed limitations in contemporary MCI identification procedures which rely on single occasion assessment ("Single-Assessment [SA] MCI") by evaluating an alternate operational definition of MCI requiring evidence of persistent cognitive impairment over multiple-testing sessions ("Multiple-Assessment [MA] MCI"). As hypothesized, prevalence of SA-MCI exceeded that of MA-MCI. Further, the MA-MCI groups showed lower baseline cognitive and functional performance and steeper cognitive decline compared with Control and SA-MCI group. Results are discussed with reference to retest effects and clinical implications.

  20. Cognitive reserve moderates the association between functional network anti-correlations and memory in MCI.

    Science.gov (United States)

    Franzmeier, Nicolai; Buerger, Katharina; Teipel, Stefan; Stern, Yaakov; Dichgans, Martin; Ewers, Michael

    2017-02-01

    Cognitive reserve (CR) shows protective effects on cognitive function in older adults. Here, we focused on the effects of CR at the functional network level. We assessed in patients with amnestic mild cognitive impairment (aMCI) whether higher CR moderates the association between low internetwork cross-talk on memory performance. In 2 independent aMCI samples (n = 76 and 93) and healthy controls (HC, n = 36), CR was assessed via years of education and intelligence (IQ). We focused on the anti-correlation between the dorsal attention network (DAN) and an anterior and posterior default mode network (DMN), assessed via sliding time window analysis of resting-state functional magnetic resonance imaging (fMRI). The DMN-DAN anti-correlation was numerically but not significantly lower in aMCI compared to HC. However, in aMCI, lower anterior DMN-DAN anti-correlation was associated with lower memory performance. This association was moderated by CR proxies, where the association between the internetwork anti-correlation and memory performance was alleviated at higher levels of education or IQ. In conclusion, lower DAN-DMN cross-talk is associated with lower memory in aMCI, where such effects are buffered by higher CR. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Serial position effects in mild cognitive impairment.

    Science.gov (United States)

    Howieson, Diane B; Mattek, Nora; Seeyle, Adriana M; Dodge, Hiroko H; Wasserman, Dara; Zitzelberger, Tracy; Jeffrey, Kaye

    2011-03-01

    Mild cognitive impairment (MCI) is often associated with the preclinical phase of Alzheimer's disease (AD). Special scoring of word-list recall data for serial position has been suggested to improve discrimination of normal aging from dementia. We examined serial position effects in word-list recall for MCI participants compared to Alzheimer patients and controls. Individuals with MCI, like Alzheimer patients, had a diminished primacy effect in recalling words from a list. No alternative scoring system was better than standard scoring of word-list recall in distinguishing MCI patients from controls. Retention weighted scoring improved the discrimination of MCI and AD groups.

  2. Cognitive Training Program to Improve Working Memory in Older Adults with MCI.

    Science.gov (United States)

    Hyer, Lee; Scott, Ciera; Atkinson, Mary Michael; Mullen, Christine M; Lee, Anna; Johnson, Aaron; Mckenzie, Laura C

    2016-01-01

    Deficits in working memory (WM) are associated with age-related decline. We report findings from a clinical trial that examined the effectiveness of Cogmed, a computerized program that trains WM. We compare this program to a Sham condition in older adults with Mild Cognitive Impairment (MCI). Older adults (N = 68) living in the community were assessed. Participants reported memory impairment and met criteria for MCI, either by poor delayed memory or poor performance in other cognitive areas. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Delayed Memory Index) and the Clinical Dementia Rating scale (CDR) were utilized. All presented with normal Mini Mental State Exams (MMSE) and activities of daily living (ADLs). Participants were randomized to Cogmed or a Sham computer program. Twenty-five sessions were completed over five to seven weeks. Pre, post, and follow-up measures included a battery of cognitive measures (three WM tests), a subjective memory scale, and a functional measure. Both intervention groups improved over time. Cogmed significantly outperformed Sham on Span Board and exceeded in subjective memory reports at follow-up as assessed by the Cognitive Failures Questionnaire (CFQ). The Cogmed group demonstrated better performance on the Functional Activities Questionnaire (FAQ), a measure of adjustment and far transfer, at follow-up. Both groups, especially Cogmed, enjoyed the intervention. Results suggest that WM was enhanced in both groups of older adults with MCI. Cogmed was better on one core WM measure and had higher ratings of satisfaction. The Sham condition declined on adjustment.

  3. Neuroanatomic changes and their association with cognitive decline in mild cognitive impairment: a meta-analysis

    OpenAIRE

    Nickl-Jockschat, Thomas; Kleiman, Alexandra; Schulz, Jörg B.; Schneider, Frank; Laird, Angela R.; Fox, Peter T.; Eickhoff, Simon B.; Reetz, Kathrin

    2011-01-01

    Mild cognitive impairment (MCI) is an acquired syndrome characterised by cognitive decline not affecting activities of daily living. Using a quantitative meta-analytic approach, we aimed to identify consistent neuroanatomic correlates of MCI and how they are related to cognitive dysfunction. The meta-analysis enrols 22 studies, involving 917 MCI (848 amnestic MCI) patients and 809 healthy controls. Only studies investigating local changes in grey matter and reporting whole-brain results in st...

  4. Which part of the Quick mild cognitive impairment screen (Qmci) discriminates between normal cognition, mild cognitive impairment and dementia?

    LENUS (Irish Health Repository)

    O'Caoimh, Rónán

    2013-05-01

    the Qmci is a sensitive and specific test to differentiate between normal cognition (NC), mild cognitive impairment (MCI) and dementia. We compared the sensitivity and specificity of the subtests of the Qmci to determine which best discriminated NC, MCI and dementia.

  5. Mild Cognitive Impairment Status and Mobility Performance

    DEFF Research Database (Denmark)

    Pedersen, Mette; Holt, Nicole E; Grande, Laura

    2014-01-01

    : An analysis was conducted on baseline data from the Boston Rehabilitative Impairment Study in the Elderly study, a cohort study of 430 primary care patients aged 65 or older. Neuropsychological tests identified participants with MCI and further subclassified those with impairment in memory domains (a......BACKGROUND: The prevalence of mild cognitive impairment (MCI) and mobility limitations is high among older adults. The aim of this study was to investigate the association between MCI status and both performance-based and self-report measures of mobility in community-dwelling older adults. METHODS...

  6. Mild Cognitive Impairment: Diagnosis, Longitudinal Course, and Emerging Treatments

    Science.gov (United States)

    Vega, Jennifer N.; Newhouse, Paul A.

    2014-01-01

    Mild cognitive impairment (MCI) is widely regarded as the intermediate stage of cognitive impairment between the changes seen in normal cognitive aging and those associated with dementia. Elderly patients with MCI constitute a high-risk population for developing dementia, in particular Alzheimer’s disease (AD). Although the core clinical criteria for MCI have remained largely unchanged, the operational definition of MCI has undergone several revisions over the course of the last decade and remains an evolving diagnosis. Prognostic implications of this diagnosis are becoming clearer with regard to the risk of progressive cognitive deterioration. Although patients with MCI may represent an optimal target population for pharmacological and non-pharmacological interventions, results from clinical trials have been mixed and a definitive effective treatment remains elusive. This article provides a brief overview of the evolution of the concept of MCI and reviews current diagnostic criteria, the longitudinal course of the disorder, and current and emerging treatments for MCI. PMID:25160795

  7. Working memory span in mild cognitive impairment. Influence of processing speed and cognitive reserve.

    Science.gov (United States)

    Facal, David; Juncos-Rabadán, Onésimo; Pereiro, Arturo X; Lojo-Seoane, Cristina

    2014-04-01

    Mild cognitive impairment (MCI) often includes episodic memory impairment, but can also involve other types of cognitive decline. Although previous studies have shown poorer performance of MCI patients in working memory (WM) span tasks, different MCI subgroups were not studied. In the present exploratory study, 145 participants underwent extensive cognitive evaluation, which included three different WM span tasks, and were classified into the following groups: multiple-domain amnestic MCI (mda-MCI), single-domain amnestic MCI (sda-MCI), and controls. General linear model was conducted by considering the WM span tasks as the within-subject factor; the group (mda-MCI, sda-MCI, and controls) as the inter-subject factor; and processing speed, vocabulary and age as covariates. Multiple linear regression models were also used to test the influence of processing speed, vocabulary, and other cognitive reserve (CR) proxies. Results indicate different levels of impairment of WM, with more severe impairment in mda-MCI patients. The differences were still present when processing resources and CR were controlled. Between-group differences can be understood as a manifestation of the greater severity and widespread memory impairment in mda-MCI patients and may contribute to a better understanding of continuum from normal controls to mda-MCI patients. Processing speed and CR have a limited influence on WM scores, reducing but not removing differences between groups.

  8. Olfactory identification in amnestic and non-amnestic mild cognitive impairment and its neuropsychological correlates.

    Science.gov (United States)

    Vyhnalek, Martin; Magerova, Hana; Andel, Ross; Nikolai, Tomas; Kadlecova, Alexandra; Laczo, Jan; Hort, Jakub

    2015-02-15

    Olfactory identification impairment in amnestic mild cognitive impairment (aMCI) patients is well documented and considered to be caused by underlying Alzheimer's disease (AD) pathology, contrasting with less clear evidence in non-amnestic MCI (naMCI). The aim was to (a) compare the degree of olfactory identification dysfunction in aMCI, naMCI, controls and mild AD dementia and (b) assess the relation between olfactory identification and cognitive performance in aMCI compared to naMCI. 75 patients with aMCI and 32 with naMCI, 26 patients with mild AD and 27 controls underwent the multiple choice olfactory identification Motol Hospital Smell Test with 18 different odors together with a comprehensive neuropsychological examination. Controlling for age and gender, patients with aMCI and naMCI did not differ significantly in olfactory identification and both performed significantly worse than controls (pmemory and visuospatial tests were significantly related to better olfactory identification ability. Conversely, no cognitive measure was significantly related to olfactory performance in naMCI. Olfactory identification is similarly impaired in aMCI and naMCI. Olfactory impairment is proportional to cognitive impairment in aMCI but not in naMCI. Copyright © 2015. Published by Elsevier B.V.

  9. Apathy and noradrenaline: silent partners to mild cognitive impairment in Parkinson's disease?

    OpenAIRE

    Loued-Khenissi Leyla; Preuschoff Kerstin

    2015-01-01

    PURPOSE OF REVIEW: Mild cognitive impairment (MCI) is a comorbid factor in Parkinson's disease. The aim of this review is to examine the recent neuroimaging findings in the search for Parkinson's disease MCI (PD MCI) biomarkers to gain insight on whether MCI and specific cognitive deficits in Parkinson's disease implicate striatal dopamine or another system. RECENT FINDINGS: The evidence implicates a diffuse pathophysiology in PD MCI rather than acute dopaminergic involvement. On the one han...

  10. A novel biomarker of amnestic MCI based on dynamic Cross-Frequency Coupling patterns during cognitive brain responses

    Directory of Open Access Journals (Sweden)

    Stavros I Dimitriadis

    2015-10-01

    Full Text Available The detection of mild cognitive impairment (MCI, the transitional stage between normal cognitive changes of aging and the cognitive decline caused by AD, is of paramount clinical importance, since MCI patients are at increased risk of progressing into AD. Electroencephalographic (EEG alterations in the spectral content of brainwaves and connectivity at resting state have been associated with early-stage AD. Recently, cognitive event-related potentials (ERPs have entered into the picture as an easy to perform screening test. Motivated by the recent findings about the role of cross-frequency coupling (CFC in cognition, we introduce a relevant methodological approach for detecting MCI based on cognitive responses from a standard auditory oddball paradigm. By using the single trial signals recorded at Pz sensor and comparing the responses to target and non-target stimuli, we first demonstrate that increased CFC is associated with the cognitive task. Then, considering the dynamic character of CFC, we identify instances during which the coupling between particular pairs of brainwave frequencies carries sufficient information for discriminating between normal subjects and patients with MCI. In this way, we form a multiparametric signature of impaired cognition. The new composite biomarker was tested using data from a cohort that consists of 25 amnestic MCI patients and 15 age-matched controls. Standard machine-learning algorithms were employed so as to implement the binary classification task. Based on leave-one-out cross-validation, the measured classification rate was found reaching very high levels (95%. Our approach compares favorably with the traditional alternative of using the morphology of averaged ERP response to make the diagnosis and the usage of features from spectro-temporal analysis of single-trial response. This further indicates that task-related CFC measurements can provide invaluable analytics in AD diagnosis and prognosis.

  11. Depressive symptoms accelerate cognitive decline in amyloid-positive MCI patients

    Energy Technology Data Exchange (ETDEWEB)

    Brendel, Matthias; Xiong, Guoming; Delker, Andreas [University of Munich, Department of Nuclear Medicine, Munich (Germany); Pogarell, Oliver [University of Munich, Department of Psychiatry, Munich (Germany); Bartenstein, Peter; Rominger, Axel [University of Munich, Department of Nuclear Medicine, Munich (Germany); Munich Cluster for Systems Neurology (SyNergy), Munich (Germany); Collaboration: for the Alzheimer' s Disease Neuroimaging Initiative

    2015-04-01

    Late-life depression even in subsyndromal stages is strongly associated with Alzheimer's disease (AD). Furthermore, brain amyloidosis is an early biomarker in subjects who subsequently suffer from AD and can be sensitively detected by amyloid PET. Therefore, we aimed to compare amyloid load and glucose metabolism in subsyndromally depressed subjects with mild cognitive impairment (MCI). [{sup 18}F]AV45 PET, [{sup 18}F]FDG PET and MRI were performed in 371 MCI subjects from the Alzheimer's Disease Neuroimaging Initiative Subjects were judged β-amyloid-positive (Aβ+; 206 patients) or β-amyloid-negative (Aβ-; 165 patients) according to [{sup 18}F]AV45 PET. Depressive symptoms were assessed by the Neuropsychiatric Inventory Questionnaire depression item 4. Subjects with depressive symptoms (65 Aβ+, 41 Aβ-) were compared with their nondepressed counterparts. Conversion rates to AD were analysed (mean follow-up time 21.5 ± 9.1 months) with regard to coexisting depressive symptoms and brain amyloid load. Aβ+ depressed subjects showed large clusters with a higher amyloid load in the frontotemporal and insular cortices (p < 0.001) with coincident hypermetabolism (p < 0.001) in the frontal cortices than nondepressed subjects. Faster progression to AD was observed in subjects with depressive symptoms (p < 0.005) and in Aβ+ subjects (p < 0.001). Coincident depressive symptoms additionally shortened the conversion time in all Aβ+ subjects (p < 0.005) and to a greater extent in those with a high amyloid load (p < 0.001). Our results clearly indicate that Aβ+ MCI subjects with depressive symptoms have an elevated amyloid load together with relative hypermetabolism of connected brain areas compared with cognitively matched nondepressed individuals. MCI subjects with high amyloid load and coexistent depressive symptoms are at high risk of faster conversion to AD. (orig.)

  12. Depressive symptoms accelerate cognitive decline in amyloid-positive MCI patients

    International Nuclear Information System (INIS)

    Brendel, Matthias; Xiong, Guoming; Delker, Andreas; Pogarell, Oliver; Bartenstein, Peter; Rominger, Axel

    2015-01-01

    Late-life depression even in subsyndromal stages is strongly associated with Alzheimer's disease (AD). Furthermore, brain amyloidosis is an early biomarker in subjects who subsequently suffer from AD and can be sensitively detected by amyloid PET. Therefore, we aimed to compare amyloid load and glucose metabolism in subsyndromally depressed subjects with mild cognitive impairment (MCI). [ 18 F]AV45 PET, [ 18 F]FDG PET and MRI were performed in 371 MCI subjects from the Alzheimer's Disease Neuroimaging Initiative Subjects were judged β-amyloid-positive (Aβ+; 206 patients) or β-amyloid-negative (Aβ-; 165 patients) according to [ 18 F]AV45 PET. Depressive symptoms were assessed by the Neuropsychiatric Inventory Questionnaire depression item 4. Subjects with depressive symptoms (65 Aβ+, 41 Aβ-) were compared with their nondepressed counterparts. Conversion rates to AD were analysed (mean follow-up time 21.5 ± 9.1 months) with regard to coexisting depressive symptoms and brain amyloid load. Aβ+ depressed subjects showed large clusters with a higher amyloid load in the frontotemporal and insular cortices (p < 0.001) with coincident hypermetabolism (p < 0.001) in the frontal cortices than nondepressed subjects. Faster progression to AD was observed in subjects with depressive symptoms (p < 0.005) and in Aβ+ subjects (p < 0.001). Coincident depressive symptoms additionally shortened the conversion time in all Aβ+ subjects (p < 0.005) and to a greater extent in those with a high amyloid load (p < 0.001). Our results clearly indicate that Aβ+ MCI subjects with depressive symptoms have an elevated amyloid load together with relative hypermetabolism of connected brain areas compared with cognitively matched nondepressed individuals. MCI subjects with high amyloid load and coexistent depressive symptoms are at high risk of faster conversion to AD. (orig.)

  13. Early Detection of Cognitive-Linguistic Change Associated with Mild Cognitive Impairment

    Science.gov (United States)

    Fleming, Valarie B.

    2014-01-01

    Individuals with mild cognitive impairment (MCI) may present with subtle declines in linguistic ability that go undetected by tasks not challenging enough to tax a relatively intact cognitive-linguistic system. This study was designed to replicate and extend a previous study of cognitive-linguistic ability in MCI using a complex discourse…

  14. Functional Hubs in Mild Cognitive Impairment

    Science.gov (United States)

    Navas, Adrián; Papo, David; Boccaletti, Stefano; Del-Pozo, F.; Bajo, Ricardo; Maestú, Fernando; Martínez, J. H.; Gil, Pablo; Sendiña-Nadal, Irene; Buldú, Javier M.

    We investigate how hubs of functional brain networks are modified as a result of mild cognitive impairment (MCI), a condition causing a slight but noticeable decline in cognitive abilities, which sometimes precedes the onset of Alzheimer's disease. We used magnetoencephalography (MEG) to investigate the functional brain networks of a group of patients suffering from MCI and a control group of healthy subjects, during the execution of a short-term memory task. Couplings between brain sites were evaluated using synchronization likelihood, from which a network of functional interdependencies was constructed and the centrality, i.e. importance, of their nodes was quantified. The results showed that, with respect to healthy controls, MCI patients were associated with decreases and increases in hub centrality respectively in occipital and central scalp regions, supporting the hypothesis that MCI modifies functional brain network topology, leading to more random structures.

  15. Patterns of Semantic Memory Impairment in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Sven Joubert

    2008-01-01

    Full Text Available Although the semantic memory impairment has been largely documented in Alzheimer's disease, little is known about semantic memory in the preclinical phase of the disease (Mild Cognitive Impairment. The purpose of this study was to document the nature of semantic breakdown using a battery of tests assessing different aspects of conceptual knowledge: knowledge about common objects, famous people and famous public events. Results indicate that all domains of semantic memory were impaired in MCI individuals but knowledge about famous people and famous events was affected to a greater extent than knowledge about objects. This pattern of results suggests that conceptual entities with distinctive and unique properties may be more prone to semantic breakdown in MCI. In summary, results of this study support the view that genuine semantic deficits are present in MCI. It could be useful to investigate the etiological outcome of patients failing or succeeding at such tests.

  16. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Kim, Soo Ryon; Baek, Min Jae; Kim, HyangHee

    2015-01-01

    The aims of this study were to investigate concrete and abstract word definition ability (1) between patients with amnestic mild cognitive impairment (aMCI) and normal adults and (2) between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI) and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI) and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train) and five abstract nouns (e.g., jealousy). Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI. PMID:26347214

  17. Abstract Word Definition in Patients with Amnestic Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Soo Ryon Kim

    2015-01-01

    Full Text Available The aims of this study were to investigate concrete and abstract word definition ability (1 between patients with amnestic mild cognitive impairment (aMCI and normal adults and (2 between the aMCI subtypes (i.e., amnestic single-domain MCI and amnestic multidomain MCI; asMCI and amMCI and normal controls. The 68 patients with aMCI (29 asMCI and 39 amMCI and 93 age- and education-matched normal adults performed word definition tasks composed of five concrete (e.g., train and five abstract nouns (e.g., jealousy. Task performances were analyzed on total score, number of core meanings, and number of supplementary meanings. The results were as follows. First, the aMCI patients scored significantly poorer than the normal controls in only abstract word definition. Second, both subtypes of aMCI performed worse than the controls in only abstract word definition. In conclusion, a definition task of abstract rather than concrete concepts may provide richer information to show semantic impairment of aMCI.

  18. Cognitive Activities and Instrumental Activity of Daily Living in Older Adults with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Takehiko Doi

    2013-10-01

    Full Text Available Aims: This study aimed to identify differences in the implementation of cognitive activities and instrumental activities of daily living (IADLs between healthy individuals and subjects with mild cognitive impairment (MCI. Methods: The study included 2,498 cognitively healthy subjects (mean age, 71.2 ± 5.1 years and 809 MCI subjects (mean age, 71.8 ± 5.4 years. The subjects were interviewed regarding their participation in cognitive activities and the implementation of IADLs. Results: We found a significant association between participation in any cognitive activities (p Conclusions: Our study revealed that greater participation in cognitive activity was associated with lower odds of MCI. Participation in cognitive activities may reflect differences between healthy and MCI subjects. To clarify the causal relationship between cognitive activities and MCI, further studies are required.

  19. Care Partner Responses to the Onset of Mild Cognitive Impairment

    Science.gov (United States)

    Blieszner, Rosemary; Roberto, Karen A.

    2010-01-01

    Purpose: We examined characteristics, responses, and psychological well-being of care partners who support and assist older adults recently diagnosed with mild cognitive impairment (MCI). Design and Methods: Based on a sample of 106 care partners of community residents diagnosed with MCI at memory clinics, we conducted face-to-face interviews…

  20. Aerobic exercise effects upon cognition in Mild Cognitive Impairment: A systematic review of randomized controlled trials.

    Science.gov (United States)

    Cammisuli, D M; Innocenti, A; Franzoni, F; Pruneti, C

    2017-07-01

    Several studies have shown that physical activity has positive effects on cognition in healthy older adults without cognitive complains but lesser is known about the effectiveness of aerobic exercise in patients suffering from Mild Cognitive Impairment (MCI). The aim of the present study was to systematically review the evidence from randomized controlled trials (RCTs) about the effects of aerobic exercise upon cognition in MCI patients. To this end, PubMed, Cochrane and Web of Science databases were analytically searched for RCTs including aerobic exercise interventions for MCI patients. There is evidence that aerobic exercise improves cognition in MCI patients. Overall research reported moderate effects for global cognition, logical memory, inhibitory control and divided attention. Due to methodological limitations of the investigated studies, findings should be interpreted with caution. Standardized training protocols, larger scale interventions and follow-ups may also provide better insight into the preventive effects of aerobic exercise on cognitive deterioration in MCI and its conversion into dementia.

  1. Subjective Cognitive Complaints and Objective Cognitive Impairment in Parkinson's Disease.

    Science.gov (United States)

    Hong, Jin Yong; Lee, Yoonju; Sunwoo, Mun Kyung; Sohn, Young H; Lee, Phil Hyu

    2018-01-01

    Subjective cognitive complaints (SCCs) are very common in patients with Parkinson's disease (PD). However, the relationship between SCCs and objective cognitive impairment is still unclear. This study aimed to determine whether SCCs are correlated with objective cognitive performance in patients with PD. Totals of 148 cognitively normal patients, 71 patients with mild cognitive impairment (MCI), and 31 demented patients were recruited consecutively from a movement-disorders clinic. Their SCCs and cognitive performances were evaluated using the Cognitive Complaints Interview (CCI) and a comprehensive neuropsychological battery. The CCI score increased with age, duration of PD, and depression score, and was inversely correlated with cognitive performance. The association between CCI score and performance remained significant after adjustment for the depression score, age, and duration of PD. The CCI score could be used to discriminate patients with dementia from cognitively normal and MCI patients [area under the receiver operating characteristics curve (AUC) of 0.80], but not patients with MCI or dementia from cognitively normal patients (AUC of 0.67). SCCs as measured by the CCI are strongly correlated with objective cognitive performance in patients with PD. The CCI can also be used to screen for dementia in patients with PD. Copyright © 2018 Korean Neurological Association.

  2. Memory complaints in subjective cognitive impairment, amnestic mild cognitive impairment and mild Alzheimer's disease.

    Science.gov (United States)

    Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun

    2016-12-01

    Memory complaints are a frequent phenomenon in elderly individuals and can lead to opportunistic help-seeking behavior. The aim of this study was to compare different aspects of memory complaints (i.e., prospective versus retrospective complaints) in individuals with subjective cognitive impairment (SCI), amnestic mild cognitive impairment (aMCI), and mild Alzheimer's disease (AD). The study included a total of 115 participants (mean age: 68.82 ± 8.83 years) with SCI (n = 34), aMCI (n = 46), and mild AD (n = 35). Memory complaints were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which consists of 16 items that describe everyday memory failure of both prospective memory (PM) and retrospective memory (RM). For aMCI and AD subjects, informants also completed an informant-rating of the PRMQ. All participants completed detailed neuropsychological tests. Results show that PM complaints were equivalent among the three groups. However, RM complaints differed. Specifically, RM complaints in aMCI were higher than SCI, but similar to AD. Informant-reported memory complaints were higher for AD than aMCI. Our study suggests that RM complaints of memory complaints may be helpful in discriminating between SCI and aMCI, but both PM and RM complaints are of limited value in differentiating aMCI from AD.

  3. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

    NARCIS (Netherlands)

    Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

    2017-01-01

    Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

  4. Positive effects of combined cognitive and physical exercise training on cognitive function in older adults with mild cognitive impairment or dementia : A meta-analysis

    NARCIS (Netherlands)

    Karssemeijer, Esther G. A.; Aaronson, Justine A.; Bossers, Willem J.; Smits, Tara; Rikkert, Marcel G. M. Olde; Kessels, Roy P. C.

    Combined cognitive and physical exercise interventions have potential to elicit cognitive benefits in older adults with mild cognitive impairment (MCI) or dementia. This meta-analysis aims to quantify the overall effect of these interventions on global cognitive functioning in older adults with MCI

  5. Cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Jing YUAN

    2017-07-01

    Full Text Available Parkinson's disease cognitive impairment (PD-CI is one of the major non-motor symtoms (NMS of PD, including Parkinson's disease with mild cognitive impairment (PD - MCI and Parkinson's disease dementia (PDD. Executive dysfunction is relatively prominent, but other cognitive domains as visuospatial ability, memory and language can also be affected. Main risk factors for PD-CI include male gender, advanced age, low education, severe motor symptoms, low baseline cognitive function and excessive daytime sleepiness (EDS. Lewy bodies are main pathological changes, and Alzheimer's disease (AD related pathological changes can also be seen. The application value of decreased α?synuclein (α-Syn and β-amyloid 1-42 (Aβ1-42 levels in cerebrospinal fluid (CSF as biomarkers remains controversial. There are few related research and no defined pathogenic genes currently. Both dopaminergic pathway and acetylcholinergic pathway are involved in the occurrence of PD - CI as demonstrated in PET studies. Cortical and subcortical atrophy are associated with PD - CI as observed in MRI studies. Olfactory dysfunction may be one of the predictors of cognitive impairment. PDD and dementia with Lewy bodies (DLB share common biological characteristics, therefore the differential diagnosis sometimes is difficult. Cholinesterase inhibitors (ChEIs and memantine help to improve clinical symptoms, but treatment decision should be made with individualization. Cognitive behavioral treatment (CBT has potential clinical value and should be investigated by more studies. DOI: 10.3969/j.issn.1672-6731.2017.06.004

  6. The heterogeneity and natural history of mild cognitive impairment of visual memory predominant type.

    Science.gov (United States)

    Ye, Byoung Seok; Chin, Juhee; Kim, Seong Yoon; Lee, Jung-Sun; Kim, Eun-Joo; Lee, Yunhwan; Hong, Chang Hyung; Choi, Seong Hye; Park, Kyung Won; Ku, Bon D; Moon, So Young; Kim, SangYun; Han, Seol-Hee; Lee, Jae-Hong; Cheong, Hae-Kwan; Park, Sun Ah; Jeong, Jee Hyang; Na, Duk L; Seo, Sang Won

    2015-01-01

    We evaluate the longitudinal outcomes of amnestic mild cognitive impairment (aMCI) according to the modality of memory impairment involved. We recruited 788 aMCI patients and followed them up. aMCI patients were categorized into three groups according to the modality of memory impairment: Visual-aMCI, only visual memory impaired; Verbal-aMCI, only verbal memory impaired; and Both-aMCI, both visual and verbal memory impaired. Each aMCI group was further categorized according to the presence or absence of recognition failure. Risk of progression to dementia was compared with pooled logistic regression analyses while controlling for age, gender, education, and interval from baseline. Of the sample, 219 (27.8%) aMCI patients progressed to dementia. Compared to the Visual-aMCI group, Verbal-aMCI (OR = 1.98, 95% CI = 1.19-3.28, p = 0.009) and Both-aMCI (OR = 3.05, 95% CI = 1.97-4.71, p Memory recognition failure was associated with increased risk of progression to dementia only in the Visual-aMCI group, but not in the Verbal-aMCI and Both-aMCI groups. The Visual-aMCI without recognition failure group were subcategorized into aMCI with depression, small vessel disease, or accelerated aging, and these subgroups showed a variety of progression rates. Our findings underlined the importance of heterogeneous longitudinal outcomes of aMCI, especially Visual-aMCI, for designing and interpreting future treatment trials in aMCI.

  7. Cognitive and functional neuroimaging correlate for anosognosia in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Hasselbalch, Steen G; Gade, Anders

    2005-01-01

    To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD).......To investigate the correlation between anosognosia and behavioural symptoms, performance on executive tests, and frontal cortex regional cerebral blood flow (rCBF) in patients with 'amnestic mild cognitive impairment' (MCI) and mild Alzheimer's disease (AD)....

  8. Awareness of deficits in mild cognitive impairment and Alzheimer's disease

    DEFF Research Database (Denmark)

    Vogel, Asmus; Stokholm, Jette; Gade, Anders

    2004-01-01

    In this study we investigated impaired awareness of cognitive deficits in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Very few studies have addressed this topic, and methodological inconsistencies make the comparison of previous studies difficult. From a prospective...

  9. Investigating Simulated Driving Errors in Amnestic Single- and Multiple-Domain Mild Cognitive Impairment.

    Science.gov (United States)

    Hird, Megan A; Vesely, Kristin A; Fischer, Corinne E; Graham, Simon J; Naglie, Gary; Schweizer, Tom A

    2017-01-01

    The areas of driving impairment characteristic of mild cognitive impairment (MCI) remain unclear. This study compared the simulated driving performance of 24 individuals with MCI, including amnestic single-domain (sd-MCI, n = 11) and amnestic multiple-domain MCI (md-MCI, n = 13), and 20 age-matched controls. Individuals with MCI committed over twice as many driving errors (20.0 versus 9.9), demonstrated difficulty with lane maintenance, and committed more errors during left turns with traffic compared to healthy controls. Specifically, individuals with md-MCI demonstrated greater driving difficulty compared to healthy controls, relative to those with sd-MCI. Differentiating between different subtypes of MCI may be important when evaluating driving safety.

  10. Positive Effects of Computer-Based Cognitive Training in Adults with Mild Cognitive Impairment

    Science.gov (United States)

    Herrera, C.; Chambon, C.; Michel, B. F.; Paban, V.; Alescio-Lautier, B.

    2012-01-01

    Considering the high risk for individuals with amnestic Mild Cognitive Impairment (A-MCI) to progress towards Alzheimer's disease (AD), we investigated the efficacy of a non-pharmacological intervention, that is, cognitive training that could reduce cognitive difficulties and delay the cognitive decline. For this, we evaluated the efficacy of a…

  11. White Matter Lesion Assessment in Patients with Cognitive Impairment and Healthy Controls: Reliability Comparisons between Visual Rating, a Manual, and an Automatic Volumetrical MRI Method—The Gothenburg MCI Study

    Directory of Open Access Journals (Sweden)

    Erik Olsson

    2013-01-01

    Full Text Available Age-related white matter lesions (WML are a risk factor for stroke, cognitive decline, and dementia. Different requirements are imposed on methods for the assessment of WML in clinical settings and for research purposes, but reliability analysis is of major importance. In this study, WML assessment with three different methods was evaluated. In the Gothenburg mild cognitive impairment study, MRI scans from 152 participants were used to assess WML with the Fazekas visual rating scale on T2 images, a manual volumetric method on FLAIR images, and FreeSurfer volumetry on T1 images. Reliability was acceptable for all three methods. For low WML volumes (2/3 of the patients, reliability was overall lower and nonsignificant for the manual volumetric method. Unreliability in the assessment of patients with low WML with manual volumetry may mainly be due to intensity variation in the FLAIR sequence used; hence, intensity standardization and normalization methods must be used for more accurate assessments. The FreeSurfer segmentations resulted in smaller WML volumes than the volumes acquired with the manual method and showed deviations from visible hypointensities in the T1 images, which quite likely reduces validity.

  12. Memory evaluation in mild cognitive impairment using recall and recognition tests

    OpenAIRE

    Bennett, IJ; Golob, EJ; Parker, ES; Starr, A

    2006-01-01

    Amnestic mild cognitive impairment (MCI) is a selective episodic memory deficit that often indicates early Alzheimer's disease. Episodic memory function in MCI is typically defined by deficits in free recall, but can also be tested using recognition procedures. To assess both recall and recognition in MCI, MCI (n = 21) and older comparison (n = 30) groups completed the USC-Repeatable Episodic Memory Test. Subjects memorized two verbally presented 15-item lists. One list was used for three fre...

  13. The progress of functional neuroimaging in the study of mild cognitive impairment

    International Nuclear Information System (INIS)

    Li Zugui

    2006-01-01

    Mild cognitive impairment (MCI) represents a transitional state between healthy aging and very mild Alzheimer's disease. MCI patients have a substantially higher rate of progression to Alzheimer's disease compared with cognitively normal elderly people. Functional neutroimaging modalities, including PET, SPECT and functional MRI show that MCI patients have special abnormalities in brain metabolism and perfusion, so they can offer great value in the predicting cognitive decline and early diagnosis of dementia. (authors)

  14. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomised controlled trial

    NARCIS (Netherlands)

    Uffelen, J.G.Z. van; Chinapaw, M.J.M.; Mechelen, W. van; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  15. Walking or vitamin B for cognition in older adults with mild cognitive impairment? A randomized controlled trial

    NARCIS (Netherlands)

    van Uffelen, J.G.Z.; Chin A Paw, M.J.M.; van Mechelen, W.; Hopman-Rock, M.

    2008-01-01

    Objective: To examine the effects of aerobic exercise or vitamin B supplementation on cognitive function in older adults with mild cognitive impairment (MCI). Design: Randomised placebo-controlled trial. Setting: General community. Participants: Community-dwelling adults aged 70-80 with MCI.

  16. Awareness of memory failures and motivation for cognitive training in mild cognitive impairment.

    Science.gov (United States)

    Werheid, Katja; Ziegler, Matthias; Klapper, Annina; Kühl, Klaus-Peter

    2010-01-01

    Awareness of cognitive deficits is considered to be decisive for the effectiveness of cognitive training in mild cognitive impairment (MCI). However, it is unclear in what way awareness influences motivation to participate in cognitive training. Thirty-two elderly adults with MCI and 72 controls completed the 5-scale Memory Functioning Questionnaire (MFQ) and a motivation questionnaire. The predictive value of the MFQ scales on motivation was analyzed using regression analysis. In the MCI group, but not in controls, higher perceived frequency of memory failures was associated with a lower motivation score. Our findings indicate that, in MCI, greater awareness of cognitive deficits does not necessarily increase motivation to participate in cognitive trainings, and suggest that success expectancy may be a moderating factor. Copyright © 2010 S. Karger AG, Basel.

  17. Cognitive profiling of Parkinson disease patients with mild cognitive impairment and dementia.

    Science.gov (United States)

    Biundo, Roberta; Weis, Luca; Facchini, Silvia; Formento-Dojot, Patrizia; Vallelunga, Annamaria; Pilleri, Manuela; Antonini, Angelo

    2014-04-01

    Prevalence of mild cognitive impairment (MCI) and dementia in Parkinson disease (PD) is variable because different classification criteria are applied and there is lack of consensus about neuropsychological tests and cut-off used for cognitive profiling. Given the important therapeutic consequences for patient management, we aimed at identifying suitable diagnostic cognitive tests and respective screening cut-off values for MCI and dementia in PD (PDD). We evaluated 105 PD patients using an extensive neuropsychological battery categorized as PD without cognitive impairment (PD-CNT) (35%), PD-MCI (47%) and PDD (18%) based on established criteria and calculated Receiver Operating Characteristic (ROC) curves. We found different sensitivity and specificity among neuropsychological tests in detecting PD-MCI and PDD. In particular performance in attention/set shifting, verbal memory and language abilities, discriminated both PD-MCI and PDD from PD-CNT. Abilities involved mainly in semantic retrieval mechanisms discriminated PD-CNT from PD-MCI but also PD-MCI from PDD. Finally deficits in executive and visual-spatial abilities were only affected in PDD. Our data point to an independent and different load of each test in defining different PD cognitive statuses. These findings can help selection of appropriate cognitive batteries in longitudinal studies and definition of stage-specific therapeutic targets. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Atsuko Hayashi

    2015-09-01

    Full Text Available Background/Aims: We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI and mild Alzheimer's disease (AD. To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji. Methods: A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. Results: For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. Conclusions: The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients.

  19. Writing Impairments in Japanese Patients with Mild Cognitive Impairment and with Mild Alzheimer's Disease.

    Science.gov (United States)

    Hayashi, Atsuko; Nomura, Hiroshi; Mochizuki, Ruriko; Ohnuma, Ayumu; Kimpara, Teiko; Suzuki, Kyoko; Mori, Etsuro

    2015-01-01

    We investigated writing abilities in patients with the amnestic type of mild cognitive impairment (aMCI) and mild Alzheimer's disease (AD). To examine the earliest changes in writing function, we used writing tests for both words and sentences with different types of Japanese characters (Hiragana, Katakana, and Kanji). A total of 25 aMCI patients, 38 AD patients, and 22 healthy controls performed writing to dictation for Kana and Kanji words, copied Kanji words, and wrote in response to a picture story task. Analysis of variance was used to test the subject group effects on the scores in the above writing tasks. For the written Kanji words, the mild AD group performed worse than the aMCI group and the controls, but there was no difference between the aMCI group and the controls. For the picture story writing task, the mild AD and aMCI groups performed worse than the controls, but the difference between the AD and the aMCI groups was not significant. The mild AD group showed defects in writing Kanji characters, and the aMCI group showed impairments in narrative writing. Our study suggests that narrative writing, which demands complex integration of multiple cognitive functions, can be used to detect the subtle writing deficits in aMCI patients.

  20. Cognitive impairment in early-stage non-demented Parkinson's disease patients

    DEFF Research Database (Denmark)

    Pfeiffer, Helle Cecilie Viekilde; Løkkegaard, A; Zoetmulder, Marielle

    2013-01-01

    In Parkinson's disease (PD), Parkinson's disease dementia (PDD) and Parkinson's disease-mild cognitive impairment (PD-MCI) are common. PD-MCI is a risk factor for developing PDD. Knowledge of cognition in early-stages PD is essential in understanding and predicting the dementia process....

  1. Functional abilities in older adults with mild cognitive impairment.

    Science.gov (United States)

    Burton, Catherine L; Strauss, Esther; Bunce, David; Hunter, Michael A; Hultsch, David F

    2009-01-01

    A classification scheme and general set of criteria for diagnosing mild cognitive impairment (MCI) were recently proposed by a multidisciplinary group of experts who met at an international symposium on MCI. One of the proposed criteria included preserved basic activities of daily living and minimal impairment in complex instrumental activities of daily living (IADLs). To investigate whether older adults with MCI classified according to the subtypes identified by the Working Group (i.e. amnestic, single non-memory domain, and multiple domain with or without a memory component) differed from cognitively intact older adults on a variety of measures indexing IADLs and to examine how well measures of IADL predict concurrent MCI status. Two hundred and fifty community-dwelling older adults, ranging in age from 66 to 92, completed self-report measures of IADLs (Lawton and Brody IADL Scale, Scales of Independent Behaviour-Revised--SIB-R) and a measure of everyday problem solving indexing IADLs (Everyday Problems Test--EPT). Ratings of participants' IADL functioning were also obtained from informants (e.g. spouse, adult child and friend). Older adults with multiple-domain MCI demonstrated poorer IADL functioning than older adults with no cognitive impairment on the EPT and the SIB-R (both self- and informant-report versions). The multiple-domain MCI participants also demonstrated poorer IADLs than MCI participants with impairments in a single cognitive domain on the self-reported SIB-R and EPT. The single-domain MCI groups demonstrated poorer IADLs than older adults without cognitive impairment on the informant-reported SIB-R and EPT. No significant group differences were found on the Lawton and Brody IADL Scale. Using the EPT and SIB-R as predictors in a multinomial regression analysis, MCI group status was reliably predicted, but the classification rate was poor. Individuals with MCI demonstrated poorer IADL functioning compared to cognitively intact older adults

  2. Mild cognitive impairment: coping with an uncertain label.

    NARCIS (Netherlands)

    Joosten-Weyn Banningh, E.W.A.; Vernooy-Dassen, M.J.F.J.; Olde Rikkert, M.G.M.; Teunisse, J.P.W.M.

    2008-01-01

    BACKGROUND: The recently introduced diagnostic label of Mild Cognitive Impairment (MCI) identifies patients with a cognitive decline that is more pronounced than is usual for a person's age and educational level but does not notably interfere with activities of daily living (ADL). The natural course

  3. Effects of mild cognitive impairment on emotional scene memory.

    Science.gov (United States)

    Waring, J D; Dimsdale-Zucker, H R; Flannery, S; Budson, A E; Kensinger, E A

    2017-02-01

    Young and older adults experience benefits in attention and memory for emotional compared to neutral information, but this memory benefit is greatly diminished in Alzheimer's disease (AD). Little is known about whether this impairment arises early or late in the time course between healthy aging and AD. This study compared memory for positive, negative, and neutral items with neutral backgrounds between patients with mild cognitive impairment (MCI) and healthy older adults. We also used a divided attention condition in older adults as a possible model for the deficits observed in MCI patients. Results showed a similar pattern of selective memory for emotional items while forgetting their backgrounds in older adults and MCI patients, but MCI patients had poorer memory overall. Dividing attention during encoding disproportionately reduced memory for backgrounds (versus items) relative to a full attention condition. Participants performing in the lower half on the divided attention task qualitatively and quantitatively mirrored the results in MCI patients. Exploratory analyses comparing lower- and higher-performing MCI patients showed that only higher-performing MCI patients had the characteristic scene memory pattern observed in healthy older adults. Together, these results suggest that the effects of emotion on memory are relatively well preserved for patients with MCI, although emotional memory patterns may start to be altered once memory deficits become more pronounced. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Effect of Pain and Mild Cognitive Impairment on Mobility.

    Science.gov (United States)

    Schepker, Caroline A; Leveille, Suzanne G; Pedersen, Mette M; Ward, Rachel E; Kurlinski, Laura A; Grande, Laura; Kiely, Dan K; Bean, Jonathan F

    2016-01-01

    To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations. Cross-sectional analysis. Academic community outpatient clinic. Individuals aged 65 and older in primary care enrolled in the Boston Rehabilitative Impairment Study in the Elderly who were at risk of mobility decline (N=430). Participants with an average score greater than three on the Brief Pain Inventory (BPI) were defined as having pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between pain and MCI, together and separately, and mobility performance (habitual gait speed, Short Physical Performance Battery), and self-reports of function and disability in various day-to-day activities (Late Life Function and Disability Instrument). The prevalence of pain was 34% and of MCI was 42%; 17% had pain only, 25% had MCI only, 17% had pain and MCI, and 41% had neither. Participants with pain and MCI performed significantly worse than all others on all mobility outcomes (Pmobility outcomes than those with neither (Pmobility, and the presence of both comorbidities was associated with the poorest status. Primary care practitioners who encounter older adults in need of mobility rehabilitation should consider screening them for pain and MCI to better inform subsequent therapeutic interventions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Subclinical naming errors in mild cognitive impairment: A semantic deficit?

    Directory of Open Access Journals (Sweden)

    Indra F. Willers

    Full Text Available Abstract Mild cognitive impairment (MCI is the transitional stage between normal aging and Alzheimer's disease (AD. Impairments in semantic memory have been demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT is a straightforward method of examining semantic or visuo-perceptual processing and therefore represents a potential diagnostic tool. The objective of this study was to examine naming ability and identify error types in patients with amnestic mild cognitive impairment (aMCI. Methods: Twenty aMCI patients, twenty AD patients and twenty-one normal controls, matched by age, sex and education level were evaluated. As part of a further neuropsychological evaluation, all subjects performed the BNT. A comprehensive classification of error types was devised in order to compare performance and ascertain semantic or perceptual origin of errors. Results: AD patients obtained significantly lower total scores on the BNT than aMCI patients and controls. aMCI patients did not obtain significant differences in total scores, but showed significantly higher semantic errors compared to controls. Conclusion: This study reveals that semantic processing is impaired during confrontation naming in aMCI.

  6. Effect of Pain and Mild Cognitive Impairment on Mobility

    DEFF Research Database (Denmark)

    Schepker, Caroline A; Leveille, Suzanne G; Pedersen, Mette Merete

    2016-01-01

    OBJECTIVES: To examine the effect of pain and mild cognitive impairment (MCI)-together and separately-on performance-based and self-reported mobility outcomes in older adults in primary care with mild to moderate self-reported mobility limitations. DESIGN: Cross-sectional analysis. SETTING...... Inventory (BPI) were defined as having pain. MCI was defined using age-adjusted scores on a neuropsychological battery. Multivariable linear regression models assessed associations between pain and MCI, together and separately, and mobility performance (habitual gait speed, Short Physical Performance...

  7. Validation of the Cuban Version of Addenbrooke's Cognitive Examination-Revised for Screening Mild Cognitive Impairment.

    Science.gov (United States)

    Broche-Pérez, Yunier; López-Pujol, Héctor Alejandro

    2017-01-01

    The diagnostic accuracy of the Cuban version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen's d) were calculated. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. The Cuban ACE-R had reliable internal consistency (Cronbach's coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE. © 2018 S. Karger AG, Basel.

  8. Age-correction of test scores reduces the validity of mild cognitive impairment in predicting progression to dementia

    NARCIS (Netherlands)

    Hessler, Johannes; Tucha, Oliver; Förstl, Hans; Mönsch, Edelgard; Bickel, Horst

    2014-01-01

    Objectives: A phase of mild cognitive impairment (MCI) precedes most forms of neurodegenerative dementia. Many definitions of MCI recommend the use of test norms to diagnose cognitive impairment. It is, however, unclear whether the use of norms actually improves the detection of individuals at risk

  9. Addenbrooke's Cognitive Examination-Revised for mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    McColgan, Peter; Evans, Jonathan R; Breen, David P; Mason, Sarah L; Barker, Roger A; Williams-Gray, Caroline H

    2012-08-01

    Cognitive impairment is common in Parkinson's disease (PD), even in the early stages, and appropriate screening tools are needed. We investigated the utility of the Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment (MCI) in PD in an incident population-representative cohort (n = 132) and investigated the relationship between performance on this instrument and behavior and quality of life (n = 219). Twenty-two percent met criteria for MCI. Receiver operating curve analysis revealed an area under the curve of 0.81. A cutoff Cognitive Rating Scale, and there were significant correlations with the Cambridge Behavioral Inventory-Revised and Parkinson's Disease Questionnaire 39. This instrument is a useful screening tool for PD-MCI, and poor performance is significantly related to impaired behavior and quality of life. Copyright © 2012 Movement Disorder Society.

  10. Medical decision-making capacity in mild cognitive impairment: a 3-year longitudinal study.

    Science.gov (United States)

    Okonkwo, O C; Griffith, H R; Copeland, J N; Belue, K; Lanza, S; Zamrini, E Y; Harrell, L E; Brockington, J C; Clark, D; Raman, R; Marson, D C

    2008-11-04

    To investigate longitudinal change in the medical decision-making capacity (MDC) of patients with amnestic mild cognitive impairment (MCI) under different consent standards. Eighty-eight healthy older controls and 116 patients with MCI were administered the Capacity to Consent to Treatment Instrument at baseline and at 1 to 3 (mean = 1.7) annual follow-up visits thereafter. Covariate-adjusted random coefficient regressions were used to examine differences in MDC trajectories across MCI and control participants, as well as to investigate the impact of conversion to Alzheimer disease on MCI patients' MDC trajectories. At baseline, MCI patients performed significantly below controls only on the three clinically relevant standards of appreciation, reasoning, and understanding. Compared with controls, MCI patients experienced significant declines over time on understanding but not on any other consent standard. Conversion affected both the elevation (a decrease in performance) and slope (acceleration in subsequent rate of decline) of MCI patients' MDC trajectories on understanding. A trend emerged for conversion to be associated with a performance decrease on reasoning in the MCI group. Medical decision-making capacity (MDC) decline in mild cognitive impairment (MCI) is a relatively slow but detectable process. Over a 3-year period, patients with amnestic MCI show progressive decline in the ability to understand consent information. This decline accelerates after conversion to Alzheimer disease (AD), reflecting increasing vulnerability to decisional impairment. Clinicians and researchers working with MCI patients should give particular attention to the informed consent process when conversion to AD is suspected or confirmed.

  11. Caregivers in China: Knowledge of Mild Cognitive Impairment

    Science.gov (United States)

    Dai, Baozhen; Mao, Zongfu; Mei, John; Levkoff, Sue; Wang, Huali; Pacheco, Misty; Wu, Bei

    2013-01-01

    This study aimed to examine the experience and knowledge of mild cognitive impairment (MCI) among Chinese family caregivers of individuals with MCI. The sample was recruited from memory clinics in Zhongnan Hospital in Wuhan, China. In-depth semi-structured interviews were used. Thirteen family members of individuals diagnosed with MCI participated in the study. Data analysis revealed three themes: 1) initial recognition of cognitive decline; 2) experience of the diagnosis of MCI; 3) perception of cognitive decline as a normal part of aging. While family members recognized the serious consequences of memory loss (e.g. getting lost), they would typically not take their family members to see a doctor until something specific triggered their access to the medical care system. The Chinese traditional perception of dementia as part of normal aging may serve to lessen the stigma of individuals with MCI, while the term “laonian chidai” which literally translates to “stupid, demented elderly” may exacerbate the stigma associated with individuals with MCI. It is suggested that family members’ worries may be relieved by improving their access to accurate knowledge of the disease, community-based and institutional care services, and culturally appropriately words are needed for MCI. PMID:23326541

  12. Caregivers in China: knowledge of mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Baozhen Dai

    Full Text Available This study aimed to examine the experience and knowledge of mild cognitive impairment (MCI among Chinese family caregivers of individuals with MCI. The sample was recruited from memory clinics in Zhongnan Hospital in Wuhan, China. In-depth semi-structured interviews were used. Thirteen family members of individuals diagnosed with MCI participated in the study. Data analysis revealed three themes: 1 initial recognition of cognitive decline; 2 experience of the diagnosis of MCI; 3 perception of cognitive decline as a normal part of aging. While family members recognized the serious consequences of memory loss (e.g. getting lost, they would typically not take their family members to see a doctor until something specific triggered their access to the medical care system. The Chinese traditional perception of dementia as part of normal aging may serve to lessen the stigma of individuals with MCI, while the term "laonian chidai" which literally translates to "stupid, demented elderly" may exacerbate the stigma associated with individuals with MCI. It is suggested that family members' worries may be relieved by improving their access to accurate knowledge of the disease, community-based and institutional care services, and culturally appropriately words are needed for MCI.

  13. Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile.

    Science.gov (United States)

    Alladi, Suvarna; Arnold, Robert; Mitchell, Joanna; Nestor, Peter J; Hodges, John R

    2006-04-01

    We explored the applicability of recently proposed research criteria for mild cognitive impairment (MCI) in a memory clinic and changes in case definition related to which memory tests are used and the status of general cognitive function in MCI. A total of 166 consecutive GP referrals to the Cambridge Memory Clinic underwent comprehensive neuropsychological and psychiatric evaluation. Of 166 cases, 42 were excluded (significant depression 8, established dementia 29 and other disorders 5). Of 124 non-demented, non-depressed patients, 72 fulfilled Petersen's criteria for amnestic MCI based upon verbal memory performance [the Rey Auditory Verbal Learning Test (RAVLT)] and 90 met criteria if performance on verbal and/or non-verbal memory tests [the Rey figure recall or the Paired Associates Learning test (PAL)] was considered. Of the 90 broadly defined MCI cases, only 25 had pure amnesia: other subtle semantic and/or attention deficits were typically present. A further 12 were classed as non-amnestic MCI and 22 as 'worried well'. Definition of MCI varies considerably dependent upon the tests used for case definition. The majority have other cognitive deficits despite normal performance on the Mini-mental State Examination (MMSE) and intact activities of daily living (ADL) and fit within multi-domain MCI. Pure amnesic MCI is rare.

  14. Amyloid-independent functional neural correlates of episodic memory in amnestic mild cognitive impairment.

    Science.gov (United States)

    Seo, Eun Hyun; Choo, I L Han

    2016-06-01

    Although amnestic mild cognitive impairment (aMCI) could have various biological characteristics, little attention has been given to the nature of episodic memory decline in aMCI with pathophysiologies other than Alzheimer's disease (AD), i.e., aMCI with low beta-amyloid (Aβ) burden. This study aimed to identify the functional neural basis of episodic memory impairment in aMCI with Aβ burden negative (aMCI-Aβ-) and to compare these results with aMCI with Aβ burden positive (aMCI-Aβ+). Individuals with aMCI (n = 498) were selected from the Alzheimer's Disease Neuroimaging Initiative database. Based on the mean florbetapir standard uptake value ratio, participants were classified as aMCI-Aβ- or aMCI-Aβ+. Correlations between memory scores and regional cerebral glucose metabolism (rCMglc) were analyzed separately for the two subgroups using a multiple regression model. For aMCI-Aβ-, significant positive correlations between memory and rCMglc were found in the bilateral claustrum, right thalamus, left anterior cingulate cortex, left insula, and right posterior cingulate. For aMCI-Aβ+, significant positive correlations between memory and rCMglc were found in the temporoparietal areas. These correlation patterns remained unchanged when clinical severity was added as a covariate Our findings indicate that memory impairment in aMCI-Aβ- is related to multimodal integrative processing and the attentional control system, whereas memory impairment in aMCI-Aβ+ is related to the typical brain memory systems and AD signature. These results suggest that although the two subgroups are clinically in the same category as aMCI, the memory impairment process depends on completely different functional brain regions according to their Aβ burden level.

  15. Poorer Financial and Health Literacy Among Community-Dwelling Older Adults With Mild Cognitive Impairment.

    Science.gov (United States)

    Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A

    2015-09-01

    Literacy is an important determinant of financial and health outcomes in old age, and cognitive decline has been linked with lower literacy. We tested the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and health literacy. Participants (n = 730) from the Rush Memory and Aging Project were given a clinical evaluation and an assessment of total, financial, and health literacy. Regression was used to examine whether MCI was associated with lower literacy. In secondary analyses, we investigated the association of particular cognitive systems with literacy. MCI was associated with lower total, financial, and health literacy. An interaction was observed such that higher education reduced the effect of MCI on total and financial literacy. Multiple cognitive systems were associated with literacy in participants with MCI, and semantic memory accounted for the most variance. Persons with MCI exhibit poorer financial and health literacy, and education mitigates this effect. © The Author(s) 2015.

  16. Cerebral Metabolic Differences Associated with Cognitive Impairment in Parkinson's Disease.

    Directory of Open Access Journals (Sweden)

    Yilin Tang

    Full Text Available To characterize cerebral glucose metabolism associated with different cognitive states in Parkinson's disease (PD using 18F-fluorodeoxyglucose (FDG and Positron Emission Tomography (PET.Three groups of patients were recruited in this study including PD patients with dementia (PDD; n = 10, with mild cognitive impairment (PD-MCI; n = 20, and with no cognitive impairment (PD-NC; n = 30. The groups were matched for age, sex, education, disease duration, motor disability, levodopa equivalent dose and Geriatric Depression Rating Scale (GDS score. All subjects underwent a FDG-PET study. Maps of regional metabolism in the three groups were compared using statistical parametric mapping (SPM5.PD-MCI patients exhibited limited areas of hypometabolism in the frontal, temporal and parahippocampal gyrus compared with the PD-NC patients (p < 0.01. PDD patients had bilateral areas of hypometabolism in the frontal and posterior parietal-occipital lobes compared with PD-MCI patients (p < 0.01, and exhibited greater metabolic reductions in comparison with PD-NC patients (p < 0.01.Compared with PD-NC patients, hypometabolism was much higher in the PDD patients than in PD-MCI patients, mainly in the posterior cortical areas. The result might suggest an association between posterior cortical hypometabolism and more severe cognitive impairment. PD-MCI might be important for early targeted therapeutic intervention and disease modification.

  17. Behavioral symptoms in community-dwelling elderly Nigerians with dementia, mild cognitive impairment, and normal cognition.

    Science.gov (United States)

    Baiyewu, Olusegun; Unverzagt, Fred W; Ogunniyi, Adesola; Smith-Gamble, Valerie; Gureje, Oye; Lane, Kathleen A; Gao, Sujuan; Hall, Kathleen S; Hendrie, Hugh C

    2012-09-01

    Few studies have examined the neuropsychiatric status of patients with dementia and cognitive impairment in the developing world despite the fact that current demographic trends suggest an urgent need for such studies. To assess the level of neuropsychiatric symptoms in community-dwelling individuals with dementia, cognitive impairment no dementia and normal cognition. Subjects were from the Ibadan site of Indianapolis-Ibadan Dementia Project with stable diagnoses of normal cognition, cognitive impairment, no dementia/mild cognitive impairment (CIND/MCI), and dementia. Informants of subjects made ratings on the neuropsychiatric inventory and blessed dementia scale; subjects were tested with the mini mental state examination. One hundred and eight subjects were included in the analytic sample, 21 were cognitively normal, 34 were demented, and 53 were CIND/MCI. The diagnostic groups did not differ in age, per cent female, or per cent with any formal education. The most frequent symptoms among subjects with CIND/MCI were depression (45.3%), apathy (37.7%), night time behavior (28.3%), appetite change (24.5%), irritability (22.6%), delusions (22.6%), anxiety (18.9%), and agitation (17.0%). Depression was significantly more frequent among the CIND/MCI and dementia (44.1%) groups compared with the normal cognition group (9.5%). Distress scores were highest for the dementia group, lowest for the normal cognition group, and intermediate for the CIND/MCI group. Significant neuropsychiatric symptomatology and distress are present among cognitively impaired persons in this community-based study of older adults in this sub-Saharan African country. Programs to assist family members of cognitively impaired and demented persons should be created or adapted for use in developing countries. Copyright © 2012 John Wiley & Sons, Ltd.

  18. The neuroimaging approach to the assessment of mild cognitive impairment

    International Nuclear Information System (INIS)

    Lucignani, Giovanni

    2006-01-01

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder

  19. The neuroimaging approach to the assessment of mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Lucignani, Giovanni [University of Milan and Unit of Molecular Imaging, Division of Radiation Therapy, European Institute of Oncology, Institute of Radiological Sciences, Milan (Italy)

    2006-06-15

    Imaging techniques, including emission tomography and magnetic resonance imaging, are progressively being exploited for the classification and prognostic evaluation (indispensable for possible treatments) of mild cognitive impairment (MCI). The main traits of MCI and unsolved issues in its assessment are discussed in two review articles by Feldman and Jacova from the Division of Neurology, Dept. of Medicine, Clinic for Alzheimer Disease and Related Disorders, University of British Columbia, in Vancouver, Canada [1] and Chong and Sahadevan from the Department of Geriatric Medicine, Tan Tock Seng Hospital, Jalan Tan Tock Seng, Singapore [2]. Because MCI has different presentations in terms of the type and degree of cognitive deficits observed, several clinical subtypes of MCI besides the amnestic form have now been recognised and characterised on the basis of deficits in different cognitive domains, either in isolation or in combination with amnesia. The different subtypes of MCI suggest that MCI has a heterogeneous nature, with several possible causes that lead to the same symptoms. This is a field in evolution, and a uniform diagnostic classification of MCI has not yet been accomplished. Lopez et al. from the Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine,Pittsburgh, Pennsylvania, USA [3] point out that the classification of MCI subtypes is useful to improve prediction of the subsequent risk of dementia and the type of dementia, and that the manner in which MCI subjects are classified into subgroups has implications for the cognitive profile of the group and thus for our inferences about the aetiology and possible clinical course of the disorder.

  20. Integration and relative value of biomarkers for prediction of MCI to AD progression: Spatial patterns of brain atrophy, cognitive scores, APOE genotype and CSF biomarkers

    Directory of Open Access Journals (Sweden)

    Xiao Da

    2014-01-01

    Full Text Available This study evaluates the individual, as well as relative and joint value of indices obtained from magnetic resonance imaging (MRI patterns of brain atrophy (quantified by the SPARE-AD index, cerebrospinal fluid (CSF biomarkers, APOE genotype, and cognitive performance (ADAS-Cog in progression from mild cognitive impairment (MCI to Alzheimer's disease (AD within a variable follow-up period up to 6 years, using data from the Alzheimer's Disease Neuroimaging Initiative-1 (ADNI-1. SPARE-AD was first established as a highly sensitive and specific MRI-marker of AD vs. cognitively normal (CN subjects (AUC = 0.98. Baseline predictive values of all aforementioned indices were then compared using survival analysis on 381 MCI subjects. SPARE-AD and ADAS-Cog were found to have similar predictive value, and their combination was significantly better than their individual performance. APOE genotype did not significantly improve prediction, although the combination of SPARE-AD, ADAS-Cog and APOE ε4 provided the highest hazard ratio estimates of 17.8 (last vs. first quartile. In a subset of 192 MCI patients who also had CSF biomarkers, the addition of Aβ1–42, t-tau, and p-tau181p to the previous model did not improve predictive value significantly over SPARE-AD and ADAS-Cog combined. Importantly, in amyloid-negative patients with MCI, SPARE-AD had high predictive power of clinical progression. Our findings suggest that SPARE-AD and ADAS-Cog in combination offer the highest predictive power of conversion from MCI to AD, which is improved, albeit not significantly, by APOE genotype. The finding that SPARE-AD in amyloid-negative MCI patients was predictive of clinical progression is not expected under the amyloid hypothesis and merits further investigation.

  1. The effect of bilingualism on amnestic mild cognitive impairment.

    Science.gov (United States)

    Ossher, Lynn; Bialystok, Ellen; Craik, Fergus I M; Murphy, Kelly J; Troyer, Angela K

    2013-01-01

    Previous reports have found that lifelong bilingualism is associated with a delay in the onset of dementia, including Dementia of the Alzheimer's Type (DAT). Because amnestic mild cognitive impairment (aMCI) is often a transition stage between normal aging and DAT, our aim in this paper was to establish whether this delay in symptom onset for bilinguals would also be seen in the onset of symptoms of aMCI and whether this delay would be consistent in different subtypes of aMCI. We examined the effect of bilingualism on the age of diagnosis in individuals with single- or multiple-domain aMCI who were administered a battery of neuropsychological tests and questionnaires about their language and social background. Our results showed an interaction between aMCI type and language history. Only individuals diagnosed with single-domain aMCI demonstrated a later age of diagnosis for bilinguals (M = 79.4 years) than monolinguals (M = 74.9 years). This preliminary evidence suggests that the early protective advantage of bilingualism may be specific to single-domain aMCI, which is the type of aMCI most specifically associated with progression to DAT.

  2. Different Patterns of Theory of Mind Impairment in Mild Cognitive Impairment.

    Science.gov (United States)

    Moreau, Noémie; Rauzy, Stéphane; Bonnefoi, Bernadette; Renié, Laurent; Martinez-Almoyna, Laurent; Viallet, François; Champagne-Lavau, Maud

    2015-01-01

    Theory of Mind refers to the ability to infer other’s mental states, their beliefs, intentions, or knowledge. To date, only two studies have reported the presence of Theory of Mind impairment in mild cognitive impairment (MCI). In the present study,we evaluated 20 MCI patients and compared them with 25 healthy control participants using two Theory of Mind tasks. The first task was a false belief paradigm as frequently used in the literature, and the second one was a referential communication task,assessing Theory of Mind in a real situation of interaction and which had never been used before in this population. The results showed that MCI patients presented difficulties inferring another person’s beliefs about reality and attributing knowledge to them in a situation of real-life interaction. Two different patterns of Theory of Mind emerged among the patients. In comparison with the control group, some MCI patients demonstrated impairment only in the interaction task and presented isolated episodicmemory impairment, while others were impaired in both Theory of Mind tasks and presented cognitive impairment impacting both episodic memory and executive functioning. Theory of Mind is thus altered in the very early stages of cognitive impairment even in real social interaction, which could impact precociously relationships in daily life.

  3. Prognostic value of posteromedial cortex deactivation in mild cognitive impairment.

    Directory of Open Access Journals (Sweden)

    Jeffrey R Petrella

    2007-10-01

    Full Text Available Normal subjects deactivate specific brain regions, notably the posteromedial cortex (PMC, during many tasks. Recent cross-sectional functional magnetic resonance imaging (fMRI data suggests that deactivation during memory tasks is impaired in Alzheimer's disease (AD. The goal of this study was to prospectively determine the prognostic significance of PMC deactivation in mild cognitive impairment (MCI.75 subjects (34 MCI, 13 AD subjects and 28 controls underwent baseline fMRI scanning during encoding of novel and familiar face-name pairs. MCI subjects were followed longitudinally to determine conversion to AD. Regression and analysis of covariance models were used to assess the effect of PMC activation/deactivation on conversion to dementia as well as in the longitudinal change in dementia measures. At longitudinal follow up of up to 3.5 years (mean 2.5+/-0.79 years, 11 MCI subjects converted to AD. The proportion of deactivators was significantly different across all groups: controls (79%, MCI-Nonconverters (73%, MCI-converters (45%, and AD (23% (p<0.05. Mean PMC activation magnitude parameter estimates, at baseline, were negative in the control (-0.57+/-0.12 and MCI-Nonconverter (-0.33+/-0.14 groups, and positive in the MCI-Converter (0.37+/-0.40 and AD (0.92+/-0.30 groups. The effect of diagnosis on PMC deactivation remained significant after adjusting for age, education and baseline Mini-Mental State Exam (p<0.05. Baseline PMC activation magnitude was correlated with change in dementia ratings from baseline.Loss of physiological functional deactivation in the PMC may have prognostic value in preclinical AD, and could aid in profiling subgroups of MCI subjects at greatest risk for progressive cognitive decline.

  4. Conversion Discriminative Analysis on Mild Cognitive Impairment Using Multiple Cortical Features from MR Images

    NARCIS (Netherlands)

    Guo, Shengwen; Lai, Chunren; Wu, Congling; Cen, Guiyin; Hariharan, A.; Vijayakumari, Anupa A.; Aarabi, Mohammad Hadi; Aballi, John; Nour, Abd Elazeim Abd Alla Mohamed; Abdelaziz, Mohammed; Abdolalizadeh, AmirHussein; Abdollahi, Mahsa; Abdul Aziz, Siti Aishah; Salam, Amritha Abdul; Abdulaziz, Nidhal; Abdulkadir, Ahmed; Abdullah, Sachal; Abdullah, Osama; Abrigo, Jill; Adachi, Noriaki; Adamson, Christopher; Adduru, Viraj; Adel, Tameem; Aderghal, Karim; Ades-Aron, Benjamin; Adeyosoye, Michael; Adlard, Paul; Srinivasa, Ag; Aganj, Iman; Agarwal, Ayush; Agarwal, Anupam; Agarwal, Anchit; Aguero, Cinthya; Aguiar, Pablo; Ahdidan, Jamila; Ahmad, Fayyaz; Ahmad, Rziwan; Ahmadi, Hessam; Ahmed, Nisar; Sid, Farid Ahmed; Ai, Edward; Ai, Qing; Aicha, Benyahia; Aitharaju, Sai; Aiyer, Aditya; Akkus, Zeynettin; Akodad, Sanae; Akramifard, Hamid; Aksman, Leon; Aktas, Said; Al-Janabi, Omar; Al-Nuaimi, Ali; AlAila, BahaaEddin; Alakwaa, Fadhl; Alam, Saruar; Alam, Fakhre; Alam Zaidi, Syed Farhan; Alan, Wiener; Alansari, Mukhtar; Alareqi, Ebrahim; Alberdi, Ane; Albsoul, Mohammad; Alderson, Thomas; Aleem, Hassan; Alex, Aishwarya; Alexander, Jacob; Alexopoulos, Panagiotis; Alfoldi, Jessica; Ali, Ayesha; Ali, Imdad; Alimoradian, Shirin; Aljabar, Paul; Aljabbouli, Hasan; Aljovic, Almir; Allen, Genevera; Alliende, Luz Maria; Almaguel, Frankis; Almgren, Hannes; Montes, Carmen Alonso; Alowaisheq, Tasneem; Alryalat, Saif Aldeen; Alsado, Majd; Alsaedi, Abdalrahman; Alshehri, Haifa; Altaf, Tooba; Altendahl, Marie; Altmann, Andre; Alvand, Ashkan; Filho, Manoel Alves; Alzubi, Raid; Amaral, Robert; Ambatipudi, Mythri; Amernath, Remya; Amlien, Inge; Amoroso, Nicola; Amri, Hakima; Anastasiou, Athanasios; Anbarasi, Jani; Anbarjafari, Gholamreza; Anderson, Wes; Anderson, Jeff; Anderson, Valerie; Anderson, Loretta; Andonov, Jovan; Andova, Vesna; Andreopoulou, Irene; Andrews, K. Abigail; Andrews, Cameron; Angeles, Michel; Anne-Laure, Aziz; Ansari, Ghulam Jillani; Ansari, Sharaf; Anstey, Kaarin; Antunes, Augusto; Aoshuang, Zhang; Aouf, Mazin; Aow Yong, Li Yew; Aporntewan, Chatchawit; Apostolova, Liana; Appiah, Frank; Apsvalka, Dace; Arab, Abazar; Araque Caballero, Miguel Ángel; Arbabyazd, Mohammad; Arbelaez, Pablo; Archer, Kellie; Ardekani, Babak; Aretouli, Eleni; Arfanakis, Konstantinos; Arisi, Ivan; Armentrout, Steven; Arnold, Matthias; Arnold, Steven; Arslan, Salim; Artacho-Perula, Emilio; Arthofer, Christoph; Aruchamy, Srinivasan; Arya, Zobair; Pizarro, Carlos Asensio; Ashford, Wes; Ashraf, Azhaar; Askland, Kathleen; Aslaksen, Per; Aslakson, Eric; Aso, Toshihiko; Astphan, Michele; Ataloglou, Dimitrios; Atay, Meltem; Athanas, Argus; Atri, Roozbeh; Au, April; Aurich, Maike; Avants, Brian; Awasthi, Niharika; Awate, Suyash; Ayaz, Aymen; Son, Yesim Aydin; Aydogan, Dogu Baran; Ayhan, Murat; Ayton, Scott; Aziz, Adel; Azmi, Mohd Hafrizal; Ba, Maowen; Bach, Kevin; Badea, Alexandra; Bag, Asim; Bagewadi, Shweta; Bai, Xiangqi; Bai, Zilong; Bai, Haoli; Baird, Geoffrey; Baiwen, Zhang; Baker, Elizabeth; Baker, John; Bakker, Arnold; Ball, Erika; Ballén Galindo, Miguel Ángel; Banaei, Amin; Bandyopadhyay, Dipankar; Bang, Ki Hun; Bangen, Katherine; Banks, Sarah; Banning, Leonie; Bao, Wan Yun; Barakat, Rita; Barbará, Eduardo; Barber, Philip; Barber, Robert; de Araujo, Flavia Roberta Barbosa; Barnes, Josephine; Barredo, Jennifer; Barret, Olivier; Barrett, Matthew; Barsamian, Barsam; Barsky, Andrey; Bartel, Fabian; Bartoszewicz, Jakub; Bartram-Shaw, David; Barwood, Caroline; Basavaraj, Suryakanth; Basavaraj, Arshitha; Basiouny, Ahmed; Baskaran, Bhuvaneshwari; Basu, Arindam; Baths, Veeky; Bathula, Deepti; Batmanghelich, Nematollah Kayhan; Bauer, Roman; Bauer, Corinna; Bawa, Vanshika; Bayley, Peter; Bayram, Ali; Bazi, Yakoub; Beach, Thomas; Beaudoin, Kristin; Beaulieu, Christian; Becker, Cassiano; Beckett, Laurel; Bedding, Alun; Beer, Simone; Beer, Joanne; Beg, Mirza Faisal; Behfar, Qumars; Behjat, Hamed; Behjat, Hamid; Behseta, Sam; Bekris, Lynn; Suresh, Mahanand Belathur; Belichenko, Nadia; Bellio, Maura; Belyaev, Mikhail; Bemiller, Shane; Ahmed, Olfa Ben; Ben Bouallègue, Fayçal; Benedikt, Michael; Benge, Jared; Benitez, Andreana; Benlloch, Jose María; Benn, Marianne; Benyoussef, El Mehdi; Bergeron, David; Bermudez, Elaine; Bessadok, Alaa; Betzel, Richard; Bezuidenhoudt, Mauritz; Bhagwat, Nikhil; Bhalerao, Shailesh; Bhandari, Anindya; Bhasin, Harsh; Bhati, Radhika; Bhatkoti, Pushkar; Bhatt, Priya; Bhattacharjee, Debotosh; Bhattacharyya, Sudeepa; Bi, Rui; Bi, Jinbo; Bi, Harvy; Biancardi, Alberto; Bidart, Rene; Bilgel, Murat; Billiet, Thibo; Binczyk, Franciszek; Bingsheng, Huang; Bird, Christopher; Bischof, Gérard; Bishnoi, Ram; Biswas, Shameek; Bjelke, David; Black, Sandra; Blackwood, Jennifer; Blaese, Elise; Blair, James; Blanchard, Gilles; Bloom, Toby; Blujus, Jenna; Blusztajn, Jan Krzysztof; Bo, Wu; Bo, Jun; Boda, Ravi; Boellaard, Ronald; Bogorodzki, Piotr; Bokde, Arun; Bolhasani, Ehsan; Bonakdarpour, Borna; Bonazzoli, Matthew; Bône, Alexandre; Borkowsky, Jennifer; Borrajo, Danielle; Bos, Isabelle; Bosco, Paolo; Bott, Nicholas; Rodrigues, Renato Botter Maio Lopes; Boughanmi, Amani; Bougias, Haralabos; Boulier, Thomas; Bourgeat, Pierrick; Bouyagoub, Samira; Bowes, Mike; Boyes, Richard; Bozoki, Andrea; Bradshaw, Tyler; Pereira, Joana Braga; Brahami, Yoann; Brambati, Simona Maria; Bras, Jose; Braskie, Meredith; Brecheisen, Ralph; Bregman, Noa; Brewer, James; Briassouli, Alexia; Brickman, Adam; Bridges, Robert; Brihmat, Nabila; Brinkmann, Benjamin; Britschgi, Markus; Broers, Thomas; Bron, Esther; Brown, Jesse; Brown, Matthew; Brown, Abel; Brown, Maria; Brunberg, James; Bu, Tao; Bubbico, Giovanna; Bubenik, Peter; Bubu, Omonigho; Buchanan, Daniel; Buchholz, Hans-Georg; Buchsbaum, Bradley; Buck, Katharina; Buckley, Rachel; Budgeon, Charley; Buhl, Derek; Sánchez, Manuel Buitrago; Bundela, Saurabh; Burciu, Irina; Burgos, Ninon; Burke, Shanna; Burn, Katherine; Burns, Jeffrey; Burns, Gully; Burzykowski, Tomasz; Bush, Sammie; Buss, Stephanie; Butcher, Bradley; Butt, Victoria; Buxbaum, Joseph; Sandeep, C. S.; Cabrera, Cristóbal; Cahyaningrum, Winda; Cai, Zhen-Nao; Cai, Siqi; Cai, Erik; Cajka, Tomas; Calamia, Matthew; Caligiuri, Maria Eugenia; Calixte, Christopher; Calon, Frederic; Cameron, Briana; Campbell, Roy; Lopez, Jose Antonio Campos; Cao, Hongliu; Cao, Jiguo; Cao, Guanqun; Cao, Bo; Capizzano, Aristides; Capon, Daniel; Carmasin, Jeremy; Carmichael, Owen; Carr, Sarah; Carrier, Jason; Carter, Greg; Carvalho, Luis; Carvalho, Janessa; Carvalho, Carolina; Casamitjana, Adrià; Casanova, Ramon; Casas, Josep R.; Cash, David; Castelluccio, Pete; Castiglioni, Isabella; Caswell, Carrie; Cattell, Liam; Cauda, Franco; Cepeda, Ileana; Çevik, Alper; Cha, Jungho; Chakrabarti, Shreya; Chakraborty, Shouvik; Chammam, Takwa; Chan, Christina; Chand, Ganesh; Chang, Catie; Chang, Yu-Ming; Chang, Rui; Chang, Hyunggi; Chang, Yu-Chuan; Chang, Ki Jung; Chang, Che-Wei; Chantrel, Steeve; Chao, Justin; Chao, Linda; Chapleau, Marianne; Charil, Arnaud; Chatterjee, Pratishtha; Chatterjee, Sambit; Chaudhry, Zainab; Chauhan, Harmanpreet; Chehade, Abdallah; Chekuri, Omkar; Cheloshkina, Kseniia; Chen, Jianhong; Chen, Gang; Chen, Geng; Chen, Ting-Huei; Chen, Yin Jie; Chen, Xi; Chen, Tzu-Chieh; Chen, Guojun; Chen, Shuzhong; Chen, Jerome; Chen, Fang; Chen, Kaifeng; Chen, Gennan; Chen, Jason; Chen, Guanhua; Chen, Ying-Hsiang; Chen, Ming-Hui; Chen, Chenbingyao; Chen, S. Y.; Chen, Hsu-Hsin; Chen, Xing; Chen, Kewei; Chen, Yuhan; Chen, Hugo; Chen, Rong; Chen, Ing-jou; Chen, Jun; Chen, Jean; Chen, Bo; Cheng, Danni; Cheng, Hewei; Cheng, Yong; Cheng, Yang; Cheng, Zhang; Cheng, Wai Ho; Chenhall, Tanya; Chepkoech, Joy-Loi; Cherukuri, Venkateswararao; Chhibber, Aparna; Chi, Haoyuan; Chi, Chih-Lin; Chiang, Gloria; Chiesa, Patrizia; Childress, Daniel Micah; Chilukuri, Yogitha; Fatt, Cherise Chin; Chincarini, Andrea; Ching, Christopher; Chiotis, Konstantinos; Cho, Soo Hyun; Cho, Yongrae; Cho, Sooyun; Choi, Jun-Sik; Choi, Hongyoon; Choi, Yeoreum; Choi, Sophia; Choi, Jaesik; Choi, Euna; Choo, I. L. Han; Chopra, Vishal; Chougrad, Hiba; Chouraki, Vincent; Christini, Amanda; Chu, Yufang; Chuang, Tzu-Chao; Chuanji, Luo; Chuanjian, Yu; Chun, Marvin; Chun, Sung; Chung, Ai; Chung, Yu-Min; Chung, Jung-Che; Chung, Ai Wern; Chung, Jaeeun; Chyzhyk, Darya; Ciarleglio, Adam; Cioli, Claudia; Cittanti, Corrado; Cives, Ana; Clark, Marissa; Clayton, David; Clement, Mark; Clifft, Daniel; Climer, Sharlee; Clouston, Sean; Clunie, David; Cohen, Phoebe; Cohen, Taco; Cole, Michael; Cole, James; Colletti, Patrick; Collingwood, Joanna; Comley, Robert; Conklin, Bryan; Conner, Lindsay; Conover, Joanne; Contardo-Berning, Ivona; Conway, Ronan; Copani, Agata; Coppola, Giovanni; Corbett, Syl; Corlier, Fabian; Correia, Rui; Cosman, Joshua; Costantino, Sebastian; Coubard, Olivier; Coulson, Elizabeth; Couser, Elizabeth; Cox, Kris; Coyle, Patrick; Cozzi, Brian; Craddock, Cameron; Crawford, Karen; Creese, Byron; Cribben, Ivor; Crisostomo-Wynne, Theodore; Crossley, Nicolas; Croteau, Etienne; Cruchaga, Carlos; Cuajungco, Math; Cui, Jing; Cui, Sue; Cullen, Nicholas; Cuneo, Daniel; Cutanda, Vicente; Cynader, Max; Binu, D.; D'Avossa, Giovanni; Dai, Tian; Dai, Peng; Dai, Hui; Davied Hong, Daivied Hong; Dakovic, Marko; Dalca, Adrian; Damiani, Stefano; Dammak, Mouna; Damoiseaux, Jessica; Dan, Zou; Dang, Xuan Hong; Dang, Shilpa; Daniel, Zinkert; Danjou, Fabrice; Darby, Eveleen; Darby, Ryan; Dardzinska, Agnieszka; Darst, Burcu; Darvesh, Sultan; Das, Kalyan; Das, Devsmita; Das, Sandhitsu; Das, Dulumani; Datta, Shounak; Dauvillier, Jérôme; Davatzikos, Christos; Davidson, Ian; de Boer, Renske; de Bruijne, Marleen; de Buhan, Maya; de Jager, Philip; de La Concha Vega, Nuño; de Lange, Siemon; de Luis Garcia, Rodrigo; de Marco, Matteo; de Sitter, Alexandra; Dean, Scott; Decarli, Charles; Decker, Summer; del Gaizo, John; Demir, Zeynep; Denby, Charles; Deng, Yanjia; Deng, Wanyu; Denisova, Kristina; Denney, William; Depue, Brendan; DeRamus, Thomas; Desikan, Rahul; Desplats, Paula; Desrosiers, Christian; Devadas, Vivek; Devanarayan, Viswanath; Devarajan, Sridharan; Devenyi, Gabriel; Dezhina, Zalina; Dhami, Devendra; Dharsee, Moyez; Dhillon, Permesh; Di, Xin; Di Mauro, Nicola; Diah, Kimberly; Diamond, Sara; Diaz-Asper, Catherine; Diciotti, Stefano; Dickerson, Bradford; Dickie, David Alexander; Dickinson, Philip; Dicks, Ellen; Diedrich, Karl; Dieumegarde, Louis; Dill, Vanderson; Dilliott, Allison; Ding, Zhaohua; Ding, Shanshan; Ding, Yanhui; Ding, Xiuhua; Ding, Xuemei; Dinov, Ivo; Dinu, Valentin; Diouf, Ibrahima; Dmitriev, Phillip; Dobromyslin, Vitaly; Dodge, Hiroko; Dolui, Sudipto; Dona, Olga; Dondelinger, Frank; Dong, Wen; Dong, Hao-Ming; Kehoe, Patricio Donnelly; Donohue, Michael; Dore, Vincent; Dougherty, Chase; Doughty, Mitchell; Dowling, N. Maritza; Doyle, Senan; Doyle, Andrew; Dragan, Matthew; Draganski, Bogdan; Draghici, Sorin; Dragomir, Andrei; Drake, Derek; Drake, Erin; Drd, Shilpa; Dronkers, Nina; Drozdowski, Madelyn; Du, Changde; Du, Yuhui; Du, Lei; Du, Guangwei; Du, Xingqi; Duan, Fang; Duan, Yuzhuo; Duan, Kuaikuai; Duchesne, Simon; Duggento, Andrea; Dukart, Juergen; Dumont, Matthieu; Dunn, Ruth; Duong, Vu; Duraisamy, Baskar; Duran, Tugce; Durrleman, Stanley; Dutta, Joyita; Dyrba, Martin; Dyvorne, Hadrien; R, Amulya E.; Eads, Jennifer; Eastman, Jennifer; Eaton, Susan; Edlund, Christopher; Edmonds, Emily; Edmondson, Mackenzie; Ehsan, Fatima; El-Gabalawy, Fady; Elander, Annie; Elango, Vidhya E.; Eldeeb, Ghaidaa; Elgamal, Fatmaelzahraa; Rodrigues, Yuri Elias; Elman, Jeremy; Elrakaiby, Nada; Emahazion, Tesfai; Emami, Behnaz; Embrechts, Jurriën; Emran Khan Emon, Mohammad Asif; Emrani, Saba; Emrani, Asieh; Emri, Miklós; Engelhardt, Barbara; Engle, Bob; Epstein, Noam; Er, Fusun; Erhardt, Erik; Eriksson, Oscar; Omay, Zeynep Erson; Escudero, Javier; Eshleman, Jason; Eskildsen, Simon; Espinosa, Luis; Essex, Ryan; Esteban, Oscar; Estrada, Karol; Ethell, Douglas; Ethridge, Kimberly; Ettehadi, Seyedrohollah; Eva, Bouguen; Evenden, Dave; Evtikheeve, Rina; Ewert, Siobhan; Fague, Scot; Fahmi, Rachid; Faizal, Sherin; Falahati, Farshad; Fan, Li; Fan, Zhen; Fan, Yong; Fan, Maohua; Fan, Yonghui; Fan, Sili; Fan, Ruzong; Fang, Chen; Fang, Xiaoling; Fanjul-Vélez, Félix; Fanti, Alessandro; Far, Bab; Farah, Martha; Farahani, Naemeh; Farahibozorg, Seyedehrezvan; Farahnak, Farhood; Farajpour, Maryam; Fardo, David; Farkhani, Sadaf; Farnsworth, Bryn; Farooq, Hamza; Farooq, Ammarah; Farouk, Yasmeen; Farrar, Danielle; Farrer, Lindsay; Fatemehh, Fatemeh; Fatemizadeh, Emad; Fatfat, Kim; Fatima, Shizza; Faux, Noel; Favan-Niven, Anne; Favary, Clélia; Fazlollahi, Amir; Fei, Gao; Feingold, Franklin; Feizi, Soheil; Félix, Eloy; Femminella, Grazia Daniela; Feng, Zijun; Feng, Ao; Feng, Brad; Feng, Xinyang; Feragen, Aasa; Fereidouni, Marzieh; Fernandes, Miguel; Fernández, Víctor; Ferrari, Ricardo; Ferraris, Sebastiano; Ferreira, Francisco; Ferreira, Luiz Kobuti; Ferreira, Hugo; Fiecas, Mark; Fieremans, Els; Fiford, Cassidy; Figurski, Michal; Filippi, Massimo; Filshtein, Teresa; Findley, Caleigh; Finger, Elizabeth; Firth, Nicholas; Fischer, Christopher; Fischer, Florian; Fitall, Simon; Fleet, Blair; Fleishman, Greg; Flokas, Lambros; Flores, Alberto; Focke, Niels; Fok, Wai Yan; Foldi, Nancy; Fôlego, Guilherme; Forero, Aura; Fornage, Myriam; Fos Guarinos, Belén; Founshtein, Gregory; Franc, Benjamin; Francois, Clement; Franke, Katja; Fraser, Mark; Frasier, Mark; Frederick, Blaise; Freitas, Fernandho; Escalin, Frency Jj; Freudenberg-Hua, Yun; Friedman, Brad; Friedmann, Theodore; Friedrich, Christoph M.; Frings, Lars; Frisoni, Giovanni; Fritzsche, Klaus; Frolov, Alexander; Frost, Robert; Fu, Ling; Fu, Zening; Fudao, Ke; Fuentes, Emmanuel; Fujishima, Motonobu; Fujiwara, Ken; Fukami, Tadanori; Funk, Cory; Furcila, Diana; Fuselier, Jessica; Nagarjuna Reddy, G.; Gaasterland, Terry; Gabelle, Audrey; Gahm, Jin; Gaiteri, Chris; Gajawelli, Niharika; Galantino, Alexis; Galarza Hernández, Javier; Galasko, Douglas; Galea, Liisa; Galisot, Gaetan; Sánchez, Antonio Javier Gallego; Gallins, Paul; Gamberger, Dragan; Gan, Hong Seng; Gan, Gavin; Ganapathi, Subha; Gancayco, Christina; Gangishetti, Umesh; Ganzetti, Marco; Gao, Fei; Gao, Jingjing; Gao, Linlin; Gao, Tianxiang; Gao, Yuanyuan; Gao, Xiaohong; Garani, Ranjini; Garbarino, Sara; Garcia, Ivan; Garcia, Xiadnai; Garcia, Jorge; Garcia, Tanya; Garcia Arias, Hernan Felipe; de La Garza, Angel Garcia; Gaig, Mireia Garcia; Novoa, Jorge Garcia; Valero, Mar Garcia; Garcia-Ojalvo, Jord; García-Polo, Pablo; Garg, Rahul; Garg, Gaurav; Garg, Divya; Garibotto, Valentina; Garvey, Matthew; Garza-Villarreal, Eduardo; Gaubert, Malo; Gauthier, Serge; Gavett, Brandon; Gavidia, Giovana; Gavtash, Barzin; Gawryluk, Jodie; Gbah, Messon; Ge, Tian; Geerts, Hugo; Geisser, Niklaus; Geng, Junxian; Gentili, Claudio; Gess, Felix; Ghaderi, Halleh; Ghahari, Shabnam; Ghanbari, Yaghoob; Ghazi-Saidi, Ladan; Ghodrati, Mojgan; Ghorbani, Behnaz; Ghoreishiamiri, Reyhaneh; Ghosal, Sayan; Ghosh, Sukanta; Ghosh, Saheb; Ghosh, Sreya; Ghoshal, Ankur; Giannicola, Galetta; Gibert, Karina; Gibson, Gary; Gieschke, Ronald; Gil Valencia, Jorge Mario; Gillen, Daniel; Giordani, Alessandro; Giraldo, Diana; Gispert, Juan D.; Gitelman, Darren; Giuffrida, Mario Valerio; Madhu, G. K.; Glass, Jesse; Glazier, Brad; Gleason, Carey; Glerean, Enrico; Glozman, Tanya; Godbey, Michael; Goettlich, Martin; Gogoi, Minakshi; Gola, Kelly; Golbabaei, Soroosh; Golden, Daniel; Goldstein, Felicia; Gomes, Carlos; de Olivera, Ramon Gomes Durães; Gomez, Isabel; Gomez Gonzalez, Juan Pablo; Gomez-Verdejo, Vanessa; Gong, Weikang; Gong, Enhao; Gong, Kuang; Gonneaud, Julie; Gonzalez, Clio; Gonzalez, Evelio; Gonzalez, Gerardo; Moreira, Eduardo Gonzalez; Goodman, James; Gopinath, Srinath; Gopu, Anusharani; Gordon, Brian; Gordon, David; Gordon, Mark; Gorriz, Juan Manuel; Gors, Dorothy; Göttler, Jens; Gounari, Xanthippi; Goyal, Devendra; Graf, John; Graff, Ariel; Graham, Leah; Graham, Jinko; Grajski, Kamil; Grami, Maziyar; Grand'Maison, Marilyn; Grant, Kiran; Grassi, Elena; Gray, Katherine; Grecchi, Elisabetta; Green, Robert; Green, Elaine; Greenberg, Jonathan; Greening, Steven; Greenwood, Bryson; Gregori, Johannes; Gregory, Michael; Greicius, Michael; Greve, Douglas; Griffin, Jason; Grill, Joshua; Grodner, Kelsey; Grolmusz, Vince; Groot, Perry; Groothuis, Irme; Gross, Alden; Grundstad, Arne; Grundy, Edward; Grzegorczyk, Tomasz; Nandith, G. S.; Gu, David; Gu, Jiena; Gu, Yun; Gu, Ginam; Guan, Sheng; Guan, Yuanfang; Guennel, Tobias; Guerin, Laurent; Guerrero, Ricardo; Guerrier, Laura; Guevara, Pamela; Guggari, Shankru; Roy, Abhijit Guha; Guidotti, Roberto; Guillon, Jérémy; Gulcher, Jeff; Gulia, Sarita; Gumedze, Freedom; Gunawardena, Nishan; Gunn, Roger; Guo, Michael; Guo, Xiao; Guo, Xingzhi; Guo, Yi; Kai, Zhang Guo; Zhao, Ma Guo; Gupta, Navin; Gupta, Anubha; Gupta, Ishaan; Guren, Onan; Gurnani, Ashita; Gurol, Mahmut Edip; Guzman, Gloria; Gyy, Gyy; Rajanna, Vanamala H.; Ha, Seongwook; Haacke, Ewart; Haaksma, Miriam; Habadi, Maryam; Habeck, Christian; Habes, Mohamad; Hackspiel Zarate, Maria Mercedes; Hadimani, Ravi; Hahn, William; Hahn, Tim; Haight, Thaddeus; Hair, Nicole; Haixing, Wang; Hajarolasvadi, Noushin; Hajjar, Ihab; Hajjo, Rima; Halchenko, Yaroslav; Hall, Anette; Hallock, Kevin; Hamdi, Shah Muhammad; Hameed, Farhan; Hamidian, Hajar; Han, Dong; Han, Yang; Han, Hio-Been; Han, Qingchang; Han, Beomsoo; Han, Duke; Han, Shizhong; Han, Xiaoxia; Han, Peipei; Han, Joo Yoon; Han, Dong-Sig; Handsaker, Robert; Hanna-Pladdy, Brenda; Hanseeuw, Bernard; Hansson, Björn; Hao, Yang; Hao, Jhon; Happ, Clara; Harischandra, Dilshan; Haritaoglu, Esin; Harris, Richard; Harris, Breanna; Hart, Brian; Hartzell, James; Harvey, Danielle; Hashimoto, Tsuyoshi; Hasooni, Hossein; Hassan, Moaied; Hassan, Mehdi; Hassanzadeh, Hamid Reza; Hassanzadeh, Oktie; Hatton, Sean; Hawchar, Jinan; Hayashi, Toshihiro; Hayashi, Norio; Hayes, Jasmeet; Hayete, Boris; Haynor, David; He, Linchen; He, Yan; He, Yao; He, Huiguang; Heegaard, Niels; Hefny, Mohamed; Heil, Julius; Heindel, William; Henderson, Samuel; Henf, Judith; Henriquez, Claudio; Herholz, Karl; Hermessi, Haithem; Hernandez, Monica; Herrera, Luis; Hibar, Derrek; Hidane, Moncef; Higuchi, Satomi; Hind, Jade; Hives, Florent; Hoang, Mimi; Hobel, Zachary; Hoffman, John; Hofmeister, Jeremy; Hohman, Timothy; Holder, Daniel; Holguin, Jess; Holmes, Robin; Hong, John; Hongliang, Zou; Hongyu, Guo; Hopkins, Paul; Hor, Soheil; Hornbeck, Russ; Horng, Andy; Horton, Wesley; Hosny, Khalid; Hosseini, Eghbal; Hosseini, Hadi; Hosseini, Zahra; Asl, Ehsan Hosseini; Hou, Beibei; Houghton, Richard; Houghton, Katherine; Householder, Erin; Howlett, James; Hsiao, John; Hsiao, Ing-Tsung; Hsu, Chih-Chin; Hu, Xixi; Hu, Lingjing; Hu, Nan; Hu, Kun; Hu, Tao; Hu, Li; Hu, Xiaolan; Hua, Fei; Huang, Marissa; Huang, Qi; Huang, Michelle; Huang, Chao; Huang, JunMing; Huang, Xingyuan; Huang, Yuhan; Huang, Sing-Hang; Huang, Shuai; Huang, Peiyu; Huang, Chun-Chao; Huang, Zhiyue; Huang, Meiyan; Huang, Zhiwen; Hubrich, Markus; Huestis, Michael; Huey, Edward; Hufton, Andrew; Huijbers, Willem; Huisman, Sjoerd; Hung, Joe; Hunsaker, Naomi; Hunt, Fostor; Huppertz, Hans-Jürgen; Huser, Vojtech; Hussain, Lal; Hutchison, R. Matthew; Hutton, Alexandre; Huyck, Els; Hwang, Jihye; Hyun, JungMoon; Iakovakis, Dimitris; Ibañez, Victoria; Ide, Kayoko; Igarashi, Takuma; Iglesias, Juan Eugenio; Muñoz, Laura Igual; Iidaka, Tetsuya; Ikeuchi, Takeshi; Ikhena, John; Ikuta, Toshikazu; Im, Hyung-Jun; Insausti, Ana; Insel, Philip; Invernizzi, Azzurra; Iosif, Ana-Maria; Ip, Nancy; Irizarry, Sierra; Irmak, Emrah; Irwin, David; Isaza, Mariano; Ishii, Makoto; Ishii, Kenji; Islam, Jyoti; Israel, Ariel; Isufi, Elvin; Ito, Kaori; Ito, Masato; Izquierdo, Walter; Alphin, J.; Akhila, J. A.; Jaberzadeh, Amir; Jackowiak, Edward; Jackson, Eric; Jackson, Chris; Jackson, Jonathan; Jacob, Samson; Jacobsen, Nina; Jacobsen, Jörn; Jacquemont, Thomas; Jacques, Nerline; Jaeger, Ralf; Jafari, Tahere; Jafari-Khouzani, Kourosh; Jagadish, Akshay Kumar; Jagtap, Priti; Jagust, William; Jahr, Joseph; Jain, Shubhankar; Jain, Shubham; Jaiswal, Ayush; Jaiswal, Akshay; Jait, Amine; Jakkoju, Chetan; Jakobsson, Andreas; James, Olga; James, Oliver; Jamlai, Maedeh; Jammeh, Emmanuel; Janardhana, Lajavanthi; Jang, Jinseong; Jang, Jae-Won; Jang, Jinhee; Jang, Hyesue; Janghel, Rekh Ram; Jawahar, Shasvat; Jean, Kharne; Jean-Baptiste, Schiratti; Jedynak, Bruno; Jefferson, Angela; Jennings, Danna; Jennings, Dominique; Jeon, Seun; Jeong, Yong; Jester, Charles; Jethwa, Ketan; Jha, Debesh; Ji, Gong-Jun; Ji, Chong; Ji, Jin; Jia, Bowen; Jiacheng, Lee; Jiajia, Guo; Jian, Weijian; Jiang, Shan; Jiang, Chunxiang; Jianhua, Gao; Jiao, Zhuqing; Jiao, Zeyu; Jiao, Du; Jimenez Alaniz, Juan Ramon; Gomez, Carolina Jimenez; Jiménez-Huete, Adolfo; Jimura, Koji; Jin, Yan; Jin, Zhu; Jogia, Jigar; Johansson, Per; John, Kimberley; Johnsen, Stian; Johnson, Leonard; Johnson, Sterling; Johnson, Kent; Johnston, Jane; Johnston, Stephen; Jomeiri, Alireza; Jonas, Katherine; Jones, Richard; Jones-Davis, Dorothy; Jönsson, Linus; Joseph, Jane; Joshi, Himanshu; Joshi, Shantanu; Joshi, Abhinay; Joyce, Katherine; Juengling, Freimut; Jung, Youngjin; Junker, Viv; Junwei, Ding; Jyothi, Singaraju; Jyotiyana, Monika; Sarthaj, K.; Kachouane, Mouloud; Kadian, Amit; Kaewaramsri, Yothin; Kaicheng, Li; Kaiser, Marcus; Kakinami, Lisa; Kalra, Sanjay; Kam, Hye Jin; Kamarudin, Nur Shazwani; Kaminker, Josh; Kandel, Benjamin; Kandiah, Nagaendran; Kaneko, Tomoki; Kang, Yun Seok; Kang, Ju Hee; Kang, Hakmook; Kang, Jian; Kansal, Anuraag; Kaouache, Mohammed; Kaplan, Adam; Kottaram, Akhil Karazhma; Karim, Faizan; Karimi-Mostowfi, Nicki; Karjoo, Mahboobe; Karlin, Daniel; Karp, Juliana; Karray, Chiheb; Kartsonis, Nick; Karu, Naama; Kasa, Jaya; Kasiri, Keyvan; Katako, Audrey; Kato, Ryo; Katsonis, Panagiotis; Katti, Hkkatti; Kaur, Prabhjot; Kauwe, John; Kawaguchi, Atsushi; Kazemi, Samaneh; Kazemi, Yosra; Rijan, K. C.; Kechin, Andrey; Kelkhoff, Douglas; Kelleher, Thomas; Kellner-Weldon, Frauke; Kennion, Oliver; Kerr, Daniel; Kesler, Shelli; Kesselman, Carl; Kessler, Daniel; Keuken, Max; Keyvanfard, Farzaneh; Khademi, April; Khajehnejad, Moein; Khan, Wasim; Khan, Tabrej; Khan, Hikmat; Khan, Anzalee; Khan, Samreen; Khanmohammadi, Sina; Khasanova, Tatiana; Khazaee, Ali; Khazan, Lenny; Kherif, Ferath; Khl, Aym; KHlif, Mohamed Salah; Khondoker, Mizanur; Khoo, Sok Kean; Khosrowabadi, Reza; Khurshid, Kiran; Kianfard, Reihaneh; Kida, Satoshi; Kiddle, Steven; Kikuchi, Masashi; Killiany, Ron; Kim, Jeongchul; Kim, Jong Hun; Kim, Hyunwoo; Kim, Jongin; Kim, Yeo Jin; Kim, Jung-Jae; Kim, Hang-Rai; Kim, Jaeyeol; Kim, Ki Hwan; Kim, Joseph; Kim, Younghoon; Kim, Mijung; Kim, Jeongsik; Kim, Bohyun; Kim, Taehyun; Kim, Heeyoung; Kim, Seonjik; Kim, Nakyoung; Kim, Byeongnam; Kim, ChanMi; Kim, Jeonghun; Kim, Seong Yoon; Kim, Sunhee; Kingery, Lisle; Kinnunen, Kirsi; Kinomes, Marie; Kirchner, Jan Hendrik; Caldwell, Jessica Kirkland; Kirwan, Brock; Kitamura, Chiemi; Kitty, Kitty; Kiviat, David; Kiyasova, Vera; Klein, Richard; Klein, Alison; Klein, Gregory; Klein, Jan; Kleinman, Aaron; Kling, Mitchel; Klinger, Joern; Klinger, Rebecca; Klink, Katharina; Kocaturk, Mustafa; Koch, Philipp Johannes; Kochova, Elena; Koenig, Loren; Koh, Natalie; Köhler, Jens Erik; Koikkalainen, Juha; Koini, Marisa; Kolachalama, Vijaya; Koncz, Rebecca; Kong, Xiang-Zhen; Kong, Vincent; Kong, Xiangzhen; Kong, Dehan; Kong, Linglong; Konukoglu, Ender; Kopeinigg, Daniel; Kopera, Krzysztof; Koppers, Simon; Korb, Matheus; Korfiatis, Panagiotis; Korolev, Igor; Korolev, Sergey; Korostyshevskiy, Valeriy; Koshiya, Heena; Kost, James; Kotari, Vikas; Koutra, Danai; Koychev, Ivan; Kruthika, K. R.; Krahnke, Tillmann; Krause, Matthew; Kraybill, Matt; Kriebel, Martin; Hari Krishna, M.; Krohn, Stephan; Kruggel, Frithjof; Kuceyeski, Amy; Kuhl, Donald; Kulshreshtha, Devang; Kumar, Santosh; Kumar, Sambath; Kumar, Kuldeep; Kumar, Anil; Kumar, Abhishek; Kumar, A.; Kumar, Saurabh; Kumar, Ashwani; Kumar, Ambar; Kumar, Dinesh; Kumar, Rishab; Kumarasinghe, Janaka; Kundu, Suprateek; Kung, Te-Han; Kuo, Li-Wei; Kuo, Phillip; Channappa, Usha Kuppe; Kuriakose, Elmy; Kurian, P.; Kwan, Kenneth; Kwasigroch, Arkadiusz; Kwon, Young Hye; Kyeong, Sunghyon; Fleur, Claire La; Wungo, Supriyadi La; Labbe, Tomas; Lacombe, Daniel; Lad, Meher; Lahoti, Geet; Lai, Ying Liang; Lai, Catherine; Lai, Dongbing; Laird, Dillon; Lakatos, Anita; Lam, Alice; Lama, Ramesh; Lambert, Christian; Landau, Susan; Landman, Bennett; Landre, Victor; Lane, Elizabeth; Lange, Catharina; Langenieux, Alexandre; Lareau, Caleb; Larson, Katelyn; Latif, Ghazanfar; Lauber, Ross; Lawliet, Z. H.; Lawrence, Emma; Lazar, Anca; Le, Ngan; Le, Thi Khuyen; Le, Matthieu; Guen, Yann Le; Scouiller, Stephanie Le; Leandrou, Stephanos; Leatherday, Christopher; Leavitt, Mackenzie; Ledbetter, Christina; Lee, Hyekyoung; Lee, Wook; Lee, Annie; Lee, Jaehong; Lee, Dongyoung; Lee, Joel; Lee, Song-Ting; Lee, Kuo-Jung; Lee, Subin; Lee, Jaeho; Lee, Catherine; Lee, Gyungtae; Lee, Suzee; Lee, Erik; Lee, Yunseong; Lee, Sang-Gil; Lee, Seonjoo; Lee, Peng Jung; Lee, Hyunna; Lee, Cheng-Hsien; Lee, Hengtong; Lee, Mi Ri; Lee, Ilgu; Lee, Qixiang; Lefterov, Iliya; Leger, Charlie; Lehallier, Benoit; Lei, B.; Lei, Shi; Lei, Hongxing; Lei, Haoyun; Leong, Tze Yun; Leong, Sharlene; Leoutsakos, Jeannie-Marie; Lepore, Natasha; Lerch, Ondrej; Leung, Yip Sang; Leung, Yuk Yee; Leung, Shuyu; Leung, Hoi-Chung; Leung, Ming-Ying; Levakov, Gidon; Levine, Abraham; Li, Chawn; Li, Miranda; Li, Huijie; Li, Junning; Li, Xiaofeng; Li, Yi; Li, Jinchao; Li, Tianhong; Li, Yongming; Li, Xiangrui; Li, Tieqiang; Li, Yan; Li, Fuhai; Li, Feijiang; Li, Shuyang; Li, Zhi; Li, Xing; Li, Rongjian; Li, Rui; Li, Y. U.; Li, Kang; Li, Zhenzhen; Li, Qingqin; Li, Wenjun; Li, Yang; Li, Jialu; Li, Guangyu; Li, Michelle; Li, Yibai; Li, Yupeng; Li, Tao; Li, Zhujun; Li, Yafen; Li, Muwei; Li, Xuan; Li, Yi-Ju; Li, Cen Sing; Li, X. W.; Li, Yingjie; Li, Lin; Li, Yihan Jessie; Li, Yaqing; Li, Xiantao; Li, Xingfeng; Li, Chenxi; Li, Chao; Li, Jicong; Li, Jiewei; Li, Tengfei; Li, Wei; Li, Xinzhong; Li, Nannan; Li, Chunfei; Li, Yeshu; Liang, Chen; Liang, Nanying; Liang, Jingjing; Liang, Shengxiang; Liang, Xiaoyun; Liang, Xia; Liang, Ying; Liberman, Sofia; Libon, David; Liébana, Sergio; Liedes, Hilkka; Lim, Wee Keong; Lim, Yen Ying; Lin, Yenching; Lin, Katherine; Lin, Ming; Lin, Ai-Ling; Lin, Ching-Heng; Lin, Bing; Lin, Lin; Lin, Jyh-Miin; Lin, W. M.; Lin, Chien-Tong; Lin, Liyan; Lin, Jing; Lindberg, Olof; Linesch, Paul; Linn, Kristin; Lippert, Christoph; Litovka, Nikita; Little, Graham; Liu, Man-Yun; Liu, Jin; Liu, Chin-Fu; Liu, Zhaowen; Liu, Eulanca; Liu, Weixiang; Liu, K. E.; Liu, Hao Chen; Liu, Jia; Liu, Richann; Liu, Dongbo; Liu, Victor; Liu, Wenjie; Liu, Tao; Liu, Xiaoli; Liu, Yong; Liu, Lin; Liu, Dan; Liu, Xiuwen; Liu, Mengmeng; Liu, Chia-Shang; Liu, Ying; Liu, Yan; Liu, Xueqing; Liu, Han; Liu, Chien-Liang; Liu, Sidong; Liu, Jundong; Liu, Yang; Liu, Tianming; Liu, Tingshan; Liu, Ning; Liu, Lan; Liuyu, Liuyu; Lizarraga, Gabriel; Llido, Jerome; Lobach, Iryna; Lockhart, Samuel; Loft, Henrik; Lohr, Kelly; Lon, Hoi Kei; Lone, Kashif Javed; Long, Ziyi; Long, Xiaojing; Longo, Frank; Alves, Isadora Lopes; Lopez, Guadalupe; Lorenzi, Marco; Lotan, Eyal; Louie, Gregory; Louis, Maxime; Loukas, Andreas; Love, Seth; Lowe, Deborah; Lu, Bin; Lu, Chia-Feng; Lu, Zixiang; Lu, Lijun; Lu, Pascal; Lu, Shen; Lu, Qing; Lu, Zheshen; Lu, Chuan; Lu, Patty; Lu, Hangquan; Lu, Bo; Luktuke, Yadnyesh; Luo, Wei; Luo, Suhuai; Luo, Sheng; Luo, Shaojun; Luo, Peggy; Luo, Shan; Luo, Weidong; Luo, Liao; Luo, Xiao; Lupton, Michelle; Lutz, Michael; Lv, Eric; Lyu, Juan; Angshul, M.; Radha, M. R.; Dinesh, M. S.; Ma, Xiangyu; Ma, Chao; Ma, Li; Ma, Yu; Ma, Qianli; MacArthur, Daniel; Macey, Paul; Mach, Eric; MacPhee, Imola; Madadi, Mahboubeh; Madan, Christopher; Madan, Bharat; Madero, Giovanny; Madhavan, Radhika; Madhyastha, Tara; Maeno, Nobuhisa; Magsood, Hamzah; Mah, Linda; Mahdavi, Shirin; Mahdavi, Asef; Mahmoud, Abeer; Mahmoud, Hentati; Mahmoud, Kariman; Mahmoudi, Ahmad; Dehkordi, Siamak Mahmoudian; Mahor, Monika; Mahseredjian, Taleen; Mai, Cha; Maia, Rui; Maiti, Taps; Maj, Carlo; Maji, Pradipta; Majidpour, Jafar; Makhlouf, Laouchedi; Makino, Satoshi; Makrievski, Stefan; Makse, Hernan; Malagi, Archana; Malakhova, Katerina; Malamon, John; Malashenkova, Irina; Malchano, Zach; Maleki-Balajoo, Somayeh; Malik, Sadia; Malik, Tamoor; Mallik, Abhirup; Malm, Tarja; Malpas, Charles; Malpica, Norberto; Malviya, Meenakshi; Mamandi, A.; Manandhar, Abinash; Mandal, Pravat; Mandali, Alekhya; Mane, Prajakta; Manning, Emily; Manoufali, Mohamed; Manser, Paul; Mantini, Dante; Mantri, Ninad; Manyakov, Nikolay; Manzak, Dİlek; Mao, Shuai; Maoyu, Tian; Maple Grødem, Jodi; Maravilla, Kenneth; Marco, Simonetti; Marcus, Daniel; Margetis, John; Margolin, Richard; Mariano, Laura; Marinescu, Razvan Valentin; Markett, Sebastian; Markiewicz, Pawel; Marnane, Michael; Maroof, Asif; Marple, Laura; Marques, Cristiane; Marrakchi, Linda; Marshall, Gad; Märtens, Kaspar; Mårtensson, Gustav; Marti, Cristian; Martin, Harold; Martinaud, Olivier; Martinez, Victor; Martinez, Oliver; Martinez, Jesus; Martinez, Carlos; Abadías, Neus Martinez; Torteya, Antonio Martinez; Martini, Jean-Baptiste; Martins, Samuel; Masciotra, Viviane; Masmoudi, Ahmed; Masny, Aliaksandr; Shah, Pir Masoom; Massaro, Tyler; Masumoto, Jun; Matan, Cristy; Mate, Karen; Mateus, Pedro; Mather, Mara; Mather, Karen; Mathew, Jesia; Mathias, Samuel; Mathiyalagan, Tamilalaghan; Matloff, Will; Matsubara, Keisuke; Matsubara, Takashi; Matsuda, Yukihisa; Matthews, Dawn; Mattis, Paul; May, Patrick; Mayburd, Anatoly; Mayo, Chantel; Mayordomo, Elvira; Mbuyi, Gaylord; McCallum, Colleen; McCann, Bryony; McCollough, Todd; McCormick, Shannon; McCurdy, Sean; McDonald, Carrie; McEligot, Archana; McEvoy, Linda; McGeown, William; McGinnis, Scott; McHugh, Thomas; McIntosh, Elissa; McIntosh, Randy; McKenzie, Andrew; McLaren, Donald; McMillan, Corey; McMillan, Alan; McPherson, Brent; McRae-McKee, Kevin; Zaini, Muhammad Hafiz Md; Meadowcroft, Mark; Mecca, Adam; Meda, Shashwath; Medikonda, Venkata Srinu; Meeker, Karin; Megherbi, Thinhinane; Mehmood, Anum; Mehrtash, Alireza; Meiberth, Dix; Meier, Dominik; Meijerman, Antoine; Mejia, Jose; Mekkayil, Lasitha; Meles, Sanne; Melie-Garcia, Lester; Melo, Hans; Melrose, Rebecca; Melzer, Corina; Mendes, Aline; Leon, Ricardo Antonio Mendoza; Gonzalez, Manuel Menendez; Meng, Dewen; Meng, Xianglai; Meng, Guilin; Mengel, David; Menon, Ramesh; Menon, Ravi; Mercado, Flavio; Messick, Viviana; Meyer, Pierre-Francois; Meyer, Carsten; Mezher, Adam; Mi, Liang; Miao, Hongyu; Michailovich, Oleg; Michels, Lars; Mickael, Guedj; Mikhail, Mark; Mikhno, Arthur; Milana, Diletta; Miller, Rachel; Miller, Brendan; Millikin, Colleen; Min, Byung Wook; Minadakis, George; Minghui, Hu; Chinh, Truong Minh; Minkova, Lora; Miranda, Michelle; Misevic, Dusan; Mishra, Amit; Mishra, Chetan; Mishra, Shiwangi; Mishra, Ashutosh; Mishra, Krishna; Misquitta, Karen; Mitchell, Brian; Mithawala, Keyur; Mitnitski, Arnold; Mitra, Sinjini; Mittal, Gaurav; Mittner, Matthias; Miyapuram, Krishna Prasad; Mlalazi, Rebaone; Mo, Daojun; Moghekar, Abhay; Moguilner, Sebastian; Moh, Heba; Mohabir, Mark; Mohajer, Bahram; Mohamed, Moataz; Mohammadi, Sadeq; Mohammadi-Nejad, Ali-Reza; Mohammady, Saed; Taqi, Arwa Mohammed; Mohan, Kishore Kumar; Mohy-Ud-Din, Hassan; Moitra, Dipanjan; Mojaradi, Mehdi; Mojtabavi, Alireza; Molina, Helena; Mollon, Jennifer; Molteni, Erika; Montajabi, Mohaddeseh; Montal, Victor; Montazami, Aram; Monté-Rubio, Gemma; Montembeault, Maxime; Montero-Odasso, Manuel; Montillo, Albert; Moon, Byung-Seung; Moon, Chan; Moon, Chooza; Moore, Archer; Morabito, Francesco C.; Moradi, Masoud; Moraes, Renato; Ballesteros, Orlando Morales; Morales-Henriquez, Daniela; Moratal, David; Moreno, Herman; Morihara, Ryuta; Mormino, Elizabeth; Morris, Jeffrey; Mortamet, Bénédicte; Morton, John; Moscato, Pablo; Rial, Alexis Moscoso; Mossa, Abdela Ahmed; Mottaghi, Setare; Mouelhi, Aymen; Moussavi, Arezou; Moustafa, Ahmed; Mowrey, Wenzhu; Mtetwa, Lungile; Muehlboeck, Sebastian; Mueller, Susanne; Mueller-Sarnowski, Felix; Mufidah, Ratna; Mukherjee, Rik; Mukherjee, Shubhabrata; Müller, Christian; Müller, Hans-Peter; Mullins, Paul; Mullins, Roger; Muncy, Nathan; Munir, Akhtar; Munirathinam, Ramesh; Munoz, David; Munro, Catherine; Muranevici, Gabriela; Rendon, Santiago Murillo; Murilo, Robson; Murphy, Sonya; Muscio, Cristina; Musso, Gabriel; Mustafa, Yasser; Myall, Daniel; Gayathri, N.; Nabavi, Shahab; Nabeel, Eman; Nagele, Robert; Naghshbandi, Hane; Naik, Shruti; Najmitabrizi, Neda; Nakawah, Mohammad Obadah; Nalls, Mike; Namboori, Krishnan; Nancy, Annie; Napolitano, Giulio; Narayan, Manjari; Narkhede, Atul; Naseri, Mahsa; Nasrallah, Ilya; Nasrallah, Fatima; Nassif, Rana; Nath, Sruthi R.; Nathoo, Farouk; Nation, Daniel; Naughton, Brian; Nault, Larry; Nautiyal, Deeksha; Nayak, Deepak Ranjan; Naz, Mufassra; Nazemian, Shayan; Nazeri, Arash; Neckoska, Emilija; Neelamegam, Malinee; Nehary, Ebrahim; Nelson, Peter; Nelson, Linda; Nematzadeh, Hosein; Nerur, Shubha; Nesteruk, Thomas; Neu, Scott; Ng, Yen-Bee; Nguyen, Tin; Nguyen, Thanh; Nguyen, Harrison; Nguyen, Nghi; Trung, Hieu Nguyen; Ni, Lucy; Nian, Yongjian; Nichols, Thomas; Nicodemus, Kristin; Nie, Yunlong; Nielsen, Casper; Nikolov, Robert; Nila, Jessica; Nishioka, Christopher; Njeh, Ines; Njie, Emalick; Nobakht, Samaneh; Noble, Andrew; Noda, Art; Noroozi, Ali; Norton, Derek; Nosarti, Chiara; Nosheny, Rachel; Notsu, Akifumi; Novak, Gerald; Nozadi, Seyed Hossein; Nu, Fen; Nudelman, Kelly; Nunes, Adonay; Nunes, Ana; Núñez, Christian; Nuno, Michelle; Nuriel, Tal; Nygaard, Haakon; Nyquist, Paul; O'Bott, Jacob; O'Charoen, Sirimon; O'Neill, William; O'Rawe, Jonathan; Obrzut, Grzegorz; Och, Ganzorig; Odaibo, David; Odry, Benjamin; Oehmichen, Axel; Ofori, Edward; Ogunsanmi, Abdulfatai; Oguz, Kaya; Oh, Jungsu; Oh, Minyoung; Oh, Hwamee; Ohigashi, Hironori; Oishi, Kenichi; Oishi, Naoya; Okhravi, Hamid; Okonkwo, Ozioma; Okyay, Savaş; Oliveira, Cyrill; Oliveira, João; Oliveira, Francisco; Oliver, Ruth; Olmos, Salvador; Olszowy, Wiktor; Oltra-Cucarella, Javier; Önen, Zehra; Ong, Rowena; Onoda, Keiichi; Onyike, Chiadi; Operto, Grégory; Oppedal, Ketil; Orejuela, Juan; Orhon, Atila; Orozco, Max; Ortuño, Juan; Osadebey, Michael; Osborn, Joseph; Osoba, Osonde; Ostadrahimi, Hamid; Ostovari, Parisa; Otis, Sarah; Overgaard, Shauna; Owen, Catrin Elin; Oxtoby, Neil; Öziç, Muhammet Üsame; Ozkaya, Gorkem; Okur, Ozlem Ozmen; Ozsolak, Fatih; Ozyildirim, Melis; Pa, Judy; Pacheco, Joe; Pack, Gary; Padilla, Daniel; Cerezo, Berizohar Padilla; Padovese, Bruno; Pae, Chongwon; Pagano, Gennaro; Pahuja, Gunjan; Pai, Shraddha; Pajavand, Shahryar; Pajula, Juha; Pak, Kyoungjune; Pakzad, Ashkan; Palaniappan, Mathiyalagan; Palanisamy, Sindhu; Palmqvist, Sebastian; Palsson, Frosti; Pan, Dan; Pan, Tiffany; Pan, Yuqing; Pan, Wei; Pan, Sun; Pan, Hongliang; Pan, Xiaoxi; Pandey, Lokesh; Pang, Qiaoyu; Pangilinan, Erin; Pannetier, Nicolas; Panpan, Xu; Panyavaraporn, Jantana; Pardini, Matteo; Paredes, José; Parikh, Jignesh; Park, Seongbeom; Park, Young Ho; Park, Min Tae; Park, Hyunjin; Park, Sejin; Park, JongSeong; Park, DooHyun; Park, Ji Eun; Park, Yuhyun; Park, Jiyong; Parker, Jason; Parker, Richard; Parodi, Alice; Bautista, Yohn Jairo Parra; Parrish, Marcus; Parthiban, Preethy; Pascariello, Guido; Pascual, Belen; Paskov, Hristo; Pasquini, Lorenzo; Tantaleán, Julio Sergio Eduardo Pastor; Pastur, Lucas; Patel, Raihaan; Patel, Sejal; Paterson, Ross; Paton, Bryan; Patriarche, Julia; Patriat, Rémi; Pattichis, Constantinos; Paul, Debashis; Pawar, Kuldeep; Pawlak, Mikolaj; Paz, Rotem; Pedroto, Maria; Pelekanos, Matthew; Péléraux, Annick; Peng, Dan; Peng, Jing; Pengfei, Tian; Perani, Daniela; Peraza, Luis; Pereira, Fabricio; Pereira, Francisco; Perkins, Diana; Perneczky, Robert; Persad, Umesh; Peter, Jessica; Peters, Mette; Peters, Ruth; Pether, Mark; Petrella, Jeffrey; Petrenko, Roman; Petrone, Paula; Petrov, Dmitry; Pezzatini, Daniele; Pfenning, Andreas; Pham, Chi-Tuan; Philipson, Pete; Phillips, Jeffrey; Phillips, Nicole; Phophalia, Ashish; Phuah, Chia-Ling; Pichai, Shanthi; Pichardo, Cesar; Binette, Alexa Pichet; Pietras, Olga; Pietrzyk, Mariusz; Pike, Kerryn; Pillai, Jagan; Piludu, Francesca; Pineda, Joanna; Ping, He; Pirraglia, Elizabeth; Pither, Richard; Piyush, Ranjan; Pizzi, Nick; Gonzalez, Luis Fernando Planella; Plassard, Andrew; Platero, Carlos; Plocharski, Maciej; Podhorski, Adam; Poggiali, Davide; Poghosyan, Mher; Pohl, Kilian; Poirier, Judes; Polakow, Jean Jacques; Politis, Marios; Poljak, Anne; Poloni, Katia Maria; Poole, Victoria; Poppenk, Jordan; Porsteinsson, Anton; Portelius, Erik; Posta, Filippo; Posthuma, Danielle; Potashman, Michele; Poulin, Stephane; Pourmennati, Bahar; Prahlad, Tejas; Pranav, Lee; Prasanth, Isaac; Prashar, Ajay; Prescott, Jeff; Prevedello, Luciano; Previtali, Fabio; Pricer, James; Prichard, James; Prince, Jerry; Prins, Samantha; Pritchard, Christopher; Priya, Priya; Priya, Anandh; Priyanka, Ahana; Properzi, Michael; Prosser, Angus; Proust-Lima, Cécile; Pruessner, Jens; Pu, Jian; Punjabi, Arjun; Punugu, Venkatapavani Pallavi; Puri, Dilip; Renjini, Anurenjan Purushothaman; Pyeon, DoYeong; Qader, Abu; Qi, Zeyao; Qi, Baihong; Qian, Xiaoning; Qian, Long; Qiao, Ju; Qiao, Jocelin; Qiaoli, Zhang; Qin, Hongsen; Qin, Wang; Qin, Tian; Qin, Yuanyuan; Qin, Qinxiaotie; Qin, Qiao; Qing, Zhao; Qiongling, Li; Qiu, Yu; Qiu, Wendy; Qiu, Deqiang; Qiu, Yingwei; Quadrelli, Scott; Qualls, Jake; Quan, Li; Quarg, Peter; Qureshi, Adnan; Anand, R.; Chitra, R.; Balaji, R.; Madhusudhan, R. N.; Raamana, Pradeep Reddy; Rabbia, Michael; Rabin, Laura; Radke, David; Pc, Muhammed Raees; Rafeiean, Mahsa; Raha, Oindrila; Rahimi, Amir; Arashloo, Shervin Rahimzadeh; Rai, Vipin; Rajamanickam, Karunanithi; Rajan, Surya; Rajapakse, Jagath; Rajaram, Sampath; Rajendran, Rajeswari; Rakovski, Cyril; Ramalhosa, Ivo; Raman, Fabio; Ramasamy, Ellankavi; Ramasangu, Hariharan; Ramirez, Alfredo; Ramos Pérez, Ana Victoria; Rana, Rahul; Rane, Swati; Rao, Anil; Rao, Vikram; Rashidi, Arash; Rasoanaivo, Oly; Rassem, Taha; Rastgoo, Hossein; Rath, Daniel; Ratnarajah, Nagulan; Ravikirthi, Prabhasa; Ravipati, Kaushik; RaviPrakash, Harish; Rawdha, Bousseta; Ray, Meredith; Ray, Debashree; Ray, Nilanjan; Ray, Dipankar; Ray, Soumi; Rebbah, Sana; Redding, Morgan; Regnerus, Bouke; Rehn, Patrick; Rehouma, Rokaya; Reid, Robert; Reimer, Alyssa; Reiss, Philip; Reitz, Christiane; Rekabi, Maryam; Rekik, Islem; Ren, Xuhua; Ren, Fujia; Ren, Xiaowei; Ren, Weijie; Renehan, William; Rennert, Lior; Rey, Samuel; Reyes, Pablo; Reza, Rifat; Rezaee, Khosro; Rhinn, Herve; Lorenzo, Pablo Ribalta; Ribeiro, Adèle Helena; Richards, John; Richards, Burt; Richards, Todd; Richardson, Hamish; Richiardi, Jonas; Richter, Nils; Ridge, Perry; Ridgway, Gerard; Ridha, Basil; Ried, Janina; Riedel, Brandalyn; Riphagen, Joost; Ritter, Kerstin; Rivaz, Hassan; Rivers-Auty, Jack; Allah, Mina Rizk; Rizzi, Massimo; Roalf, David; Robb, Catherine; Roberson, Erik; Robieson, Weining; Rocca-Serra, Philippe; Rodrigues, Marcos Antonio; Rodriguez, Alain; Aguiar, Güise Lorenzo Rodríguez; Rodriguez-Sanchez, Antonio; Rodriguez-Vieitez, Elena; Roes, Meighen; Rogalski, Emily; Rogers, James; Rogers, Baxter; Rohani, Hosna; Rollins, Carin; Rollo, Jenny; Romanillos, Adrian; Romero, Marcelo; Romero, Klaus; Rominger, Axel; Rondina, Jane; Ronquillo, Jeremiah; Roohparvar, Sanaz; Rosand, Jonathan; Rose, Gregory; Roshchupkin, Gennady; Rosoce, Jeremy; Ross, David; Ross, Joel; Ross, Owen; Rossi, Stephanie; Roussarie, Jean-Pierre; Roy, Arkaprava; Roy, Snehashis; Ruble, Cara; Rubright, Jonathan; Rudovic, Ognjen; Ruggiero, Denise; Rui, Qiao; Ruiz, Pablo; Rullmann, Michael; Rusmevichientong, Pimbucha; Russell, Rolf; Rutten, Julie; Saadatmand-Tarzjan, Mahdi; Saba, Valiallah; Sabuncu, Mert; Sacuiu, Simona; Sampathkumar, Srihari Sadhu; Sadikhov, Shamil; Saeedi, Sarah; Saf, Naz; Safapur, Alireza; Safi, Asad; Saint-Aubert, Laure; Saito, Noboru; Saito, Naomi; Sakata, Muneyuki; Frigerio, Carlo Sala; Sala-Llonch, Roser; Salah, Zainab; Salamanca, Luis; Salat, David; Salehzade, Mahdi; Salter, Hugh; Samatova, Nagiza; Sampat, Mehul; Gonzalez, Jorge Samper; Samtani, Mahesh; Samuel, Pearl; Bohorquez, Sandra Sanabria; Sanbao, Cheng; Sanchez, Iñigo; Sánchez, Irina; Sandella, Nick; Sanderlin, Ashley Hannah; Sanders, Elizabeth; Sankar, Tejas; Sanroma, Gerard; Sanson, Horacio; Santamaria, Mar; de Lourdes, Daniella; de Andrade, Luna Santana; Santhanam, Prasanna; Ribeiro, Andre Santos; Sardi, Pablo; Sardina, Davide; Saremi, Arvin; Sarica, Alessia; Sarnowski, Chloé; Sarraf, Saman; Saslow, Adam; Sato, Takayuki; Sato, Joao; Sattler, Sophia; Savic, Milos; Saxon, Jillian; Saya, Boson; Saykin, Andrew; Sbeiti, Elia; Scarapicchia, Vanessa; Scelsi, Marzia Antonella; Schaerer, Joel; Scharre, Douglas; Scherr, Martin; Schevenels, Klara; Schibler, Tony; Schiller, Florian; Schirmer, Markus; Schmansky, Nick; Schmidt, Marco; Schmidt, Paul; Schmitz, Taylor; Schmuker, Michael; Schneider, Anja; Schneider, Reinhard; Schoemaker, Dorothee; Schöll, Michael; Schouten, Tijn; Schramm, Hauke; Schreiber, Frank; Schultz, Timothy; Schultz, Aaron; Schürmann, Heike; Schwab, Patrick; Schwartz, Pamela; Schwarz, Adam; Schwarz, Christopher; Schwarzbauer, Christian; Scott, Julia; Scott, F. Jeffrey; Scott, David; Scussel, Artur; Seale, William; Seamons, John; Seemiller, Joseph; Sekine, Tetsuro; Selnes, Per; Sembritzki, Klaus; Senanayake, Vijitha; Seneca, Nicholas; Senjem, Matthew; Filho, Antonio Carlos Senra; Sensi, Stefano; Seo, Eun Hyun; Seo, Kangwon; Seong, Sibaek; Sepeta, Leigh; Seraji-Bozorgzad, Navid; Serra-Cayuela, Arnau; Seshadri, Sudha; Sgouros, Nicholas; Sha, Miao; Shackman, Alexander; Shafee, Rebecca; Shah, Rupali; Shah, Hitul; Shahid, Mohammad; Shahparian, Nastaran; Shakeri, Mahsa; Shams, Sara; Shams, Ali; Baboli, Aref Shams; Shamul, Naomi; Shan, Guogen; Shang, Yuan; Shao, Rui; Shao, Hanyu; Shao, Xiaozhe; Shaoxun, Yuan; Noghabi, Hossein Sharifi; Sharlene, Newman; Sharma, Avinash; Sharma, Ankita; Sharma, Aman; Shaw, Leslie; Shaw, Saurabh; Shcherbinin, Sergey; Sheline, Yvette; Shen, Li; Shen, Yanhe; Shen, Qian; Sherriff, Ian; Shi, Xin; Shi, Lei; Shi, Yonggang; Shi, Yue; Shi, Yupan; Shi, Jie; Shi, Feng; Shiban, Nisreen; Shields, Trevor; Shiiba, Takuro; Shiino, Akihiko; 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Taswell, Koby; Taswell, Carl; Tatsuoka, Curtis; Taylan, Pakize; Taylor, Jonathan; Taylor, Brad; Tayubi, Iftikhar; Tchistiakova, Ekaterina; tee, Yee Kai; Teipel, Stefan; Temizer, Leyla; Kate, Mara Ten; Tenbergen, Carlijn; Tenenbaum, Jessica; Teng, Zi; Teng, Yuan-Ching; Teng, Edmond; Termenon, Maite; Terry, Eloise; Thaker, Ashesh; Theobald, Chuck; Thiel, Taylor; Thiele, Ines; Thiele, Frank; Thierry, Jean Pierre; Thirunavu, Vineeth; Thomas, Chris; Thomas, Kelsey; Thomas, Anoop Jacob; Thomas, Benjamin; Thomas, Ronald; Thomas, Adam; Thomopoulos, Sophia; Thompson, Gerard; Thompson, Jeff; Thompson, Will; Thompson, Paul; Thung, Kimhan; Tian, Sijia; Tierney, Mary; Tilquin, Florian; Tingay, Karen; Tirrell, Lee; Tirumalai, Sindhuja; Tobis, Jonathan; Todkari, Suhasini; Tohka, Jussi; Tokuda, Takahiko; Toledo, Juan B.; Toledo, Jon; Tolonen, Antti; Tombari, Federico; Tomiyama, Tetsuro; Tomola, Lauren; Tong, Yunjie; Tong, Liz; Tong, Li; Tong, Xiaoran; Torgerson, Carinna; Toro, Roberto; Torok, Levente; Toschi, Nicola; Tosto, Giuseppe; Tosun, Duygu; Tourandaz, Morteza; Toussaint, Paule; Towhidi, Sasan Maximilian; Towler, Stephen; Toyama, Teruhide; Tractenberg, Rochelle E.; Tran, Thao; Tran, Daniel; Trapani, Benjamin; Tremolizzo, Lucio; Tripathi, Shashi; Trittschuh, Emily; Trivedi, Ashish; Trojacanec, Katarina; Truong, Dennis; Tsanas, Athanasios; Tse, Kai-Hei; Tsoy, Elena; Tu, Yanshuai; Tubeleviciute-Aydin, Agne; Tubi, Meral; Tucholka, Alan; Tufail, Ahsan; Tumati, Shankar; Tuo, Shouheng; Tuovinen, Timo; Tustison, Nicholas; Tutunji, Rayyan; Tward, Daniel; Tyagi, Gaurav; Tzioras, Nikolaos; Raghavendra, U.; Uberti, Daniela; Uchiyama, Yoshikazu; Ueki, Masao; Ulug, Aziz; Umek, Robert; University, Northwestern; de Almeida, Sofia Urioste Y. Nunes; Urrutia, Leandro; Usama, Ahmed; Ustun, Ali Alp; Uus, Alena; Uyar, Muharrem Umit; Visalatchi, V.; Rajinikanth, V.; Vafaei, Amin; Vairre, Darlene; Vaishnavi, Sanjeev; Vaithinathan, Krishnakumar; Vakorin, Vasily; Hernández, Maria Valdés; van Bokhoven, Pieter; Deerlin, Vivianna Van; van der Brug, Marcel; Dijk, Koene Van; van Duijn, Cornelia; van Erp, Theo; van Hooren, Roy; Leemput, Koen Van; van Loenhoud, Anita; Schependom, Jeroen Van; van Velden, Floris; van Westen, Danielle; Vandekar, Simon; Vandijck, Manu; Vanhoutte, Matthieu; Vannini, Patrizia; Vansteenkiste, Elias; Varatharajah, Yogatheesan; Vardarajan, Badri; Varey, Stephen; Vargas, Hernan; Varkey, Julia; Varma, Susheel; Varma, Vijay; Varma, Sudhr; Vasanthakumar, Aparna; Vashi, Tejal; Vasilchuk, Kseniia; Vassileva, Albena; Vatsalan, Dinusha; Vb, Nastaran; Veeramacheneni, Teja; Veeranah, Darvesh; Vejdani, Kaveh; Veldsman, Michele; Velgos, Stefanie; Veloso, Adriano; Vemuri, Prashanthi; Venero, Cesar; Venkataraman, Ashwin; Venkatasubramanian, Palamadai; Venkatraghavan, Vikram; Venugopal, Vinisha; Venugopalan, Janani; Verbeeck, Rudi; Verbel, David; Verbist, Bie; Verdoliva, Luisa; Verma, Ajay Kumar; Verma, Tarun; Verma, Ishan; Veronese, Mattia; Grabovetsky, Alejandro Vicente; Victor, Jonathan; Vieira, Domingos; Vijayaraj, Vinesh Raja; Vikas, Vinutha; Vilaplana, Veronica; Vilaplana, Eduard; Villar, José Ramón; Vincent, Fabrice; Vinkler, Mojmir; Viswanath, Satish; Viswanathan, Srikrishnan; Vitek, Michael; Viti, Mario; Vladutu, Liviu; Vlock, Daniel; Voineskos, Aristotle; Vora, Anvi; Vos, Stephanie; Voyle, Nicola; Vrenken, Hugo; Vu, Tien Duong; Vucetic, Zivjena; Vuksanovic, Vesna; Wachinger, Christian; Wada, Masataka; Wade, Sara; Wagstyl, Konrad; Wahba, Grace; Waldorf, Johannes; Walker, Douglas; Moore, Kim Poki Walker; Walsh, Dominic; Wan, Lin; Wang, Di; Wang, Jane-Ling; Wang, Yongmao; Wang, Huaming; Wang, Miao; Wang, Zi-Rui; Wang, Zheyu; Wang, Z. 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U.; Xiaoxi, Ji; Xiaoya, Zhu; Xiaoying, Qi; Xie, Yuchen; Xie, Zhiyong; Xie, Lei; Xie, Xiancheng; Xin, Huang; Xingyi, Huang; Xiong, Yuanpeng; Xiong, Momiao; Xu, Yongchao; Xu, XiaoYing; Xu, Qiqi; Xu, Lijun; Xu, Hewen; Xu, Yunlong; Xu, Zhilei; Xu, Ziliang; Xu, Jiayuan; Xu, Yadong; Xu, Lu; Xu, Shuoyu; Xue, Fei; Xuesong, Yang; Xz, Zarric; Yadav, Rishi; Yaish, Aviv; Yakushev, Igor; Yamada, Shigeki; Yamamoto, Utako; Yamashita, Alexandre; Yamashita, Fumio; Yan, Li; Yan, Yu; Yan, Jianhua; Yan, Shiju; Yan, Chao-Gan; Yan, Qingyu; Yan, Jingwen; Yan, Chen; Yan, Meng; Yang, Meng; Yang, Bin; Yang, Jiarui; Yang, Zhi; Yang, Xianfeng; Yang, Sli; Yang, Liang; Yang, Robert; Yang, Aleex; Yang, Hyungjeong; Yang, ChengHao; Yang, Haiwei; Yang, Jhih-Ying; Yang, Xu; Yangyang, Xia; Yao, Xufeng; Yaping, Wang; Yaqiong, Bi; Yared, Surafael; Yashin, Anatoliy; Yassine, Hussein; Yau, Tat; Yavorsky, Christian; Ye, Chang; Ye, Byoung Seok; Ye, Joy; Ye, Yongkai; Ye, Yuting; Ye, Wu; Yelampalli, Praveen Kumar Reddy; Thomas Yeo, B. T.; Yi, Zhao; Yi, Wang; Yi, Yuan; Yijing, Ruan; Yilmaz, Zeynep; Yin, Baocai; Yin, Tang-Kai; Ying, Li; Yingjiang, Wu; Yiyun, Yu; Yoichiro, Sato; Yokoyama, Jennifer; Yong, Zhang; Yonghong, Shi; Yonghu, Guo; Yongqi, Huang; Yoo, Inwan; Yoon, So Hoon; Yoon, Jee Seok; Yoon, Seung-Yong; Yoshida, Hisako; Yoshio, Kiyofumi; You, Jia; You, You; You, Xiaozhen; Young, Alexandra; Yu, Peng; Yu, Jaemin; Yu, Lin; Yu, Sui; Yu, Philip S.; Yu, Guan; Yu, Fengli; Yu, Jiaxin; Yu, Shaode; Yu, Suizhi; Yu, Donghyeon; Yuan, Yue; Yuan, Shaofeng; Yuan, Shuai; Yuanyuan, Chen; Yue, Ye; Yue, Cynthia; Yunaiyama, Daisuke; YushaoChen, YushaoChen; Yushkevich, Paul; Yx, W.; Zafeiris, Dimitrios; Zagorchev, Lyubomir; Zalocusky, Kelly; Zamorano, Francisco; Zandifar, Azar; Zanella, Laura; Zang, Yufeng; Zanke, Brent; Zaranek, Alexander Wait; Zawaideh, Mazen; Zawawi, Nour; Zee, Jarcy; Zeighami, Yashar; Zeitzer, Jamie; Zemla, Jeffrey; Zeng, Qi; Zeng, Fan; Zeng, Donglin; Zeng, Wei; Zeng, Yingying; Ženko, Bernard; Zereshki, Ehsan; Zeskind, Benjamin; Zhan, Justin; Zhang, Chenghui; Zhang, Yixuan; Zhang, Xiong; Zhang, Li; Zhang, Zhi; Zhang, Jianlun; Zhang, Jing; Zhang, Jianwei; Zhang, Yufei; Zhang, Sai; Zhang, Shan; Zhang, Xiaoling; Zhang, Changle; Zhang, Qingtian; Zhang, Fan; Zhang, Xiangliang; Zhang, Linda; Zhang, Yingteng; Zhang, Jianhua; Zhang, Xiaoqun; Zhang, Ziwei; Zhang, Ping; Zhang, Tuo; Zhang, Bin; Zhang, Hong; Zhang, Yuping; Zhang, Zhan; Zhang, Yu; Zhang, Jie; Zhang, Lijun; Zhang, ChengZhi; Zhang, Jian; Zhang, Peng; Zhang, Zhengjun; Zhang, Wen; Zhang, Guishan; Zhang, Xixue; Zhang, Tianhao; Zhangyi, Zhangyi; Zhao, Wenting; Zhao, Xuewu; Zhao, Peng; Zhao, Yifei; Zhao, Xing-Ming; Zhao, Di; Zhao, Qian; Zhao, Yang; Zhao, Lu; Zheng, Lijuan; Zheng, Kaiping; Zheng, Weihao; Zheng, Du; Zheng, Muhua; Zheng, Qiang; Zheng, Bichen; Zheng, Lihong; Zhong, Wenxuan; Zhong, Yujia; Zhou, Tian; Zhou, Jiayin; Zhou, Zhen; Zhou, Yongxia; Zhou, Lixin; Zhou, Bowei; Zhou, Juan; Zhou, Qixin; Zhou, Levi; Zhou, Fengfeng; Zhou, Jiayu; Zhou, Luping; Zhou, Yun; Zhou, Yingjie; Zhou, Ying; Zhou, Frankie; Zhu, Zonghai; Zhu, Xiaoya; Zhu, Xiaolu; Zhu, Shanfeng; Zhu, David; Zhu, Hongxiao; Zhu, Lida; Zhu, Xiaofeng; Zhuxin, Jin; Zigon, Robert; Zille, Pascal; Zimmer, Eduardo; Zimmer, Jennifer; Zimmerman, Earl; Zimmerman, Karl; Zimmermann, Joelle; Zipperer, Erin; Zito, Giancarlo; Zou, Yang; Zuo, Maria; Zywiec, Andrew

    2017-01-01

    Neuroimaging measurements derived from magnetic resonance imaging provide important information required for detecting changes related to the progression of mild cognitive impairment (MCI). Cortical features and changes play a crucial role in revealing unique anatomical patterns of brain regions,

  5. Validation of the Dutch version of the quick mild cognitive impairment screen (Qmci-D).

    LENUS (Irish Health Repository)

    Bunt, Steven

    2015-10-01

    Differentiating mild cognitive impairment (MCI) from dementia is important, as treatment options differ. There are few short (<5 min) but accurate screening tools that discriminate between MCI, normal cognition (NC) and dementia, in the Dutch language. The Quick Mild Cognitive Impairment (Qmci) screen is sensitive and specific in differentiating MCI from NC and mild dementia. Given this, we adapted the Qmci for use in Dutch-language countries and validated the Dutch version, the Qmci-D, against the Dutch translation of the Standardised Mini-Mental State Examination (SMMSE-D).

  6. Behavioral symptoms related to cognitive impairment

    Directory of Open Access Journals (Sweden)

    Dillon C

    2013-09-01

    Full Text Available Carol Dillon,1 Cecilia M Serrano,1 Diego Castro,1 Patricio Perez Leguizamón,1 Silvina L Heisecke,1,2 Fernando E Taragano1 1CEMIC (Centro de Educación Médica e Investigaciones Clínicas University Institute, 2CONICET (Consejo Nacional de Investigaciones Cientificas y Técnicas, Buenos Aires, Argentina Abstract: Neuropsychiatric symptoms (NPS are core features of Alzheimer's disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct ‘MBI’ and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI and dementia stages of Alzheimer’s disease and frontotemporal lobar degeneration. Keywords: behavioral or neuropsychiatric symptoms, cognitive impairment, dementia

  7. Cognitive Profiles of Patients with Mild Cognitive Impairment or Dementia in Alzheimer's or Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Helmut Hildebrandt

    2013-04-01

    Full Text Available Background: Alzheimer's disease (AD and Parkinson's disease (PD are associated with severe cognitive decline, but it is still unclear to what extent they become functionally more similar over time. Methods: We compared amnestic mild cognitively impaired (aMCI; n = 29 patients to mild cognitively impaired (MCI PD patients (n = 25, and patients with AD (n = 34 to patients with PD dementia (PDD; n = 15 with respect to cognitive functioning and mood. Results: aMCI patients were impaired in episodic memory, while MCI PD patients showed deficits in visuoconstruction and attention. AD and PDD patients showed comparable deficits on tests for language, attention and visuoconstruction. However, unlike PDD patients but similar to aMCI patients, AD patients showed a characteristic memory impairment, especially commission errors on recognition tasks, whereas PDD patients scored higher on the depressive mood questionnaire. Conclusions: In advanced stages of both diseases, the pattern of functional deficits associated with parietal and temporal lobe functions (attention, visuoconstruction and language is similar. However, specific differences, already present in the early stage (recognition errors in AD, associated with mediobasal temporal lobe functioning, and depressed mood in PDD, associated with non-motor basal ganglia loops, are also observed in the late stage.

  8. Anosognosia and Anosodiaphoria in Mild Cognitive Impairment and Alzheimer's Disease

    Directory of Open Access Journals (Sweden)

    Maria Lindau

    2014-12-01

    Full Text Available Aims: To evaluate the occurrence of anosognosia (lack of awareness and anosodiaphoria (insouciance in mild cognitive impairment (MCI and Alzheimer's disease (AD and to evaluate the influence of a worsening of dementia on these phenomena. Methods: A self-evaluation scale was used assessing degrees of anosognosia and anosodiaphoria; furthermore, a neuropsychological assessment and statistical analyses with nonparametric tests which could cope with data on an ordinal scale level and small samples were employed. Results: Cognitive ability was lower in AD (n = 9 than in MCI patients (n = 12, but AD patients self-rated lower cognitive disabilities, which is interpreted as one relative sign of anosognosia in AD. Awareness of the reasons for cognitive problems was also lower in AD, which is considered as another sign of anosognosia. The main pattern in MCI found that the higher the awareness, the lower the cognitive ability. In AD low awareness paralleled low cognitive functioning. Anosodiaphoria was present in AD but not in MCI. Conclusion: According to the literature anosognosia and anosodiaphoria seem to increase with progression of dementia from MCI as a result of right hemispheric alterations.

  9. Tocopherols and tocotrienols plasma levels are associated with cognitive impairment.

    Science.gov (United States)

    Mangialasche, Francesca; Xu, Weili; Kivipelto, Miia; Costanzi, Emanuela; Ercolani, Sara; Pigliautile, Martina; Cecchetti, Roberta; Baglioni, Mauro; Simmons, Andrew; Soininen, Hilkka; Tsolaki, Magda; Kloszewska, Iwona; Vellas, Bruno; Lovestone, Simon; Mecocci, Patrizia

    2012-10-01

    Vitamin E includes 8 natural compounds (4 tocopherols, 4 tocotrienols) with potential neuroprotective activity. α-Tocopherol has mainly been investigated in relation to cognitive impairment. We examined the relation of all plasma vitamin E forms and markers of vitamin E damage (α-tocopherylquinone, 5-nitro-γ-tocopherol) to mild cognitive impairment (MCI) and Alzheimer's disease (AD). Within the AddNeuroMed-Project, plasma tocopherols, tocotrienols, α-tocopherylquinone, and 5-nitro-γ-tocopherol were assessed in 168 AD cases, 166 MCI, and 187 cognitively normal (CN) people. Compared with cognitively normal subjects, AD and MCI had lower levels of total tocopherols, total tocotrienols, and total vitamin E. In multivariable-polytomous-logistic regression analysis, both MCI and AD cases had 85% lower odds to be in the highest tertile of total tocopherols and total vitamin E, and they were, respectively, 92% and 94% less likely to be in the highest tertile of total tocotrienols than the lowest tertile. Further, both disorders were associated with increased vitamin E damage. Low plasma tocopherols and tocotrienols levels are associated with increased odds of MCI and AD. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review

    NARCIS (Netherlands)

    Jekel, K.; Damian, M.; Wattmo, C.; Hausner, L.; Bullock, R.; Connelly, P.J.; Dubois, B.; Eriksdotter, M.; Ewers, M.; Graessel, E.; Kramberger, M.G.; Law, E.; Mecocci, P.; Molinuevo, J.L.; Nygard, L.; Olde Rikkert, M.G.M.; Orgogozo, J.M.; Pasquier, F.; Peres, K.; Salmon, E.; Sikkes, S.A.; Sobow, T.; Spiegel, R.; Tsolaki, M.; Winblad, B.; Frolich, L.

    2015-01-01

    INTRODUCTION: There is a growing body of evidence that subtle deficits in instrumental activities of daily living (IADL) may be present in mild cognitive impairment (MCI). However, it is not clear if there are IADL domains that are consistently affected across patients with MCI. In this systematic

  11. Increased Sensitivity to Proactive and Retroactive Interference in Amnestic Mild Cognitive Impairment: New Insights

    Science.gov (United States)

    Hanseeuw, Bernard J.; Seron, Xavier; Ivanoiu, Adrian

    2012-01-01

    Background: Increased sensitivity to proactive (PI) and retroactive (RI) interference has been observed in amnestic mild cognitive impairment (aMCI). PI and RI are often explained as being the result of a response competition mechanism. However, patients with aMCI are supposed to suffer mostly from encoding deficits. We hypothesized that in aMCI…

  12. Optimizing the diagnosis of early Alzheimer's disease in mild cognitive impairment subjects

    DEFF Research Database (Denmark)

    Mattila, Jussi; Soininen, Hilkka; Koikkalainen, Juha

    2012-01-01

    of the disease. Several studies have analyzed data of mild cognitive impairment (MCI) subjects, showing that conversion from MCI to AD can be predicted with a classification accuracy of 60-80%. This accuracy may not be high enough for influencing diagnostic decisions. In this work, the prediction problem...

  13. Brain Substrates of Learning and Retention in Mild Cognitive Impairment Diagnosis and Progression to Alzheimer's Disease

    Science.gov (United States)

    Chang, Yu-Ling; Bondi, Mark W.; Fennema-Notestine, Christine; McEvoy, Linda K.; Hagler, Donald J., Jr.; Jacobson, Mark W.; Dale, Anders M.

    2010-01-01

    Understanding the underlying qualitative features of memory deficits in mild cognitive impairment (MCI) can provide critical information for early detection of Alzheimer's disease (AD). This study sought to investigate the utility of both learning and retention measures in (a) the diagnosis of MCI, (b) predicting progression to AD, and (c)…

  14. Late-Life Depression, Mild Cognitive Impairment, and Dementia

    NARCIS (Netherlands)

    Richard, Edo; Reitz, Christiane; Honig, Lawrence H.; Schupf, Nicole; Tang, Ming X.; Manly, Jennifer J.; Mayeux, Richard; Devanand, Devangere; Luchsinger, José A.

    2013-01-01

    Objective: To evaluate the association of late-life depression with mild cognitive impairment (MCI) and dementia in a multiethnic community cohort. Design and Setting: A cohort study was conducted in Northern Manhattan, New York, New York. Participants: A total of 2160 community-dwelling Medicare

  15. Characterisation of Physical Frailty and Associated Physical and Functional Impairments in Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Ma Shwe Zin Nyunt

    2017-12-01

    Full Text Available ObjectiveTo characterize the physical frailty phenotype and its associated physical and functional impairments in mild cognitive impairment (MCI.MethodParticipants with MCI (N = 119, normal low cognition (NLC, N = 138, and normal high cognition (NHC, N = 1,681 in the Singapore Longitudinal Ageing Studies (SLAS-2 were compared on the prevalence of physical frailty, low lean body mass, weakness, slow gait, exhaustion and low physical activity, and POMA balance and gait impairment and fall risk.ResultsThere were significantly higher prevalence of frailty in MCI (18.5%, than in NLC (8.0% and NHC (3.9%, and pre-frailty in MCI (54.6%, NLC (52.9% than in NHC (48.0%. Age, sex, and ethnicity-adjusted OR (95% CI of association with MCI (versus NHC for frailty were 4.65 (2.40–9.04 and for pre-frailty, 1.67 (1.07–2.61. Similar significantly elevated prevalence and adjusted ORs of association with MCI were observed for frailty-associated physical and functional impairments. Further adjustment for education, marital status, living status, comorbidities, and GDS significantly reduced the OR estimates. However, the OR estimates remained elevated for frailty: 3.86 (1.83–8.17, low body mass: 1.70 (1.08–2.67, slow gait: 1.84 (1.17–2.89, impaired gait: 4.17 (1.98–8.81, and elevated fall risk 3.42 (1.22–9.53.ConclusionTwo-thirds of MCI were physically frail or pre-frail, most uniquely due to low lean muscle mass, slow gait speed, or balance and gait impairment. The close associations of frailty and physical and functional impairment with MCI have important implications for improving diagnostic acuity of MCI and targetting interventions among cognitively frail individuals to prevent dementia and disability.

  16. [Screening methods for mild cognitive impairment in primary care].

    Science.gov (United States)

    Freire Pérez, Alberto

    2017-06-01

    Diagnosis of mild cognitive impairment (MCI) is always clinical and screening methods only indicate that the patient has a higher risk of this condition. In MCI, there is a slight decline in some cognitive abilities that does not affect activities of daily living and therefore does not produce social or occupational disability. The definitive diagnosis of MCI requires a considerable time investment that is very rarely possible to provide in primary care (PC) consultations. Hence the need for PC physicians to employ rapid and simple screening methods (brief cognitive assessment -BCA-) that allow objective identification of patients likely to have MCI in a few minutes. This article reviews the BCA tools that can truly be applied in less than 10 minutes. The phototest is a brief screening tool that is easy to use and interpret by physicians and is well accepted by patients. Consequently, it is one of the most useful tests in PC for screening of both MCI and dementia. In addition to BCA, instrumental activities of daily living scales should also be applied to differentiate MCI from dementia. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. The Cognitive and Neural Expression of Semantic Memory Impairment in Mild Cognitive Impairment and Early Alzheimer's Disease

    Science.gov (United States)

    Joubert, Sven; Brambati, Simona M.; Ansado, Jennyfer; Barbeau, Emmanuel J.; Felician, Olivier; Didic, Mira; Lacombe, Jacinthe; Goldstein, Rachel; Chayer, Celine; Kergoat, Marie-Jeanne

    2010-01-01

    Semantic deficits in Alzheimer's disease have been widely documented, but little is known about the integrity of semantic memory in the prodromal stage of the illness. The aims of the present study were to: (i) investigate naming abilities and semantic memory in amnestic mild cognitive impairment (aMCI), early Alzheimer's disease (AD) compared to…

  18. Memory Binding Test Predicts Incident Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Mowrey, Wenzhu B; Lipton, Richard B; Katz, Mindy J; Ramratan, Wendy S; Loewenstein, David A; Zimmerman, Molly E; Buschke, Herman

    2016-07-14

    The Memory Binding Test (MBT), previously known as Memory Capacity Test, has demonstrated discriminative validity for distinguishing persons with amnestic mild cognitive impairment (aMCI) and dementia from cognitively normal elderly. We aimed to assess the predictive validity of the MBT for incident aMCI. In a longitudinal, community-based study of adults aged 70+, we administered the MBT to 246 cognitively normal elderly adults at baseline and followed them annually. Based on previous work, a subtle reduction in memory binding at baseline was defined by a Total Items in the Paired (TIP) condition score of ≤22 on the MBT. Cox proportional hazards models were used to assess the predictive validity of the MBT for incident aMCI accounting for the effects of covariates. The hazard ratio of incident aMCI was also assessed for different prediction time windows ranging from 4 to 7 years of follow-up, separately. Among 246 controls who were cognitively normal at baseline, 48 developed incident aMCI during follow-up. A baseline MBT reduction was associated with an increased risk for developing incident aMCI (hazard ratio (HR) = 2.44, 95% confidence interval: 1.30-4.56, p = 0.005). When varying the prediction window from 4-7 years, the MBT reduction remained significant for predicting incident aMCI (HR range: 2.33-3.12, p: 0.0007-0.04). Persons with poor performance on the MBT are at significantly greater risk for developing incident aMCI. High hazard ratios up to seven years of follow-up suggest that the MBT is sensitive to early disease.

  19. Semantic memory and depressive symptoms in patients with subjective cognitive decline, mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Lehrner, J; Coutinho, G; Mattos, P; Moser, D; Pflüger, M; Gleiss, A; Auff, E; Dal-Bianco, P; Pusswald, G; Stögmann, E

    2017-07-01

    Semantic memory may be impaired in clinically recognized states of cognitive impairment. We investigated the relationship between semantic memory and depressive symptoms (DS) in patients with cognitive impairment. 323 cognitively healthy controls and 848 patients with subjective cognitive decline (SCD), mild cognitive impairment (MCI), and Alzheimer's disease (AD) dementia were included. Semantic knowledge for famous faces, world capitals, and word vocabulary was investigated. Compared to healthy controls, we found a statistically significant difference of semantic knowledge in the MCI groups and the AD group, respectively. Results of the SCD group were mixed. However, two of the three semantic memory measures (world capitals and word vocabulary) showed a significant association with DS. We found a difference in semantic memory performance in MCI and AD as well as an association with DS. Results suggest that the difference in semantic memory is due to a storage loss rather than to a retrieval problem.

  20. Vascular cognitive impairment

    Directory of Open Access Journals (Sweden)

    N.V. Vakhnina

    2014-01-01

    Full Text Available Vascular pathology of the brain is the second most common cause of cognitive impairment after Alzheimer's disease. The article describes the modern concepts of etiology, pathogenetic mechanisms, clinical features and approaches to diagnosis and therapy of vascular cognitive impairment (VCI. Cerebrovascular accident, chronic cerebral circulatory insufficiency and their combination, sometimes in combination with a concomitant neurodegenerative process, are shown to be the major types of brain lesions leading to VCI. The clinical presentation of VCI is characterized by the neuropsychological status dominated by impairment of the executive frontal functions (planning, control, attention in combination with focal neurological symptoms. The diagnosis is based on comparing of the revealed neuropsychological and neurological features with neuroimaging data. Neurometabolic, acetylcholinergic, glutamatergic, and other vasoactive drugs and non-pharmacological methods are widely used to treat VCI. 

  1. Erythrocyte polyunsaturated fatty acid status, memory, cognition and mood in older adults with mild cognitive impairment and healthy controls.

    Science.gov (United States)

    Milte, Catherine M; Sinn, Natalie; Street, Steven J; Buckley, Jonathan D; Coates, Alison M; Howe, Peter R C

    2011-01-01

    Polyunsaturated fatty acid (PUFA) levels are altered in adults with cognitive decline and also depression. Depression facilitates progression from mild cognitive impairment (MCI) to dementia. We investigated associations between omega-3 (n-3) and omega-6 (n-6) PUFAs and cognition, memory and depression in 50 adults ≥65 years with MCI and 29 controls. Memory, depressive symptoms and erythrocyte PUFAs (% total fatty acids) were assessed. Eicosapentaenoic acid (EPA) was lower in MCI vs controls (.94% vs 1.26%, pcognitive decline in this population. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Principal component analysis of FDG PET in amnestic MCI

    International Nuclear Information System (INIS)

    Nobili, Flavio; Girtler, Nicola; Brugnolo, Andrea; Dessi, Barbara; Rodriguez, Guido; Salmaso, Dario; Morbelli, Silvia; Piccardo, Arnoldo; Larsson, Stig A.; Pagani, Marco

    2008-01-01

    The purpose of the study is to evaluate the combined accuracy of episodic memory performance and 18 F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls. Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI). 18 F-FDG PET volumetric regions of interest underwent principal component analysis (PCA) that identified 12 principal components (PC), expressed by coarse component scores (CCS). Discriminant analysis was performed using the significant PCs and episodic memory scores. PCA highlighted relative hypometabolism in PC5, including bilateral posterior cingulate and left temporal pole, and in PC7, including the bilateral orbitofrontal cortex, both in MCI/MCI and MCI/AD vs CTR. PC5 itself plus PC12, including the left lateral frontal cortex (LFC: BAs 44, 45, 46, 47), were significantly different between MCI/AD and MCI/MCI. By a three-group discriminant analysis, CTR were more accurately identified by PET-CCS + delayed recall score (100%), MCI/MCI by PET-CCS + either immediate or delayed recall scores (91%), while MCI/AD was identified by PET-CCS alone (82%). PET increased by 25% the correct allocations achieved by memory scores, while memory scores increased by 15% the correct allocations achieved by PET. Combining memory performance and 18 F-FDG PET yielded a higher accuracy than each single tool in identifying CTR and MCI/MCI. The PC containing bilateral posterior cingulate and left temporal pole was the hallmark of MCI/MCI patients, while the PC including the left LFC was the hallmark of conversion to AD. (orig.)

  3. Principal component analysis of FDG PET in amnestic MCI

    Energy Technology Data Exchange (ETDEWEB)

    Nobili, Flavio; Girtler, Nicola; Brugnolo, Andrea; Dessi, Barbara; Rodriguez, Guido [University of Genoa, Clinical Neurophysiology, Department of Endocrinological and Medical Sciences, Genoa (Italy); S. Martino Hospital, Alzheimer Evaluation Unit, Genoa (Italy); S. Martino Hospital, Head-Neck Department, Genoa (Italy); Salmaso, Dario [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Morbelli, Silvia [University of Genoa, Nuclear Medicine Unit, Department of Internal Medicine, Genoa (Italy); Piccardo, Arnoldo [Galliera Hospital, Nuclear Medicine Unit, Department of Imaging Diagnostics, Genoa (Italy); Larsson, Stig A. [Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden); Pagani, Marco [CNR, Institute of Cognitive Sciences and Technologies, Rome (Italy); CNR, Institute of Cognitive Sciences and Technologies, Padua (Italy); Karolinska Hospital, Department of Nuclear Medicine, Stockholm (Sweden)

    2008-12-15

    The purpose of the study is to evaluate the combined accuracy of episodic memory performance and {sup 18}F-FDG PET in identifying patients with amnestic mild cognitive impairment (aMCI) converting to Alzheimer's disease (AD), aMCI non-converters, and controls. Thirty-three patients with aMCI and 15 controls (CTR) were followed up for a mean of 21 months. Eleven patients developed AD (MCI/AD) and 22 remained with aMCI (MCI/MCI). {sup 18}F-FDG PET volumetric regions of interest underwent principal component analysis (PCA) that identified 12 principal components (PC), expressed by coarse component scores (CCS). Discriminant analysis was performed using the significant PCs and episodic memory scores. PCA highlighted relative hypometabolism in PC5, including bilateral posterior cingulate and left temporal pole, and in PC7, including the bilateral orbitofrontal cortex, both in MCI/MCI and MCI/AD vs CTR. PC5 itself plus PC12, including the left lateral frontal cortex (LFC: BAs 44, 45, 46, 47), were significantly different between MCI/AD and MCI/MCI. By a three-group discriminant analysis, CTR were more accurately identified by PET-CCS + delayed recall score (100%), MCI/MCI by PET-CCS + either immediate or delayed recall scores (91%), while MCI/AD was identified by PET-CCS alone (82%). PET increased by 25% the correct allocations achieved by memory scores, while memory scores increased by 15% the correct allocations achieved by PET. Combining memory performance and {sup 18}F-FDG PET yielded a higher accuracy than each single tool in identifying CTR and MCI/MCI. The PC containing bilateral posterior cingulate and left temporal pole was the hallmark of MCI/MCI patients, while the PC including the left LFC was the hallmark of conversion to AD. (orig.)

  4. Estrogen and cognitive functioning in men with mild cognitive impairment.

    Science.gov (United States)

    Sherwin, Barbara B

    2002-01-01

    Although men do not experience an abrupt cessation of gonadal hormone production at midlife as do women, levels of testosterone (T) decrease gradually with aging. Because estradiol (E2) arises mainly from the conversion of T in men, the availability of E2 also decreases with increasing age. In randomized clinical trials, E2 replacement therapy has been shown to maintain aspects of cognition in postmenopausal women, specifically with regard to verbal memory. The present prospective, randomized, cross-over trial is being undertaken in order to determine whether E2 will enhance verbal memory in men with Mild Cognitive Impairment (MCI). Men with MCI will randomly receive E2 or placebo for the first 3 mo of treatment and will then be crossed-over to the other treatment for an additional 3 mo. A battery of neuropsychological tests will be administered at pretreatment and, again, following each 3-mo treatment phase. It is hypothesized that elderly men with MCI will perform better on tests of explicit memory when they are being treated with E2 compared to their performance under placebo conditions.

  5. Assessing Working Memory in Mild Cognitive Impairment with Serial Order Recall.

    Science.gov (United States)

    Emrani, Sheina; Libon, David J; Lamar, Melissa; Price, Catherine C; Jefferson, Angela L; Gifford, Katherine A; Hohman, Timothy J; Nation, Daniel A; Delano-Wood, Lisa; Jak, Amy; Bangen, Katherine J; Bondi, Mark W; Brickman, Adam M; Manly, Jennifer; Swenson, Rodney; Au, Rhoda

    2018-01-01

    Working memory (WM) is often assessed with serial order tests such as repeating digits backward. In prior dementia research using the Backward Digit Span Test (BDT), only aggregate test performance was examined. The current research tallied primacy/recency effects, out-of-sequence transposition errors, perseverations, and omissions to assess WM deficits in patients with mild cognitive impairment (MCI). Memory clinic patients (n = 66) were classified into three groups: single domain amnestic MCI (aMCI), combined mixed domain/dysexecutive MCI (mixed/dys MCI), and non-MCI where patients did not meet criteria for MCI. Serial order/WM ability was assessed by asking participants to repeat 7 trials of five digits backwards. Serial order position accuracy, transposition errors, perseverations, and omission errors were tallied. A 3 (group)×5 (serial position) repeated measures ANOVA yielded a significant group×trial interaction. Follow-up analyses found attenuation of the recency effect for mixed/dys MCI patients. Mixed/dys MCI patients scored lower than non-MCI patients for serial position 3 (p Mixed/dys MCI patients also produced more transposition errors than both groups (p order parameters obtained from the BDT may provide a useful operational definition as well as additional diagnostic information regarding working memory deficits in MCI.

  6. Prefrontal activation may predict working-memory training gain in normal aging and mild cognitive impairment

    NARCIS (Netherlands)

    Vermeij, A.; Kessels, R.P.C.; Heskamp, L.; Simons, E.M.F.; Dautzenberg, P.LJ.; Claassen, J.A.H.R.

    2017-01-01

    Cognitive training has been shown to result in improved behavioral performance in normal aging and mild cognitive impairment (MCI), yet little is known about the neural correlates of cognitive plasticity, or about individual differences in responsiveness to cognitive training. In this study, 21

  7. Prevalence and associated behavioral symptoms of depression in mild cognitive impairment and dementia due to Alzheimer's disease

    NARCIS (Netherlands)

    Van der Mussele, Stefan; Bekelaar, Kim; Le Bastard, Nathalie; Vermeiren, Yannick; Saerens, Jos; Somers, Nore; Marien, Peter; Goeman, Johan; De Deyn, Peter P.; Engelborghs, Sebastiaan

    Background: Mild cognitive impairment (MCI) is a clinical concept that categorizes subjects who are in an intermediate cognitive state between normal aging and dementia. The aims of this study are to determine the prevalence of significant depressive symptoms in MCI and Alzheimer's disease (AD)

  8. Global efficiency of structural networks mediates cognitive control in Mild Cognitive Impairment

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    Rok Berlot

    2016-12-01

    Full Text Available Background: Cognitive control has been linked to both the microstructure of individual tracts and the structure of whole-brain networks, but their relative contributions in health and disease remain unclear. Objective: To determine the contribution of both localised white matter tract damage and disruption of global network architecture to cognitive control, in older age and Mild Cognitive Impairment (MCI.Methods: 25 patients with MCI and 20 age, sex and intelligence-matched healthy volunteers were investigated with 3 Tesla structural magnetic resonance imaging (MRI. Cognitive control and episodic memory were evaluated with established tests. Structural network graphs were constructed from diffusion MRI-based whole-brain tractography. Their global measures were calculated using graph theory. Regression models utilized both global network metrics and microstructure of specific connections, known to be critical for each domain, to predict cognitive scores. Results: Global efficiency and the mean clustering coefficient of networks were reduced in MCI. Cognitive control was associated with global network topology. Episodic memory, in contrast, correlated with individual temporal tracts only. Relationships between cognitive control and network topology were attenuated by addition of single tract measures to regression models, consistent with a partial mediation effect. The mediation effect was stronger in MCI than healthy volunteers, explaining 23-36% of the effect of cingulum microstructure on cognitive control performance. Network clustering was a significant mediator in the relationship between tract microstructure and cognitive control in both groups. Conclusions: The status of critical connections and large-scale network topology are both important for maintenance of cognitive control in MCI. Mediation via large-scale networks is more important in patients with MCI than healthy volunteers. This effect is domain-specific, and true for cognitive

  9. Roles of Education and IQ in Cognitive Reserve in Parkinson’s Disease-Mild Cognitive Impairment

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    M.J. Armstrong

    2012-08-01

    Full Text Available Background/Aims: The role of cognitive reserve in Parkinson’s disease (PD-mild cognitive impairment (MCI is incompletely understood. Methods: The relationships between PD-MCI, years of education, and estimated premorbid IQ were examined in 119 consecutive non-demented PD patients using logistic regression models. Results: Higher education and IQ were associated with reduced odds of PD-MCI in univariate analysis. In multivariable analysis, a higher IQ was associated with a significantly decreased odds of PD-MCI, but education was not. Conclusion: The association of higher IQ and decreased odds of PD-MCI supports a role for cognitive reserve in PD, but further studies are needed to clarify the interaction of IQ and education and the impact of other contributors such as employment and hobbies.

  10. Cross-Sectional Relationships of Physical Activity and Sedentary Behavior With Cognitive Function in Older Adults With Probable Mild Cognitive Impairment.

    Science.gov (United States)

    Falck, Ryan S; Landry, Glenn J; Best, John R; Davis, Jennifer C; Chiu, Bryan K; Liu-Ambrose, Teresa

    2017-10-01

    Mild cognitive impairment (MCI) represents a transition between normal cognitive aging and dementia and may represent a critical time frame for promoting cognitive health through behavioral strategies. Current evidence suggests that physical activity (PA) and sedentary behavior are important for cognition. However, it is unclear whether there are differences in PA and sedentary behavior between people with probable MCI and people without MCI or whether the relationships of PA and sedentary behavior with cognitive function differ by MCI status. The aims of this study were to examine differences in PA and sedentary behavior between people with probable MCI and people without MCI and whether associations of PA and sedentary behavior with cognitive function differed by MCI status. This was a cross-sectional study. Physical activity and sedentary behavior in adults dwelling in the community (N = 151; at least 55 years old) were measured using a wrist-worn actigraphy unit. The Montreal Cognitive Assessment was used to categorize participants with probable MCI (scores of Cognitive function was indexed using the Alzheimer Disease Assessment Scale-Cognitive-Plus (ADAS-Cog Plus). Physical activity and sedentary behavior were compared based on probable MCI status, and relationships of ADAS-Cog Plus with PA and sedentary behavior were examined by probable MCI status. Participants with probable MCI (n = 82) had lower PA and higher sedentary behavior than participants without MCI (n = 69). Higher PA and lower sedentary behavior were associated with better ADAS-Cog Plus performance in participants without MCI (β = -.022 and β = .012, respectively) but not in participants with probable MCIcognitive function. The diagnosis of MCI was not confirmed with a physician; therefore, this study could not conclude how many of the participants categorized as having probable MCI would actually have been diagnosed with MCI by a physician. Participants with probable MCI were less active

  11. Processing complex pseudo-words in mild cognitive impairment: The interaction of preserved morphological rule knowledge with compromised cognitive ability.

    Science.gov (United States)

    Manouilidou, Christina; Dolenc, Barbara; Marvin, Tatjana; Pirtošek, Zvezdan

    2016-01-01

    Mild cognitive impairment (MCI) affects the cognitive performance of elderly adults. However, the level of severity is not high enough to be diagnosed with dementia. Previous research reports subtle language impairments in individuals with MCI specifically in domains related to lexical meaning. The present study used both off-line (grammaticality judgment) and on-line (lexical decision) tasks to examine aspects of lexical processing and how they are affected by MCI. 21 healthy older adults and 23 individuals with MCI saw complex pseudo-words that violated various principles of word formation in Slovenian and decided if each letter string was an actual word of their language. The pseudo-words ranged in their degree of violability. A task effect was found, with MCI performance to be similar to that of healthy controls in the off-line task but different in the on-line task. Overall, the MCI group responded slower than the elderly controls. No significant differences were observed in the off-line task, while the on-line task revealed a main effect of Violation type, a main effect of Group and a significant Violation × Group interaction reflecting a difficulty for the MCI group to process pseudo-words in real time. That is, while individuals with MCI seem to preserve morphological rule knowledge, they experience additional difficulties while processing complex pseudo-words. This was attributed to an executive dysfunction associated with MCI that delays the recognition of ungrammatical formations.

  12. Reduced mismatch negativity in mild cognitive impairment: associations with neuropsychological performance.

    Science.gov (United States)

    Mowszowski, Loren; Hermens, Daniel F; Diamond, Keri; Norrie, Louisa; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2012-01-01

    Mild cognitive impairment (MCI) refers to a transitory state between healthy aging and dementia. Biomarkers are needed to facilitate early identification of MCI and predict progression to dementia. One potential neurophysiological biomarker, mismatch negativity (MMN), is an event-related potential reflecting fundamental, pre-attentive cognitive processes. MMN is reduced in normal aging and dementia and in neuropsychiatric samples and is associated with verbal memory deficits and poor executive functioning. This study aimed to investigate auditory MMN and its relationship to neuropsychological performance in MCI. Twenty-eight MCI participants and fourteen controls, aged ≥50 years, underwent neurophysiological and neuropsychological assessment, and completed questionnaires pertaining to disability. Relative to controls, the MCI group demonstrated reduced temporal MMN amplitude (p patients with MCI exhibit altered pre-attentive information processing, which in turn is associated with memory and psychosocial deficits. These findings overall suggest that MMN may be a viable neurophysiological biomarker of underlying disease in this 'at risk' group.

  13. Functional mobility in a divided attention task in older adults with cognitive impairment.

    Science.gov (United States)

    Borges, Sheila de Melo; Radanovic, Márcia; Forlenza, Orestes Vicente

    2015-01-01

    Motor disorders may occur in mild cognitive impairment (MCI) and at early stages of Alzheimer's disease (AD), particularly under divided attention conditions. We examined functional mobility in 104 older adults (42 with MCI, 26 with mild AD, and 36 cognitively healthy) using the Timed Up and Go test (TUG) under 4 experimental conditions: TUG single task, TUG plus a cognitive task, TUG plus a manual task, and TUG plus a cognitive and a manual task. Statistically significant differences in mean time of execution were found in all four experimental conditions when comparing MCI and controls (p .8, p .7, p < .001 for MCI vs. AD). The authors conclude that functional motor deficits occurring in MCI can be assessed by the TUG test, in single or dual task modality.

  14. Visual selective attention in amnestic mild cognitive impairment.

    Science.gov (United States)

    McLaughlin, Paula M; Anderson, Nicole D; Rich, Jill B; Chertkow, Howard; Murtha, Susan J E

    2014-11-01

    Subtle deficits in visual selective attention have been found in amnestic mild cognitive impairment (aMCI). However, few studies have explored performance on visual search paradigms or the Simon task, which are known to be sensitive to disease severity in Alzheimer's patients. Furthermore, there is limited research investigating how deficiencies can be ameliorated with exogenous support (auditory cues). Sixteen individuals with aMCI and 14 control participants completed 3 experimental tasks that varied in demand and cue availability: visual search-alerting, visual search-orienting, and Simon task. Visual selective attention was influenced by aMCI, auditory cues, and task characteristics. Visual search abilities were relatively consistent across groups. The aMCI participants were impaired on the Simon task when working memory was required, but conflict resolution was similar to controls. Spatially informative orienting cues improved response times, whereas spatially neutral alerting cues did not influence performance. Finally, spatially informative auditory cues benefited the aMCI group more than controls in the visual search task, specifically at the largest array size where orienting demands were greatest. These findings suggest that individuals with aMCI have working memory deficits and subtle deficiencies in orienting attention and rely on exogenous information to guide attention. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Cognitive impairments in epilepsy

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    Aleksandr Anatolyevich Kostylev

    2013-01-01

    Full Text Available Cognitive impairments in epilepsy are a current problem in neurology. The basis of the idea on the pathogenesis of higher nervous system dysfunctions is the interaction of a few factors that include the form and duration of the disease, gender differences, and the impact of antiepileptic therapy. The role of interattack epileptiform changes in the development of cognitive deficit in adults and epileptic encephalopathies in children is discussed. Up-to-date neurophysiological and neuroimaging diagnostic methods allow the detection of new features in the course and progression of higher nervous system dysfunctions in epilepsy.

  16. [Patterns of detection of mild cognitive impairment in nursing].

    Science.gov (United States)

    Sebastián Hernández, Ana J; Arranz Santamaría, Luís Carlos

    2017-06-01

    Mild cognitive impairment (MCI) is characterized by an acquired cognitive loss that places individuals, mainly older adults, in an intermediate stage between normal cognitive functioning and dementia. This impairment has a high risk of progression to dementia and is suitable for screening, which allows more effective early intervention. Nursing professionals, especially community-based primary care nurses, play an important role in the detection and follow-up of MCI and in interventions for this condition. The first step should be to take a thorough history from both the patient and his or her carers, which should assess the changes occurring in the patient's daily, family and social life through functional patterns. In subsequent assessment of cognitive function, brief screening tests can be used such as the Mini Mental State Examination (MMSE) or other similar tests. Special attention should be paid to the presence of affective or depressive symptoms, sensory deficits, polypharmacy, decompensated cardiovascular risk factors, and rapid functional deterioration, given their particular influence on MCI. Finally, various nurse-led, non-pharmacological interventions that are effective in MCI can be recommended, based on cardiovascular risk factor control, physical exercise, and cognitive and psychosocial interventions. Copyright © 2017 Sociedad Española de Geriatría y Gerontología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Volume changes in Alzheimer's disease and mild cognitive impairment: cognitive associations

    International Nuclear Information System (INIS)

    Evans, Matthew C.; Barnes, Josephine; Nielsen, Casper; Clegg, Shona L.; Blair, Melanie; Douiri, Abdel; Boyes, Richard G.; Fox, Nick C.; Kim, Lois G.; Leung, Kelvin K.; Ourselin, Sebastien

    2010-01-01

    To assess the relationship between MRI-derived changes in whole-brain and ventricular volume with change in cognitive scores in Alzheimer's disease (AD), mild cognitive impairment (MCI) and control subjects. In total 131 control, 231 MCI and 99 AD subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort with T1-weighted volumetric MRIs from baseline and 12-month follow-up were used to derive volume changes. Mini mental state examination (MMSE), Alzheimer's disease assessment scale (ADAS)-cog and trails test changes were calculated over the same period. Brain atrophy rates and ventricular enlargement differed between subject groups (p < 0.0005) and in MCI and AD were associated with MMSE changes. Both measures were additionally associated with ADAS-cog and trails-B in MCI patients, and ventricular expansion was associated with ADAS-cog in AD patients. Brain atrophy (p < 0.0005) and ventricular expansion rates (p = 0.001) were higher in MCI subjects who progressed to AD within 12 months of follow-up compared with MCI subjects who remained stable. MCI subjects who progressed to AD within 12 months had similar atrophy rates to AD subjects. Whole-brain atrophy rates and ventricular enlargement differed between patient groups and healthy controls, and tracked disease progression and psychological decline, demonstrating their relevance as biomarkers. (orig.)

  18. Attribution of mild cognitive impairment etiology in patients and their care partners.

    Science.gov (United States)

    Rodakowski, Juleen; Schulz, Richard; Gentry, Amanda; Garand, Linda; Lingler, Jennifer Hagerty

    2014-05-01

    This study examined the attribution of mild cognitive impairment (MCI) etiology assigned by individuals with MCI and their care partners, and the extent to which the dyads agreed on the attribution of MCI etiology. We conducted secondary analyses of cross-sectional data from a cohort of individuals with MCI (n = 60) and their care partners (n = 60). The mean age of the individuals with MCI was 71.0 ± 9.4 years and of care partners 64.2 ± 11.0 years. The primary outcome was attribution assigned to memory deficits on the Illness Perception Questionnaire. We categorized the attribution of MCI etiology as either potentially controllable or uncontrollable factors. We described the distribution of MCI etiology with descriptive and contingency tables. We determined the odds of a patient or care partner choosing one type of MCI etiology over another. Although individuals with MCI and their care partners most frequently attributed MCI to uncontrollable factors (81.7% and 61.0%, respectively), care partners were 28.41 (95% CI, 1.26 to 645.48) times more likely to attribute MCI etiology to potentially controllable factors than individuals with MCI. No significant associations between demographic factors and attribution of MCI etiology were found for the individuals with MCI or the care partners. Findings demonstrated that members of the dyad attributed MCI etiology to different causes. Attributions of MCI etiology should be explored by professionals to clarify misconceptions and potentially improve subsequent voluntary actions intended to assist oneself or others. Copyright © 2013 John Wiley & Sons, Ltd.

  19. The Alzheimer's Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI.

    Science.gov (United States)

    Skinner, Jeannine; Carvalho, Janessa O; Potter, Guy G; Thames, April; Zelinski, Elizabeth; Crane, Paul K; Gibbons, Laura E

    2012-12-01

    The Alzheimer's Disease Assessment Scale cognitive subscale (ADAS-Cog) is widely used in AD, but may be less responsive to change when used in people with mild cognitive impairment (MCI). Participants from the Alzheimer's Disease Neuroimaging Initiative were administered a neuropsychological battery and 1.5 T MRI scans over 2-3 years. Informants were queried regarding functional impairments. Some participants had lumbar punctures to obtain cerebrospinal fluid (CSF). We added executive functioning (EF) and functional ability (FA) items to the ADAS-Cog to generate candidate augmented measures. We calibrated these candidates using baseline data (n = 811) and selected the best candidate that added EF items alone and that added EF and FA items. We selected candidates based on their responsiveness over three years in a training sample of participants with MCI (n = 160). We compared traditional ADAS-Cog scores with the two candidates based on their responsiveness in a validation sample of participants with MCI (n = 234), ability to predict conversion to dementia (n = 394), strength of association with baseline MRI (n = 394) and CSF biomarkers (n = 193). The selected EF candidate added category fluency (ADAS Plus EF), and the selected EF and FA candidate added category fluency, Digit Symbol, Trail Making, and five items from the Functional Assessment Questionnaire (ADAS Plus EF&FA). The ADAS Plus EF& FA performed as well as or better than traditional ADAS-Cog scores. Adding EF and FA items to the ADAS-Cog may improve responsiveness among people with MCI without impairing validity.

  20. Extent and neural basis of semantic memory impairment in mild cognitive impairment.

    Science.gov (United States)

    Barbeau, Emmanuel J; Didic, Mira; Joubert, Sven; Guedj, Eric; Koric, Lejla; Felician, Olivier; Ranjeva, Jean-Philippe; Cozzone, Patrick; Ceccaldi, Mathieu

    2012-01-01

    An increasing number of studies indicate that semantic memory is impaired in mild cognitive impairment (MCI). However, the extent and the neural basis of this impairment remain unknown. The aim of the present study was: 1) to evaluate whether all or only a subset of semantic domains are impaired in MCI patients; and 2) to assess the neural substrate of the semantic impairment in MCI patients using voxel-based analysis of MR grey matter density and SPECT perfusion. 29 predominantly amnestic MCI patients and 29 matched control subjects participated in this study. All subjects underwent a full neuropsychological assessment, along with a battery of five tests evaluating different domains of semantic memory. A semantic memory composite Z-score was established on the basis of this battery and was correlated with MRI grey matter density and SPECT perfusion measures. MCI patients were found to have significantly impaired performance across all semantic tasks, in addition to their anterograde memory deficit. Moreover, no temporal gradient was found for famous faces or famous public events and knowledge for the most remote decades was also impaired. Neuroimaging analyses revealed correlations between semantic knowledge and perirhinal/entorhinal areas as well as the anterior hippocampus. Therefore, the deficits in the realm of semantic memory in patients with MCI is more widespread than previously thought and related to dysfunction of brain areas beyond the limbic-diencephalic system involved in episodic memory. The severity of the semantic impairment may indicate a decline of semantic memory that began many years before the patients first consulted.

  1. The Efficacy of Cognitive Stimulation on Depression and Cognition in Elderly Patients with Cognitive Impairment: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Federerico Filipin

    2015-12-01

    Full Text Available Cognitive decline due to neurodegenerative diseases is a prevalent worldwide problem. Both pharmacological and non-pharmacological treatments to improve, delay or stop disease progression are of vital importance. Cognitive stimulation is frequently used in clinical practice; however, there are few studies that demonstrate its efficacy. Aim: To evaluate the efficacy of cognitive stimulation in patients with mild cognitive impairment (CDR = 0.5 and dementia (CDR = 1. Methods: A retrospective cohort study was performed. Patients with cognitive impairment receiving weekly cognitive stimulation (16 or 24 sessions were evaluated with a complete neuropsychological battery before and after the stimulation program. Each stimulation session was carried out by a trained neuropsychologist. Results: Forty two patients receiving cognitive stimulation were evaluated over a period of 12.53 months (SD 5.5. Patients were grouped as 11 amnesic mild cognitive impairment (aMCI, 23 multi domain mild cognitive impairment (mMCI and 8 Mild Alzheimer's Dementia (CDR 1. None of the groups improved their cognitive functions after the cognitive stimulation program. MCI group was also divided according to their global intelligence quotient (IQ into two groups: low (IQ < 98.5 and high (IQ > 98.5. Each group was compared before and after the stimulation program and no significant difference was found (p ≥ 0.05. Moreover, MCI group was also analyzed according to the duration of the stimulation program: less than 9, between 9 and 13 and more than 13 months. Different duration groups were compared before and after the cognitive stimulation program and no significant differences were found. Depression, anxiety and subjective memory symptoms were also analysed and neither improvement nor worsening could be demonstrated. Conclusions: Patients remained stable, both in cognitive and behavioural domains, for more than 18 months. However, no significant cognitive or behavioural

  2. Emotion recognition in mild cognitive impairment: relationship to psychosocial disability and caregiver burden.

    Science.gov (United States)

    McCade, Donna; Savage, Greg; Guastella, Adam; Hickie, Ian B; Lewis, Simon J G; Naismith, Sharon L

    2013-09-01

    Impaired emotion recognition in dementia is associated with increased patient agitation, behavior management difficulties, and caregiver burden. Emerging evidence supports the presence of very early emotion recognition difficulties in mild cognitive impairment (MCI); however, the relationship between these impairments and psychosocial measures is not yet explored. Emotion recognition abilities of 27 patients with nonamnestic MCI (naMCI), 29 patients with amnestic MCI (aMCI), and 22 control participants were assessed. Self-report measures assessed patient functional disability, while informants rated the degree of burden they experienced. Difficulties in recognizing anger was evident in the amnestic subtype. Although both the patient groups reported greater social functioning disability, compared with the controls, a relationship between social dysfunction and anger recognition was evident only for patients with naMCI. A significant association was found between burden and anger recognition in patients with aMCI. Impaired emotion recognition abilities impact MCI subtypes differentially. Interventions targeted at patients with MCI, and caregivers are warranted.

  3. Callosal degeneration topographically correlated with cognitive function in amnestic mild cognitive impairment and Alzheimer's disease dementia.

    Science.gov (United States)

    Wang, Pei-Ning; Chou, Kun-Hsien; Chang, Ni-Jung; Lin, Ker-Neng; Chen, Wei-Ta; Lan, Gong-Yau; Lin, Ching-Po; Lirng, Jiing-Feng

    2014-04-01

    Degeneration of the corpus callosum (CC) is evident in the pathogenesis of Alzheimer's disease (AD). However, the correlation of microstructural damage in the CC on the cognitive performance of patients with amnestic mild cognitive impairment (aMCI) and AD dementia is undetermined. We enrolled 26 normal controls, 24 patients with AD dementia, and 40 single-domain aMCI patients with at least grade 1 hippocampal atrophy and isolated memory impairment. Diffusion tensor imaging (DTI) with fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (DA), and radial diffusivity (DR) were measured. The entire CC was parcellated based on fiber trajectories to specific cortical Brodmann areas using a probabilistic tractography method. The relationship between the DTI measures in the subregions of the CC and cognitive performance was examined. Although the callosal degeneration in the patients with aMCI was less extended than in the patients with AD dementia, degeneration was already exhibited in several subregions of the CC at the aMCI stage. Scores of various neuropsychological tests were correlated to the severity of microstructural changes in the subregional CC connecting to functionally corresponding cortical regions. Our results confirm that CC degeneration is noticeable as early as the aMCI stage of AD and the disconnection of the CC subregional fibers to the corresponding Brodmann areas has an apparent impact on the related cognitive performance. Copyright © 2013 Wiley Periodicals, Inc.

  4. A behavioral rehabilitation intervention for amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Greenaway, Melanie C.; Hanna, Sherrie M.; Lepore, Susan W.; Smith, Glenn E.

    2010-01-01

    Individuals with amnestic Mild Cognitive Impairment (MCI) currently have few treatment options for combating their memory loss. The Memory Support System (MSS) is a calendar and organization system with accompanying 6-week curriculum designed for individuals with progressive memory impairment. Ability to learn the MSS and its utility were assessed in 20 participants. Participants were significantly more likely to successfully use the calendar system after training. Ninety-five percent were compliant with the MSS at training completion, and 89% continued to be compliant at follow-up. Outcome measures revealed a medium effect size for improvement in functional ability. Subjects further reported improved independence, self-confidence, and mood. This initial examination of the MSS suggests that with appropriate training, individuals with amnestic MCI can and will use a memory notebook system to help compensate for memory loss. These results are encouraging that the MSS may help with the symptoms of memory decline in MCI. PMID:18955724

  5. Interference impacts working memory in mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Sara Aurtenetxe

    2016-10-01

    Full Text Available Mild cognitive impairment (MCI is considered a transitional stage between healthy aging and dementia, specifically Alzheimer’s disease (AD. The most common cognitive impairment of MCI includes episodic memory loss and difficulties in working memory (WM. Interference can deplete WM, and an optimal WM performance requires an effective control of attentional resources between the memoranda and the incoming stimuli. Difficulties in handling interference lead to forgetting. However, the interplay between interference and WM in MCI is not well understood and needs further investigation. The current study investigated the effect of interference during a WM task in 20 MCIs and 20 healthy elder volunteers. Participants performed a delayed match-to-sample paradigm which consisted in two interference conditions, distraction and interruption, and one control condition without any interference. Results evidenced a disproportionate impact of interference on the WM performance of MCIs, mainly in the presence of interruption. These findings demonstrate that interference, and more precisely interruption, is an important proxy for memory-related deficits in MCI. Thus the current findings reveal novel evidence regarding the causes of WM forgetting in MCI patients, associated with difficulties in the mechanisms of attentional control.

  6. Behavioral symptoms related to cognitive impairment.

    Science.gov (United States)

    Dillon, Carol; Serrano, Cecilia M; Castro, Diego; Leguizamón, Patricio Perez; Heisecke, Silvina L; Taragano, Fernando E

    2013-01-01

    Neuropsychiatric symptoms (NPS) are core features of Alzheimer's disease and related dementias. On one hand, behavioral symptoms in patients with mild cognitive impairment (MCI) can indicate an increased risk of progressing to dementia. On the other hand, mild behavioral impairment (MBI) in patients who usually have normal cognition indicates an increased risk of developing dementia. Whatever the cause, all dementias carry a high rate of NPI. These symptoms can be observed at any stage of the disease, may fluctuate over its course, are a leading cause of stress and overload for caregivers, and increase rates of hospitalization and early institutionalization for patients with dementia. The clinician should be able to promptly recognize NPI through the use of instruments capable of measuring their frequency and severity to support diagnosis, and to help monitor the treatment of behavioral symptoms. The aims of this review are to describe and update the construct 'MBI' and to revise the reported NPS related to prodromal stages of dementia (MCI and MBI) and dementia stages of Alzheimer's disease and frontotemporal lobar degeneration.

  7. Fine Motor Function Skills in Patients with Parkinson Disease with and without Mild Cognitive Impairment.

    Science.gov (United States)

    Dahdal, Philippe; Meyer, Antonia; Chaturvedi, Menorca; Nowak, Karolina; Roesch, Anne D; Fuhr, Peter; Gschwandtner, Ute

    2016-01-01

    The objective of this study was to investigate the relation between impaired fine motor skills in Parkinson disease (PD) patients and their cognitive status, and to determine whether fine motor skills are more impaired in PD patients with mild cognitive impairment (MCI) than in non-MCI patients. Twenty PD MCI and 31 PD non-MCI patients (mean age 66.7 years, range 50-84, 36 males/15 females), all right-handed, took part in a motor performance test battery. Steadiness, precision, dexterity, velocity of arm-hand movements, and velocity of wrist-finger movements were measured and compared across groups and analyzed for confounders (age, sex, education, severity of motor symptoms, and disease duration). Statistical analysis included t tests corrected for multiple testing, and a linear regression with stepwise elimination procedure was used to select significant predictors for fine motor function. PD MCI patients performed significantly worse in precision (p motor function skills were confounded by age. Fine motor skills in PD MCI patients are impaired compared to PD non-MCI patients. Investigating the relation between the fine motor performance and MCI in PD might be a relevant subject for future research. © 2016 S. Karger AG, Basel.

  8. Cardiorespiratory Fitness and Cognitive Function are Positively Related Among Participants with Mild and Subjective Cognitive Impairment.

    Science.gov (United States)

    Stuckenschneider, Tim; Askew, Christopher David; Rüdiger, Stefanie; Cristina Polidori, Maria; Abeln, Vera; Vogt, Tobias; Krome, Andreas; Olde Rikkert, Marcel; Lawlor, Brian; Schneider, Stefan

    2018-01-01

    By 2030, about 74 million people will be diagnosed with dementia, and many more will experience subjective (SCI) or mild cognitive impairment (MCI). As physical inactivity has been identified to be a strong modifiable risk factor for dementia, exercise and physical activity (PA) may be important parameters to predict the progression from MCI to dementia, but might also represent disease trajectory modifying strategies for SCI and MCI. A better understanding of the relationship between activity, fitness, and cognitive function across the spectrum of MCI and SCI would provide an insight into the potential utility of PA and fitness as early markers, and treatment targets to prevent cognitive decline. 121 participants were stratified into three groups, late MCI (LMCI), early MCI (EMCI), and SCI based on the Montreal Cognitive Assessment (MoCA). Cognitive function assessments also included the Trail Making Test A+B, and a verbal fluency test. PA levels were evaluated with an interviewer-administered questionnaire (LAPAQ) and an activity monitor. An incremental exercise test was performed to estimate cardiorespiratory fitness and to determine exercise capacity relative to population normative data. ANCOVA revealed that LMCI subjects had the lowest PA levels (LAPAQ, p = 0.018; activity monitor, p = 0.041), and the lowest exercise capacity in relation to normative values (p = 0.041). Moreover, a modest correlation between MoCA and cardiorespiratory fitness (r = 0.25; p cognitive impairment PA and exercise capacity might present a marker for the risk of further cognitive decline. This finding warrants further investigation using longitudinal cohort studies.

  9. Anosognosia for cognitive and behavioral symptoms in Parkinson's disease with mild dementia and mild cognitive impairment: Frequency and neuropsychological/neuropsychiatric correlates.

    Science.gov (United States)

    Orfei, Maria Donata; Assogna, Francesca; Pellicano, Clelia; Pontieri, Francesco Ernesto; Caltagirone, Carlo; Pierantozzi, Mariangela; Stefani, Alessandro; Spalletta, Gianfranco

    2018-04-17

    Anosognosia is a multidimensional phenomenon with detrimental effects on patients' illness course, therapy compliance and quality of life. We aimed at investigating anosognosia for cognitive and behavioral symptoms in Parkinson's Disease (PD) with dementia (PDD) and, for the first time, in PD with Mild Cognitive Impairment (MCI-PD). Community dwelling subjects (47 mild PDD, 136 multidomain MCI-PD (mdMCI-PD), 5 single domain MCI-PD (sdMCI-PD), and 197 PD without cognitive impairment (noCI-PD) were enrolled in a cross-sectional design study. All the subjects were administered the Anosognosia Questionnaire for Dementia, the Mental Deterioration Battery and a number of neuropsychiatric inventories. A diagnosis of anosognosia was made in 36% of patients with mild PDD and 16% with mdMCI-PD, whether it was negligible in sdMCI-PD and noCI-PD. Higher severity of anosognosia for cognitive impairment was also found in PDD and in mdMCI-PD. SdMCI-PD had the lower severity of anosognosia for cognitive impairment. Higher anosognosia for cognitive impairment was associated to lower depression in noCI-PD (r = -0.227, p = 0.0013) and mdMCI-PD (r = -0.266, p = 0.0016), and to reduced hedonic tone in noCI-PD (r = -0.191, p = 0.0071). Greater anosognosia was associated to lower executive performances in PDD (r = 0.424, p = 0.0074). Anosognosia for non-motor symptoms is frequent in PD patients with mild dementia or mdMCI. Results confirm the role of neuropsychiatric characteristics in anosognosia also in PD, the high prevalence of anosognosia in neurodegenerative illnesses and suggest a common pathogenic path for anosognosia in different neurodegenerative and psychiatric disorders. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Low uric acid is a risk factor in mild cognitive impairment.

    Science.gov (United States)

    Xue, LingLing; Liu, YongBing; Xue, HuiPing; Xue, Jin; Sun, KaiXuan; Wu, LinFeng; Hou, Ping

    2017-01-01

    Mild cognitive impairment (MCI) represents a transitional stage between normal aging and dementia. Uric acid is a water-soluble antioxidant found in the body. Many recent studies have found that uric acid plays an important role in cognitive impairment, although the effects of uric acid on MCI are not clear. The objective of this study was to explore the relationship between uric acid and MCI. Using a random sampling method, this study investigated 58 patients with MCI and 57 healthy elderly from January 2016 to November 2016. Demographic information was collected, the subjects were evaluated using the Mini Mental Status Examination (MMSE), and uric acid was measured in fasting venous blood. A total of 57 (49.6%) participants are healthy and 58 (50.4%) participants had MCI. The uric acid level was significantly lower in the patients with MCI (292.28±63.71 μmol/L) than in the normal controls (322.49±78.70 μmol/L; P uric acid level (all P uric acid was a protective factor for MCI (odds ratio =0.999, 95% CI =0.987-0.999). A low uric acid level is a risk factor for MCI, and an appropriate increase in uric acid can be used to slow down the occurrence and development of MCI.

  11. Everyday episodic memory in amnestic mild cognitive impairment: a preliminary investigation

    OpenAIRE

    LAWLOR, BRIAN; COEN, ROBERT; O'MARA, SHANE MICHAEL

    2011-01-01

    PUBLISHED Background: Decline in episodic memory is one of the hallmark features of Alzheimer's disease (AD) and is also a defining feature of amnestic Mild Cognitive Impairment (MCI), which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient's daily life. In order to fully explore the impa...

  12. Everyday episodic memory in amnestic mild cognitive impairment: a preliminary investigation

    OpenAIRE

    Irish, Muireann; Lawlor, Brian A; Coen, Robert F; O'Mara, Shane M

    2011-01-01

    Abstract Background Decline in episodic memory is one of the hallmark features of Alzheimer's disease (AD) and is also a defining feature of amnestic Mild Cognitive Impairment (MCI), which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient's daily life. In order to fully explore the impact of di...

  13. Face-Name Associative Recognition Deficits in Subjective Cognitive Decline and Mild Cognitive Impairment.

    Science.gov (United States)

    Polcher, Alexandra; Frommann, Ingo; Koppara, Alexander; Wolfsgruber, Steffen; Jessen, Frank; Wagner, Michael

    2017-01-01

    There is a need for more sensitive neuropsychological tests to detect subtle cognitive deficits emerging in the preclinical stage of Alzheimer's disease (AD). Associative memory is a cognitive function supported by the hippocampus and affected early in the process of AD. We developed a short computerized face-name associative recognition test (FNART) and tested whether it would detect memory impairment in memory clinic patients with mild cognitive impairment (MCI) and subjective cognitive decline (SCD). We recruited 61 elderly patients with either SCD (n = 32) or MCI (n = 29) and 28 healthy controls (HC) and compared performance on FNART, self-reported cognitive deterioration in different domains (ECog-39), and, in a reduced sample (n = 46), performance on the visual Paired Associates Learning of the CANTAB battery. A significant effect of group on FNART test performance in the total sample was found (p < 0.001). Planned contrasts indicated a significantly lower associative memory performance in the SCD (p = 0.001, d = 0.82) and MCI group (p < 0.001, d = 1.54), as compared to HCs, respectively. The CANTAB-PAL discriminated only between HC and MCI, possibly because of reduced statistical power. Adjusted for depression, performance on FNART was significantly related to ECog-39 Memory in SCD patients (p = 0.024) but not in MCI patients. Associative memory is substantially impaired in memory clinic patients with SCD and correlates specifically with memory complaints at this putative preclinical stage of AD. Further studies will need to examine the predictive validity of the FNART in SCD patients with regard to longitudinal (i.e., conversion to MCI/AD) and biomarker outcomes.

  14. Cognitive impairment and pragmatics.

    Science.gov (United States)

    Gutiérrez-Rexach, Javier; Schatz, Sara

    2016-01-01

    One of the most important ingredients of felicitous conversation exchanges is the adequate expression of illocutionary force and the achievement of perlocutionary effects, which can be considered essential to the functioning of pragmatic competence. The breakdown of illocutionary and perlocutionary functions is one of the most prominent external features of cognitive impairment in Alzheimer's Disease, with devastating psychological and social consequences for patients, their family and caregivers. The study of pragmatic functions is essential for a proper understanding of the linguistic and communicative aspects of Alzheimer's disease.

  15. Cognitive Impairment Associated with Cancer

    Science.gov (United States)

    Pendergrass, J. Cara; Harrison, John E.

    2018-01-01

    This brief review explores the areas of cognitive impairment that have been observed in cancer patients and survivors, the cognitive assessment tools used, and the management of the observed cognitive changes. Cognitive changes and impairment observed in patients with cancer and those in remission can be related to the direct effects of cancer itself, nonspecific factors or comorbid conditions that are independent of the actual disease, and/or the treatments or combination of treatments administered. Attention, memory, and executive functioning are the most frequently identified cognitive domains impacted by cancer. However, the prevalence and extent of impairment remains largely unknown due to marked differences in methodology, definitions of cognitive impairment, and the assessment measures used. Assessment of cognitive functioning is an important and necessary part of a comprehensive oncological care plan. Research is needed to establish a better understanding of cognitive changes and impairments associated with cancer so that optimal patient outcomes can be achieved. PMID:29497579

  16. Impairment in proverb interpretation as an executive function deficit in patients with amnestic mild cognitive impairment and early Alzheimer's disease.

    Science.gov (United States)

    Leyhe, Thomas; Saur, Ralf; Eschweiler, Gerhard W; Milian, Monika

    2011-01-01

    Proverb interpretation is assumed to reflect executive functions. We hypothesized that proverb interpretation is impaired in patients with amnestic mild cognitive impairment (aMCI) diagnosed as single-domain impairment by common neuropsychological testing. We compared performance in a proverb interpretation test in single-domain aMCI patients and patients with early Alzheimer's disease (EAD). The groups with aMCI and EAD performed significantly worse than healthy controls. Both patient groups gave concrete answers with a similar frequency. However, patients with EAD tended to give senseless answers more frequently. Our data suggest that in patients diagnosed as single-domain aMCI, deterioration of executive functions is detectable with subtle and appropriate neuropsychological testing. Implementation of these procedures may improve the early prediction of AD.

  17. Dysfunctional whole brain networks in mild cognitive impairment patients: an fMRI study

    Science.gov (United States)

    Liu, Zhenyu; Bai, Lijun; Dai, Ruwei; Zhong, Chongguang; Xue, Ting; You, Youbo; Tian, Jie

    2012-03-01

    Mild cognitive impairment (MCI) was recognized as the prodromal stage of Alzheimer's disease (AD). Recent researches have shown that cognitive and memory decline in AD patients is coupled with losses of small-world attributes. However, few studies pay attention to the characteristics of the whole brain networks in MCI patients. In the present study, we investigated the topological properties of the whole brain networks utilizing graph theoretical approaches in 16 MCI patients, compared with 18 age-matched healthy subjects as a control. Both MCI patients and normal controls showed small-world architectures, with large clustering coefficients and short characteristic path lengths. We detected significantly longer characteristic path length in MCI patients compared with normal controls at the low sparsity. The longer characteristic path lengths in MCI indicated disrupted information processing among distant brain regions. Compared with normal controls, MCI patients showed decreased nodal centrality in the brain areas of the angular gyrus, heschl gyrus, hippocampus and superior parietal gyrus, while increased nodal centrality in the calcarine, inferior occipital gyrus and superior frontal gyrus. These changes in nodal centrality suggested a widespread rewiring in MCI patients, which may be an integrated reflection of reorganization of the brain networks accompanied with the cognitive decline. Our findings may be helpful for further understanding the pathological mechanisms of MCI.

  18. Prediction of Alzheimer’s disease in mild cognitive impairment using sulcal morphology and cortical thickness

    DEFF Research Database (Denmark)

    Plocharski, Maciej; Østergaard, Lasse Riis

    2019-01-01

    converters, or MCIc). The purpose of this study was to predict future AD-conversion in patients with MCI using machine learning with sulcal morphology and cortical thickness measures as classification features. 32 sulci per subject were extracted from 1.5T T1-weighted ADNI database MRI scans of 90 MCIc......Mild cognitive impairment (MCI) is an intermediate condition between healthy ageing and dementia. The amnestic MCI is often a high risk factor for subsequent Alzheimer’s disease (AD) conversion. Some MCI patients never develop AD (MCI non-converters, or MCInc), but some do progress to AD (MCI...... subjects as future converters, (89.7% sensitivity, 84.4% specificity, 0.94 AUC), using 10-fold cross-validation. These results using sulcal and cortical features are superior to the state-of-the-art methods. The most discriminating predictive features were observed in the temporal and frontal lobes...

  19. Category verbal fluency performance may be impaired in amnestic mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Márcio Luiz Figueredo Balthazar

    Full Text Available Abstract To study category verbal fluency (VF for animals in patients with amnestic mild cognitive impairment (aMCI, mild Alzheimer disease (AD and normal controls. Method: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, while aMCI was based on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent testing of category VF for animals, lexical semantic function (Boston Naming-BNT, CAMCOG Similarities item, WAIS-R forward and backward digit span, Rey Auditory Verbal Learning (RAVLT, Mini-Mental Status Examination (MMSE, and other task relevant functions such as visual perception, attention, and mood state (with Cornell Scale for Depression in Dementia. Data analysis used ANOVA and a post-hoc Tukey test for intergroup comparisons, and Pearson's coefficient for correlations of memory and FV tests with other task relevant functions (statistical significance level was p<0.05. Results: aMCI patients had lower performance than controls on category VF for animals and on the backward digit span subtest of WAIS-R but higher scores compared with mild AD patients. Mild AD patients scored significantly worse than aMCI and controls across all tests. Conclusion: aMCI patients may have poor performance in some non-memory tests, specifically category VF for animals in our study, where this could be attributable to the influence of working memory.

  20. Ability to manage everyday technology : a comparison of persons with dementia or mild cognitive impairment and older adults without cognitive impairment.

    OpenAIRE

    Malinowsky, Camilla; Almkvist, Ove; Kottorp, Anders; Nygård, Louise

    2010-01-01

    Purpose: The ability to manage technology is important for performance and participation in everyday activities. This study compares the management of technology in everyday activities among people with mild-stage dementia or MCI with older adults without known cognitive impairment (OA). Method: Persons with mild-stage dementia (n=38), MCI (n=34) and OA (n=45) were observed and interviewed when managing their everyday technology at home by using the Management of Everyday Technology Ass...

  1. A Large, Cross-sectional Observational Study of Serum BDNF, Cognitive Function, and Mild Cognitive Impairment in the Elderly

    Directory of Open Access Journals (Sweden)

    Hiroyuki eShimada

    2014-04-01

    Full Text Available Objective: The clinical relationship between brain-derived neurotrophic factor (BDNF and cognitive function or mild cognitive impairment (MCI is not well understood. The purpose of this study was to identify the relationship between serum BDNF and cognitive function and MCI, and determine whether serum BDNF level might be a useful biomarker for assessing risk for MCI in older people.Materials and Methods: A total of 4463 individuals aged 65 years or older (mean age 72 years participating in the study. We measured performance in a battery of neuropsychological and cognitive function tests; serum BDNF concentration.Results: Eight hundred twenty-seven participants (18.8% had MCI. After adjustment for sex, age, education level, diabetes, and current smoking, serum BDNF was associated with poorer performance in the story memory, and digit symbol substitution task scores. Serum BDNF was marginally associated with the presence of MCI (OR, 95% CI: 1.41, 1.00–1.99 when BDNF was 1.5 SD lower than the mean value standardized for sex and age, education level, diabetes, and current smoking.Conclusion: Low serum BDNF was associated with lower cognitive test scores and MCI. Future prospective studies should establish the discriminative value of serum BDNF for the risk of MCI.

  2. Post-stroke cognitive impairments

    Directory of Open Access Journals (Sweden)

    Elena Anatolyevna Katunina

    2013-01-01

    Full Text Available Post-stroke cognitive impairments are common effects of stroke. Vascular cognitive impairments are characterized by the heterogeneity of the neuropsychological profile in relation to the site and pattern of stroke. Their common trait is the presence of dysregulation secondary to frontal dysfunction. The treatment of vascular cognitive impairments should be multimodality and aimed at stimulating neuroplasticity processes, restoring neurotransmitter imbalance, and preventing recurrent vascular episodes.

  3. Improving Sensitivity to Detect Mild Cognitive Impairment: Cognitive Load Dual-Task Gait Speed Assessment.

    Science.gov (United States)

    MacAulay, Rebecca K; Wagner, Mark T; Szeles, Dana; Milano, Nicholas J

    2017-07-01

    Longitudinal research indicates that cognitive load dual-task gait assessment is predictive of cognitive decline and thus might provide a sensitive measure to screen for mild cognitive impairment (MCI). However, research among older adults being clinically evaluated for cognitive concerns, a defining feature of MCI, is lacking. The present study investigated the effect of performing a cognitive task on normal walking speed in patients presenting to a memory clinic with cognitive complaints. Sixty-one patients with a mean age of 68 years underwent comprehensive neuropsychological testing, clinical interview, and gait speed (simple- and dual-task conditions) assessments. Thirty-four of the 61 patients met criteria for MCI. Repeated measure analyses of covariance revealed that greater age and MCI both significantly associated with slower gait speed, pscognitive dual task within a clinically representative population. Cognitive load dual-task gait assessment may provide a cost efficient and sensitive measure to detect older adults at high risk of a dementia disorder. (JINS, 2017, 23, 493-501).

  4. Wechsler Memory Scale-III Faces test performance in patients with mild cognitive impairment and mild Alzheimer's disease.

    Science.gov (United States)

    Seelye, Adriana M; Howieson, Diane B; Wild, Katherine V; Moore, Mindy Milar; Kaye, Jeffrey A

    2009-08-01

    Little is known about the sensitivity of the Wechsler Memory Scale-Third Edition (WMS-III) Faces subtest to memory impairment associated with mild cognitive impairment (MCI). In this study, Faces performance was examined in 24 MCI patients, 46 mild Alzheimer's disease (AD) patients, and 98 elderly controls. We hypothesized that participants with diagnoses of MCI or AD would be impaired relative to controls on Faces. Analyses showed that AD participants performed significantly worse than MCI and intact participants, although there were no significant differences between MCI and intact participants. Data suggest that brain areas specialized for face recognition memory may be less affected by MCI and mild AD than regions specialized for verbal memory.

  5. Computer-Based Cognitive Training for Mild Cognitive Impairment: Results from a Pilot Randomized, Controlled Trial

    OpenAIRE

    Barnes, Deborah E.; Yaffe, Kristine; Belfor, Nataliya; Jagust, William J.; DeCarli, Charles; Reed, Bruce R.; Kramer, Joel H.

    2009-01-01

    We performed a pilot randomized, controlled trial of intensive, computer-based cognitive training in 47 subjects with mild cognitive impairment (MCI). The intervention group performed exercises specifically designed to improve auditory processing speed and accuracy for 100 minutes/day, 5 days/week for 6 weeks; the control group performed more passive computer activities (reading, listening, visuospatial game) for similar amounts of time. Subjects had a mean age of 74 years and 60% were men; 7...

  6. [Working memory for music in patients with mild cognitive impairment and early stage Alzheimer's disease].

    Science.gov (United States)

    Kerer, Manuela; Marksteiner, Josef; Hinterhuber, Hartmann; Mazzola, Guerino; Kemmler, Georg; Bliem, Harald R; Weiss, Elisabeth M

    2013-01-01

    A variety of studies demonstrated that some forms of memory for music are spared in dementia, but only few studies have investigated patients with early stages of dementia. In this pilot-study we tested working memory for music in patients with mild cognitive impairment (MCI) and early stage Alzheimer's disease (AD) with a newly created test. The test probed working memory using 7 gradually elongated tone-lines and 6 chords which were each followed by 3 similar items and 1 identical item. The participants of the study, namely 10 patients with MCI, 10 patients with early stage AD and 23 healthy subjects were instructed to select the identical tone-line or chord. Subjects with MCI and early AD showed significantly reduced performance than controls in most of the presented tasks. In recognizing chords MCI- participants surprisingly showed an unimpaired performance. The gradual increase of the impairment during the preclinical phase of AD seems to spare this special ability in MCI.

  7. Adenosine A2A Receptor and IL-10 in Peripheral Blood Mononuclear Cells of Patients with Mild Cognitive Impairment

    Directory of Open Access Journals (Sweden)

    Beatrice Arosio

    2011-01-01

    Full Text Available Adenosine suppresses immune responses through the A2A receptor (A2AR. This study investigated the interleukin 10 (IL-10 genetic profile and the expression of A2AR in peripheral blood mononuclear cells (PBMCs of patients with mild cognitive impairment (MCI, Alzheimer disease (AD, and age-matched controls to verify, if they may help distinguish different forms of cognitive decline. We analyzed the IL-10 genotype and the expression of A2AR in 41 subjects with AD, 10 with amnestic MCI (a-MCI, 49 with multiple cognitive domain MCI (mcd-MCI, and 46 controls. There was a significant linear increase in A2AR mRNA levels and A2AR density from mcd-MCI to a-MCI, with intermediate levels being found in AD. The IL-10 AA genotype frequency was 67% in a-MCI, 46% in AD, 35% in mcd-MCI, and 20% in controls. These data suggest that the assessment of the IL-10 genotype and the expression of A2AR in PBMCs may be a valuable means of differentiating between a-MCI and mcd-MCI.

  8. Rivastigmine for refractory REM behavior disorder in mild cognitive impairment.

    Science.gov (United States)

    Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Lapenta, Leonardo; Mariotti, Paolo; Marra, Camillo; Rossini, Paolo Maria; Della Marca, Giacomo

    2014-03-01

    Mild Cognitive Impairment (MCI) and REM Behavior Disorder (RBD) are both associated with a degeneration of ponto-medullary cholinergic pathways. We conducted a placebo-controlled, cross-over pilot trial of Rivastigmine (RVT) in 25 consecutive patients with MCI, who presented RBD refractory to conventional first-line treatments (melatonin up to 5 mg/day and clonazepam up to 2 mg/day). RVT treatment was followed by a significant reduction of RBD episodes when compared with placebo. Our data suggest that, in MCI patients with RBD resistant to conventional therapies (muscle relaxants benzodiazepines or melatonin,) treatment with RVT may induce a reduction in the frequency of RBD episodes compared to placebo.

  9. Affective symptoms as predictors of Alzheimer's disease in subjects with mild cognitive impairment: a 10-year follow-up study

    NARCIS (Netherlands)

    Ramakers, I.H.G.B.; Visser, P.J.; Aalten, P.; Kester, A.; Jolles, J.; Verhey, F.R.J.

    2010-01-01

    Background Affective symptoms are common in subjects with mild cognitive impairment (MCI), but there is disagreement whether these symptoms are predictive for Alzheimer's disease (AD). We investigated the predictive accuracy of affective symptoms for AD during a follow-up study in subjects with MCI,

  10. Association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment in type 2 diabetic patients

    OpenAIRE

    Huang, Rong; Han, Jing; Tian, Sai; Cai, Rongrong; Sun, Jie; Shen, Yanjue; Wang, Shaohua

    2017-01-01

    Background and aims People with insulin resistance and type 2 diabetes mellitus (T2DM) are at increased risks of cognitive impairment. We aimed to investigate the association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment (MCI) in T2DM patients. Results In addition to elevated glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR), T2DM patients with MCI had decreased plasma ghre...

  11. Alteration of affective Theory of Mind in amnestic mild cognitive impairment.

    Science.gov (United States)

    Poletti, Michele; Bonuccelli, Ubaldo

    2013-03-01

    The concept of amnestic mild cognitive impairment (aMCI) concerns a population of older individuals at high risk of developing probable Alzheimer's disease (AD). Impairments of the cognitive component of Theory of Mind (ToM), that is the inference about other people's beliefs, have been well documented in AD; on the contrary, controversial findings have been reported on the affective component of ToM (inference about other's feelings), a process mainly based on medial portions of the prefrontal cortex. The current study aimed at evaluating the affective component of ToM in aMCI subjects. Twenty aMCI subjects and 20 age-matched healthy controls (HC) underwent a standard neuropsychological assessment and the assessment of affective ToM with the full 36-item version of reading the mind in the eyes (RME). Although aMCI subjects had formal impaired performances only in memory tasks, HC outperformed aMCI subjects in several cognitive tasks, including also the RME (mean RME scores 21.7 ± 3.0 vs. 17.0 ± 3.8%; 60.3% of correct answers vs. 47.2%). The lower RME performance of aMCI patients provides the first empirical evidence that aMCI may be associated with difficulties in tasks of affective ToM, in accordance with recent findings of early difficulties of aMCI patients in other processes that are mainly dependent on the medial prefrontal cortex, such as reversal learning and decision making under ambiguity. Findings of the current study need further empirical confirmation in larger samples of aMCI patients and also the investigation of other MCI subtypes is needed. © 2012 The British Psychological Society.

  12. Source Memory for Self and Other in Patients With Mild Cognitive Impairment due to Alzheimer's Disease.

    Science.gov (United States)

    Rosa, Nicole M; Deason, Rebecca G; Budson, Andrew E; Gutchess, Angela H

    2016-01-01

    The present study examined the role of enactment in source memory in a cognitively impaired population. As seen in healthy older adults, it was predicted that source memory in people with mild cognitive impairment due to Alzheimer's disease (MCI-AD) would benefit from the self-reference aspect of enactment. Seventeen participants with MCI-AD and 18 controls worked in small groups to pack a picnic basket and suitcase and were later tested for their source memory for each item. For item memory, self-referencing improved corrected recognition scores for both MCI-AD and control participants. The MCI-AD group did not demonstrate the same benefit as controls in correct source memory for self-related items. However, those with MCI-AD were relatively less likely to misattribute new items to the self and more likely to misattribute new items to others when committing errors, compared with controls. The enactment effect and self-referencing did not enhance accurate source memory more than other referencing for patients with MCI-AD. However, people with MCI-AD benefited in item memory and source memory, being less likely to falsely claim new items as their own, indicating some self-reference benefit occurs for people with MCI-AD. Published by Oxford University Press on behalf of the Gerontological Society of America 2014.

  13. Neuropsychiatric Symptoms in Parkinson's Disease with Mild Cognitive Impairment and Dementia

    Directory of Open Access Journals (Sweden)

    Iracema Leroi

    2012-01-01

    Full Text Available Neuropsychiatric symptoms commonly complicate Parkinson’s disease (PD, however the presence of such symptoms in mild cognitive impairment (PD-MCI specifically has not yet been well described. The objective of this study was to examine and compare the prevalence and profile of neuropsychiatric symptoms in patients with PD-MCI (n = 48 to those with PD and no cognitive impairment (PD-NC, n = 54 and to those with dementia in PD (PDD, n = 25. PD-MCI and PDD were defined using specific consensus criteria, and neuropsychiatric symptoms were assessed with the 12-item Neuropsychiatric Inventory (NPI. Self-rated apathy, depression, and anxiety rating scales were also administered. Over 79% of all participants reported at least one neuropsychiatric symptom in the past month. The proportion in each group who had total NPI scores of ≥4 (“clinically significant” was as follows: PD-NC, 64.8%; PD-MCI, 62%; PDD 76%. Apathy was reported in almost 50% of those with PD-MCI and PDD, and it was an important neuropsychiatric symptom differentiating PD-MCI from PD-NC. Psychosis (hallucinations and delusions increased from 12.9% in PD-NC group; 16.7% in PD-MCI group; and 48% in PDD group. Identifying neuropsychiatric symptoms in PD-MCI may have implications for ascertaining conversion to dementia in PD.

  14. Disrupted topological organization of resting-state functional brain network in subcortical vascular mild cognitive impairment.

    Science.gov (United States)

    Yi, Li-Ye; Liang, Xia; Liu, Da-Ming; Sun, Bo; Ying, Sun; Yang, Dong-Bo; Li, Qing-Bin; Jiang, Chuan-Lu; Han, Ying

    2015-10-01

    Neuroimaging studies have demonstrated both structural and functional abnormalities in widespread brain regions in patients with subcortical vascular mild cognitive impairment (svMCI). However, whether and how these changes alter functional brain network organization remains largely unknown. We recruited 21 patients with svMCI and 26 healthy control (HC) subjects who underwent resting-state functional magnetic resonance imaging scans. Graph theory-based network analyses were used to investigate alterations in the topological organization of functional brain networks. Compared with the HC individuals, the patients with svMCI showed disrupted global network topology with significantly increased path length and modularity. Modular structure was also impaired in the svMCI patients with a notable rearrangement of the executive control module, where the parietal regions were split out and grouped as a separate module. The svMCI patients also revealed deficits in the intra- and/or intermodule connectivity of several brain regions. Specifically, the within-module degree was decreased in the middle cingulate gyrus while it was increased in the left anterior insula, medial prefrontal cortex and cuneus. Additionally, increased intermodule connectivity was observed in the inferior and superior parietal gyrus, which was associated with worse cognitive performance in the svMCI patients. Together, our results indicate that svMCI patients exhibit dysregulation of the topological organization of functional brain networks, which has important implications for understanding the pathophysiological mechanism of svMCI. © 2015 John Wiley & Sons Ltd.

  15. Do subjective memory complaints herald the onset of mild cognitive impairment in Parkinson disease?

    Science.gov (United States)

    Erro, Roberto; Santangelo, Gabriella; Barone, Paolo; Picillo, Marina; Amboni, Marianna; Longo, Katia; Giordano, Flavio; Moccia, Marcello; Allocca, Roberto; Pellecchia, Maria Teresa; Vitale, Carmine

    2014-12-01

    Longitudinal studies on healthy participants have shown that subjective memory impairment (defined as subjective cognitive complaints with normal cognitive objective performance) might be a strong predictor of mild cognitive impairment (MCI). Parkinson disease (PD) also manifests cognitive disturbances, but whether subjective memory complaints may predict the development of MCI in PD has not yet been explored. We prospectively screened newly diagnosed, untreated patients with PD in order to evaluate whether subjective memory complaints may predict development of MCI over a 2-year follow-up evaluation. We enrolled 76 de novo untreated patients with PD. Of the 76 patients, 23 (30.3%) complained memory issues. Among the patients cognitively unimpaired at baseline, those with subjective complaints were more likely to develop MCI at follow-up. The regression model confirmed that presence of subjective memory complaints at baseline was an independent predictor of development of MCI at follow-up. This is the first prospective study to explore the relationship between subjective and objective cognitive deficits in newly diagnosed, untreated patients. Our results provide preliminary evidence that subjective memory complaints might predict future development of MCI. © The Author(s) 2014.

  16. Psychological well-being in individuals with mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Gates N

    2014-05-01

    Full Text Available Nicola Gates,1–3 Michael Valenzuela,3 Perminder S Sachdev,1,2,4 Maria A Fiatarone Singh5,61School of Psychiatry, 2Centre for Healthy Brain Ageing (CheBA, University of New South Wales, Sydney, NSW, Australia; 3Regenerative Neuroscience Group, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia; 4Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, Australia; 5Exercise Health and Performance Faculty Research Group, Sydney Medical School, The University of Sydney, Lidcombe, NSW, Australia; 6Hebrew SeniorLife, Boston, MA, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USAObjectives: Cognitive impairments associated with aging and dementia are major sources of burden, deterioration in life quality, and reduced psychological well-being (PWB. Preventative measures to both reduce incident disease and improve PWB in those afflicted are increasingly targeting individuals with mild cognitive impairment (MCI at early disease stage. However, there is very limited information regarding the relationships between early cognitive changes and memory concern, and life quality and PWB in adults with MCI; furthermore, PWB outcomes are too commonly overlooked in intervention trials. The purpose of this study was therefore to empirically test a theoretical model of PWB in MCI in order to inform clinical intervention.Methods: Baseline data from a convenience sample of 100 community-dwelling adults diagnosed with MCI enrolled in the Study of Mental Activity and Regular Training (SMART trial were collected. A series of regression analyses were performed to develop a reduced model, then hierarchical regression with the Baron Kenny test of mediation derived the final three-tiered model of PWB.Results: Significant predictors of PWB were subjective memory concern, cognitive function, evaluations of quality of life, and negative affect, with a final model explaining 61% of the variance

  17. A depressive endophenotype of mild cognitive impairment and Alzheimer's disease.

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    Leigh A Johnson

    Full Text Available Alzheimer's disease (AD is a devastating public health problem that affects over 5.4 million Americans. Depression increases the risk of Mild Cognitive Impairment (MCI and AD. By understanding the influence of depression on cognition, the potential exists to identify subgroups of depressed elders at greater risk for cognitive decline and AD. The current study sought to: 1 clinically identify a sub group of geriatric patients who suffer from depression related cognitive impairment; 2 cross validate this depressive endophenotype of MCI/AD in an independent cohort.Data was analyzed from 519 participants of Project FRONTIER. Depression was assessed with the GDS30 and cognition was assessed using the EXIT 25 and RBANS. Five GDS items were used to create the Depressive endophenotype of MCI and AD (DepE. DepE was significantly negatively related to RBANS index scores of Immediate Memory (B=-2.22, SE=.37, p<0.001, visuospatial skills (B=-1.11, SE=0.26, p<0.001, Language (B=-1.03, SE=0.21, p<0.001, Attention (B=-2.56, SE=0.49, p<0.001, and Delayed Memory (B=-1.54, SE = 037, p<0.001, and higher DepE scores were related to poorer executive functioning (EXIT25; B=0.65, SE=0.19, p=0.001. DepE scores significantly increased risk for MCI diagnosis (odds ratio [OR] = 2.04; 95% CI=1.54-2.69. Data from 235 participants in the TARCC (Texas Alzheimer's Research & Care Consortium were analyzed for cross-validation of findings in an independent cohort. The DepE was significantly related to poorer scores on all measures, and a significantly predicted of cognitive change over 12- and 24-months.The current findings suggest that a depressive endophenotype of MCI and AD exists and can be clinically identified using the GDS-30. Higher scores increased risk for MCI and was cross-validated by predicting AD in the TARCC. A key purpose for the search for distinct subgroups of individuals at risk for AD and MCI is to identify novel treatment and preventative opportunities.

  18. Mild cognitive impairment and its management in older people

    Directory of Open Access Journals (Sweden)

    Eshkoor SA

    2015-04-01

    Full Text Available Sima Ataollahi Eshkoor, Tengku Aizan Hamid, Chan Yoke Mun, Chee Kyun Ng Institute of Gerontology, Universiti Putra Malaysia, Selangor, Malaysia Abstract: Mild cognitive impairment (MCI is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals’ daily activities. It can act as a transitional level of evolving dementia with a range of conversion of 10%–15% per year. Thus, it is crucial to protect older people against MCI and developing dementia. The preventive interventions and appropriate treatments should improve cognitive performance, and retard or prevent progressive deficits. The avoidance of toxins, reduction of stress, prevention of somatic diseases, implementation of mental and physical exercises, as well as the use of dietary compounds like antioxidants and supplements can be protective against MCI. The modification of risk factors such as stopping smoking, as well as the treatment of deficiency in vitamins and hormones by correcting behaviors and lifestyle, can prevent cognitive decline in the elderly. The progressive increase in the growth rate of the elderly population can enhance the rate of MCI all over the world. There is no exact cure for MCI and dementia; therefore, further studies are needed in the future to determine causes of MCI and risk factors of progression from MCI to dementia. This will help to find better ways for prevention and treatment of cognitive impairment worldwide. Keywords: AD, Alzheimer’s disease, cognition, dementia, MCI

  19. N-Terminal Pro-B Type Natriuretic Peptide is Associated with Mild Cognitive Impairment in the General Population.

    Science.gov (United States)

    Kara, Kaffer; Mahabadi, Amir Abbas; Weimar, Christian; Winkler, Angela; Neumann, Till; Kälsch, Hagen; Dragano, Nico; Moebus, Susanne; Erbel, Raimund; Jöckel, Karl-Heinz; Jokisch, Martha

    2017-01-01

    N-terminal pro-B type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and is linked with silent cardiac diseases. While associations of cognitive impairment with manifest cardiovascular diseases are established, data on whether subclinical elevation of NT-proBNP levels below clinically established threshold of heart failure is related with cognitive functioning, especially mild cognitive impairment (MCI), is rare. Aim of the present study was to investigate the cross-sectional association of NT-proBNP levels and MCI in a population-based study sample without heart failure. We used data from the second examination of the population based Heinz-Nixdorf-Recall-Study. Subjects with overt coronary heart disease and subjects with NT-proBNP levels indicating potential heart failure (NT-proBNP≥300 pg/ml) were excluded from this analysis. Participants performed a validated brief cognitive assessment and were classified either as MCI [subtypes: amnestic-MCI (aMCI), non-amnestic-MCI (naMCI)], or cognitively-normal. We included 419 participants with MCI (63.1±7.4 y; 47% men; aMCI n = 209; naMCI n = 210) and 1,206 cognitively normal participants (62.42±7.1 y; 48% men). NT-proBNP-levels≥125 pg/ml compared to heart failure, higher NT-proBNPlevels are associated with MCI and both MCI subtypes independent of traditional cardiovascular risk factors and sociodemographic parameters.

  20. Informant-reported cognitive symptoms that predict amnestic mild cognitive impairment

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    Malek-Ahmadi Michael

    2012-02-01

    Full Text Available Abstract Background Differentiating amnestic mild cognitive impairment (aMCI from normal cognition is difficult in clinical settings. Self-reported and informant-reported memory complaints occur often in both clinical groups, which then necessitates the use of a comprehensive neuropsychological examination to make a differential diagnosis. However, the ability to identify cognitive symptoms that are predictive of aMCI through informant-based information may provide some clinical utility in accurately identifying individuals who are at risk for developing Alzheimer's disease (AD. Methods The current study utilized a case-control design using data from an ongoing validation study of the Alzheimer's Questionnaire (AQ, an informant-based dementia assessment. Data from 51 cognitively normal (CN individuals participating in a brain donation program and 47 aMCI individuals seen in a neurology practice at the same institute were analyzed to determine which AQ items differentiated aMCI from CN individuals. Results Forward stepwise multiple logistic regression analysis which controlled for age and education showed that 4 AQ items were strong indicators of aMCI which included: repetition of statements and/or questions [OR 13.20 (3.02, 57.66]; trouble knowing the day, date, month, year, and time [OR 17.97 (2.63, 122.77]; difficulty managing finances [OR 11.60 (2.10, 63.99]; and decreased sense of direction [OR 5.84 (1.09, 31.30]. Conclusions Overall, these data indicate that certain informant-reported cognitive symptoms may help clinicians differentiate individuals with aMCI from those with normal cognition. Items pertaining to repetition of statements, orientation, ability to manage finances, and visuospatial disorientation had high discriminatory power.

  1. Clinical and Cognitive Phenotype of Mild Cognitive Impairment Evolving to Dementia with Lewy Bodies

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    Annachiara Cagnin

    2015-11-01

    Full Text Available Objective: The aim of this study was to determine which characteristics could better distinguish dementia with Lewy bodies (DLB from Alzheimer's disease (AD at the mild cognitive impairment (MCI stage, with particular emphasis on visual space and object perception abilities. Methods: Fifty-three patients with mild cognitive deficits that were eventually diagnosed with probable DLB (MCI-DLB: n = 25 and AD (MCI-AD: n = 28 at a 3-year follow-up were retrospectively studied. At the first visit, the patients underwent cognitive assessment including the Qualitative Scoring Mini Mental State Examination Pentagon Test and the Visual Object and Space Perception Battery. The Neuropsychiatric Inventory Questionnaire, Unified Parkinson's Disease Rating Scale (UPDRS and questionnaires for cognitive fluctuations and sleep disorders were also administered. Results: The best clinical predictor of DLB was the presence of soft extrapyramidal signs (mean UPDRS score: 4.04 ± 5.9 detected in 72% of patients, followed by REM sleep behavior disorder (60% and fluctuations (60%. Wrong performances in the pentagon's number of angles were obtained in 44% of DLB and 3.7% of AD patients and correlated with speed of visual attention. Executive functions, visual attention and visuospatial abilities were worse in DLB, while verbal episodic memory impairment was greater in AD. Deficits in the visual-perceptual domain were present in both MCI-DLB and AD. Conclusions: Poor performance in the pentagon's number of angles is specific of DLB and correlates with speed of visual attention. The dorsal visual stream seems specifically more impaired in MCI-DLB with respect to the ventral visual stream, the latter being involved in both DLB and AD. These cognitive features, associated with subtle extrapyramidal signs, should alert clinicians to a diagnostic hypothesis of DLB.

  2. Anosognosia in mild cognitive impairment: Relationship to activation of cortical midline structures involved in self-appraisal

    Science.gov (United States)

    Ries, Michele L.; Jabbar, Britta M.; Schmitz, Taylor W.; Trivedi, Mehul A.; Gleason, Carey E.; Carlsson, Cynthia M.; Rowley, Howard A.; Asthana, Sanjay; Johnson, Sterling C.

    2009-01-01

    Awareness of cognitive dysfunction shown by individuals with Mild Cognitive Impairment (MCI), a condition conferring risk for Alzheimer’s disease (AD), is variable. Anosognosia, or unawareness of loss of function, is beginning to be recognized as an important clinical symptom of MCI. However, little is known about the brain substrates underlying this symptom. We hypothesized that MCI participants’ activation of cortical midline structures (CMS) during self-appraisal would covary with level of insight into cognitive difficulties (indexed by a discrepancy score between patient and informant ratings of cognitive decline in each MCI participant). To address this hypothesis, we first compared 16 MCI participants and 16 age-matched controls, examining brain regions showing conjoint or differential BOLD response during self-appraisal. Second, we used regression to investigate the relationship between awareness of deficit in MCI and BOLD activity during self-appraisal, controlling for extent of memory impairment. Between-group comparisons indicated that MCI participants show subtly attenuated CMS activity during self-appraisal. Regression analysis revealed a highly-significant relationship between BOLD response during self-appraisal and self-awareness of deficit in MCI. This finding highlights the level of anosognosia in MCI as an important predictor of response to self-appraisal in cortical midline structures, brain regions vulnerable to changes in early AD. PMID:17445294

  3. Comparison of a Mirror Neuron System among Elders with Mild Cognitive Impairment, Alzheimer's Disease, and No Disease

    International Nuclear Information System (INIS)

    Rattanachayoto, P.; Tritanon, O.; Laothamatas, J.; Sungkarat, W.

    2012-01-01

    Alzheimer's disease (AD) is the most common cause of dementia. There are lots of old people suffering from the disease. Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia. An individual with MCI has an increased risk of developing AD. The mirror neuron system (MNS), activated during the observation and execution of actions, has been linked with cognitive processes.The objective of this study is to examine the MNS abnormalities in elders with MCI and AD. Ninety-two subjects (5 MCI,7 mild AD, and 80 cognitively normal) were studied by using functional magnetic resonance imaging (fMRI). In the fMRI experiment, subjects were asked to observe a video showing hand movement (tearing a piece of paper) and a control condition (observing a fixation point).The image data were analyzed using SPM2 (Statistical Parametric Mapping).There were significant activations of bilateral inferior frontal lobule and inferior parietal lobule due to the observation of hand movement.The brain activations of the normal group were statistical significant greater than those in the MCI and mild AD groups.There was no significant difference between the MCI and mild AD groups. Elders with MCI and mild AD had fewer MNS activations than the normal controls, suggesting that the dysfunction of MNS may underlie cognitive impairments in MCI and AD patients.These findings imply that fMRI is sufficiently sensitive to detect MNS changes occurring in MCI and AD.

  4. Cognitive impairment in elderly women

    DEFF Research Database (Denmark)

    Rasmussen, Henrik Berg; Bagger, Yu Z; Tankó, László B

    2006-01-01

    BACKGROUND: A variety of factors contribute to the development of cognitive impairment in elderly people. Previous studies have focused upon a single or a few risk factors. In this study we assessed and compared the significance of a wide variety of potential risk factors for cognitive impairment...... in postmenopausal women. METHODS: A total of 208 pairs of elderly women (mean age = 73.2 years) were examined in a cross-sectional case-control study. Each pair consisted of a case (with impaired cognition) and a control subject matched by age and educational status. Cognitive functions were determined using...

  5. Mild cognitive impairment is associated with poorer decision-making in community-based older persons.

    Science.gov (United States)

    Han, S Duke; Boyle, Patricia A; James, Bryan D; Yu, Lei; Bennett, David A

    2015-04-01

    To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. Community-based epidemiological cohort study. Communities throughout northeastern Illinois. Older persons without dementia from the Rush Memory and Aging Project (N = 730). All participants underwent a detailed clinical evaluation and decision-making assessment using a measure that closely approximates materials used in real-world financial and healthcare settings. This allowed for measurement of total decision-making and financial and healthcare decision-making. Regression models were used to examine whether MCI was associated with a lower level of decision-making. In subsequent analyses, the relationship between specific cognitive systems (episodic memory, semantic memory, working memory, perceptual speed, visuospatial ability) and decision-making was explored in participants with MCI. MCI was associated with lower total, financial, and healthcare decision-making scores after accounting for the effects of age, education, and sex. The effect of MCI on total decision-making was equivalent to the effect of more than 10 additional years of age. Additional models showed that, when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision-making in participants with MCI. Persons with MCI may have poorer financial and healthcare decision-making in real-world situations, and perceptual speed may be an important contributor to poorer decision-making in persons with MCI. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  6. Serial position effects in Alzheimer's disease, mild cognitive impairment, and normal aging: predictive value for conversion to dementia.

    Science.gov (United States)

    Cunha, Catarina; Guerreiro, Manuela; de Mendonça, Alexandre; Oliveira, Paulo Eduardo; Santana, Isabel

    2012-01-01

    Serial position effects in word list learning have been used to differentiate normal aging and dementia. Prominent recency and diminished primacy have consistently been observed in Alzheimer's disease (AD). We examined serial position effects in patients with mild cognitive impairment (MCI), in patients with AD, and in normal healthy controls. Additionally, we classified MCI patients into those who progressed to AD (MCI-p) and those who did not (MCI-np). We compared two serial position measures: regional and standard scores. Regional scores, mainly the primacy effect, improved discrimination between MCI and controls and between MCI-np and MCI-p, proving to be more sensitive and specific than the recency effect.

  7. Improvement of Screening Accuracy of Mini-Mental State Examination for Mild Cognitive Impairment and Non-Alzheimer's Disease Dementia by Supplementation of Verbal Fluency Performance.

    Science.gov (United States)

    Kim, Jee Wook; Lee, Dong Young; Seo, Eun Hyun; Sohn, Bo Kyung; Choe, Young Min; Kim, Shin Gyeom; Park, Shin Young; Choo, Il Han; Youn, Jong Chul; Jhoo, Jin Hyeong; Kim, Ki Woong; Woo, Jong Inn

    2014-01-01

    THIS STUDY AIMED TO INVESTIGATE WHETHER THE SUPPLEMENTATION OF VERBAL FLUENCY: Animal category test (VF) performance can improve the screening ability of Mini-Mental State Examination (MMSE) for mild cognitive impairment (MCI), dementia and their major subtypes. Six hundred fifty-five cognitively normal (CN), 366 MCI [282 amnestic MCI (aMCI); 84 non-amnestic MCI (naMCI)] and 494 dementia [346 Alzheimer's disease (AD); and 148 non-Alzheimer's disease dementia (NAD)] individuals living in the community were included (all aged 50 years and older) in the study. The VF-supplemented MMSE (MMSE+VF) score had a significantly better screening ability for MCI, dementia and overall cognitive impairment (MCI plus dementia) than the MMSE raw score alone. MMSE+VF showed a significantly better ability than MMSE for both MCI subtypes, i.e., aMCI and naMCI. In the case of dementia subtypes, MMSE+VF was better than the MMSE alone for NAD screening, but not for AD screening. The results support the usefulness of VF-supplementation to improve the screening performance of MMSE for MCI and NAD.

  8. Old worries and new anxieties: behavioral symptoms and mild cognitive impairment in a population study.

    Science.gov (United States)

    Andreescu, Carmen; Teverovsky, Esther; Fu, Bo; Hughes, Tiffany F; Chang, Chung-Chou H; Ganguli, Mary

    2014-03-01

    To disentangle the complex associations of depression and anxiety with mild cognitive impairment (MCI) at the population level. We examined subgroups of anxiety symptoms and depression symptom profiles in relation to MCI, which we defined using both cognitive and functional approaches. We used an epidemiologic, cross-sectional study with an age-stratified, random, population-based sample of 1,982 individuals aged 65 years and over. Three definitions of MCI were used: 1) a purely cognitive classification into amnestic and nonamnestic MCI, 2) a combined cognitive-functional definition by International Working Group (IWG) criteria, and 3) a purely functional definition by the Clinical Dementia Rating (CDR) of 0.5. Three depression profiles were identified by factor analysis of the modified Center for Epidemiological Studies-Depression Scale: core mood, self-esteem/interpersonal, and apathy/neurovegetative profiles. Three anxiety groups, chronic mild worry, chronic severe anxiety, and recent-onset anxiety, were based on screening questions. Recent-onset anxiety was associated with MCI by nonamnestic and IWG criteria, chronic severe anxiety was associated with MCI by all definitions, and chronic mild worry was associated with none. Of the depression profiles, the core mood profile was associated with CDR-defined MCI, the apathy/neurovegetative profile was associated with MCI by amnestic, IWG, and CDR definitions, and the self-esteem/interpersonal profile was associated with none. In this population-based sample, subgroups with different anxiety and depression profiles had different relationships with cognitive and functional definitions of MCI. Anxiety, depression, and MCI are all multidimensional entities, interacting in complex ways that may shed light on underlying neural mechanisms. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  9. A retrospective study of white matter integrity in mild cognitive impairment

    Science.gov (United States)

    van Bruggen, Thomas; Stieltjes, Bram; Meinzer, Hans-Peter; Fritzsche, Klaus H.

    2011-03-01

    Prior work has shown that white matter fiber integrity decreases in Alzheimer's disease (AD) and mild cognitive impairment (MCI). This can be achieved by quantifying anisotropic water movement in the brain using diffusion tensor imaging techniques. Since less than half (but still a considerable amount) of the MCI patients convert to AD it is important to identify features that can predict the chance of conversion to AD within a certain time frame. In this study we applied tract-based spatial statistics (TBSS) in order to perform this task, which overcomes limitations that are commonly associated with ROI-based approaches and voxel-based morphometry (VBM). Diffusion weighted images were taken from 15 healthy controls, 15 AD patients and 17 MCI patients. 8 MCI patients remained stable within 3 years of follow-up investigations ("non-converters" or MCI-nc) and 9 converted to AD ("converters" or MCI-c). Significant differences between the MCI-nc and MCI-c groups were found in large parts of the fornix, the corpus callosum and the cingulum. In comparison, the MCI-c group did not differ significantly from the AD group and the MCI-nc group exhibited features similar to the control group in most parts of the structures. These results demonstrate that, although MCI-c and MCI-nc patients were clinically similar at time of inclusion, the MCI-c group already exhibited pathologic features of fiber integrity associated with AD. This finding could lead to more powerful techniques in the early identification of AD and thus support an earlier and more successful treatment.

  10. Patterns of 11C-PIB cerebral retention in mild cognitive impairment patients.

    Science.gov (United States)

    Banzo, I; Jiménez-Bonilla, J F; Martínez-Rodríguez, I; Quirce, R; de Arcocha-Torres, M; Bravo-Ferrer, Z; Lavado-Pérez, C; Sánchez-Juan, P; Rodríguez, E; Jiménez-Alonso, M; López-Defilló, J; Carril, J M

    2016-01-01

    To evaluate the patterns of cerebral cortical distribution of (11)C-PIB in patients with mild cognitive impairment (MCI). The study included 69 patients (37 male, age range 42-79 years) with MCI, sub-classified as 53 with amnestic-MCI (A-MCI), and 16 with non-amnestic-MCI (NA-MCI). Patients underwent (11)C-PIB PET/CT scan 60min after intravenous injection of the radiotracer. A visual analysis of the images was performed by 2 experienced physicians. (11)C-PIB-positive studies were considered when gray matter uptake was equal to or greater than white matter. According to the regions involved, (11)C-PIB-positive studies were classified into A-pattern (predominant retention in frontal, anterior cingulate, lateral temporal, and basal ganglia) and B-pattern (generalized retention). Thirty-nine of the 69 (56%) patients with MCI showed (11)C-PIB retention. Of the 53 A-MCI patients, 36 (68%) showed (11)C-PIB retention. Eleven out of 36 (30%) positive scans in A-MCI patients showed A-pattern, and 25 out of 36 (70%) patients had a B-pattern. Positive (11)C-PIB was observed in 3 out of 16 (19%) patients with NA-MCI. Regional distribution in these 3 patients showed A-pattern in 1, and B-pattern in 2 patients. Cortical retention of (11)C-PIB was more frequent in A-MCI than in NA-MCI patients, and also B-pattern than A-pattern in the (11)C-PIB positive group. The recognition of (11)C-PIB distribution patterns allows MCI patients to be classified, and the A-pattern may offer a therapeutic window for potential future treatments. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  11. Role of cognitive reserve in progression from mild cognitive impairment to dementia

    Directory of Open Access Journals (Sweden)

    Ricardo F. Allegri

    Full Text Available Abstract Cognitive reserve is the ability to optimize performance through differential recruitment of brain networks, which may reflect the use of alternative cognitive strategies. Objectives: To identify factors related to cognitive reserve associated with progression from mild cognitive impairment (MCI to degenerative dementia. Methods: A cohort of 239 subjects with MCI (age: 72.2±8.1 years, 58% women, education: 12 years was assessed and followed for five years (2001 to 2006. Results: In the first year, 13.7% of MCI converted to dementia and 34.7% converted within three years (78.3% converted to Alzheimer's dementia. Risk factors for those who converted were education less than 12 years, MMSE score less than 27, Boston naming test score less than 51, IQ (Intelligence Quotient less than 111, age over 75 years, lack of occupation at retirement, and presence of intrusions in memory recall (all account for 56% of the variability of conversion. Conclusions: MCI patients are a population at high risk for dementia. The study of risk factors (e.g. IQ, education and occupation, particularly those related to cognitive reserve, can contribute important evidence to guide the decision-making process in routine clinical activity and public health policy.

  12. Parkinson's disease mild cognitive impairment: application and validation of the criteria

    NARCIS (Netherlands)

    Geurtsen, Gert J.; Hoogland, Jeroen; Goldman, Jennifer G.; Schmand, Ben A.; Tröster, Alexander I.; Burn, David J.; Litvan, Irene; Filoteo, J. Vincent; Hurtig, Howard; Chen-Plotkin, Alice; Adler, Charles H.; Jacobson, Sandra A.; Leverenz, Jim; Zabetian, Cyrus; Huang, Xuemei; Eslinger, Paul J.; Marras, Connie; Duff-Canning, Sarah; Dalrymple-Alford, John C.; Anderson, Tim J.; Naismith, Sharon L.; Lewis, Simon J. G.; Wu, Ruey-Meei; Yu, Rwei-Ling; Bhattacharyya, Kalyan B.; Williams-Gray, Caroline H.; Breen, David P.; Barker, Roger A.; Yarnall, Alison J.; de Bie, Rob M. A.; Koene, Ted; Klein, Martin; Trautmann, Ellen; Mollenhauer, Brit; Dodel, Richard; Kulisevsky, Jaime; Pagonabaragga, Javier; Rodriguez-Oroz, Maria C.; Gasca-Salas, Carmen; Junque, Carme; Segura, Barbara; Sportiello, Marco Timpano; Cammisuli, Davide M.; Barone, Paolo; Pedersen, Kenn Freddy; Alves, Guido

    2014-01-01

    Dementia in Parkinson's disease (PD) is a serious health issue and a major concern for many patients. In most cases mild cognitive impairment (MCI) is considered a transitional stage between normal cognitive functioning and dementia which is of potential importance in the early identification of

  13. Dimensions of Ambiguous Loss in Couples Coping with Mild Cognitive Impairment

    Science.gov (United States)

    Blieszner, Rosemary; Roberto, Karen A.; Wilcox, Karen L.; Barham, Elizabeth J.; Winston, Brianne L.

    2007-01-01

    We applied the theory of ambiguous loss to couples with mild cognitive impairment (MCI), an age-related decline in memory and other cognitive processes assumed not to interfere with daily activities or the maintenance of personal relationships. Face-to-face interviews with 67 older married couples revealed that lack of understanding about the…

  14. Evidence-based medical research on diagnostic criteria and screening technique of vascular mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Xia-wei LIU

    2015-07-01

    Full Text Available Background Vascular mild cognitive impairment (VaMCI is the prodromal syndrome of vascular dementia (VaD and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI.  Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level Ⅰ, 5 on Level Ⅱ studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA/American Stroke Association (ASA in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG in 2014. Fifteen literatures (4 on LevelⅠ, 11 on Level Ⅱ described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level Ⅰ, 10 on Level Ⅱ described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN was being good consistency with other neuropsychological

  15. Nutrition and cognitive impairment

    Science.gov (United States)

    Hernando-Requejo, Virgilio

    2016-07-12

    Dementia, closely linked to environmental predisposing factors such as diet, is a public health problem of increasing magnitude: currently there are more than 35 million patients with Alzheimer´s disease, and is expected to exceed 135 million by 2050. If we can delay the development of dementia 5 years will reduce its prevalence by 50%. Patients with dementia modify their diet, and it has been reported in them deficits, among others, of folic acid, vitamin B12, B6, C, E, A, D, K, beta carotene and omega 3 fatty acids, that must be resolved with proper diet and with extra contributions if needed in some cases. But to reduce, or at least delay, the prevalence of dementia we advocate prevention through proper diet from the beginning of life, an idea that is reinforced given that cardiovascular risk factors are related directly to the development of dementia. A lot of literature are available that, although with limits, allows us to make nutritional recommendations for preventing cognitive impairment. Better results are achieved when complete diets have been studied and considered over specific nutrients separately. Particularly, the Mediterranean diet has great interest in this disease, since it ensures a high intake of vegetables, fruits, nuts, legumes, cereals, fish and olive oil, and moderate intake of meat, dairy products and alcohol. We will focus more on this article in this type of diet.

  16. REM Sleep Behavior Disorder and Cognitive Impairment in Parkinson's Disease.

    Science.gov (United States)

    Jozwiak, Natalia; Postuma, Ronald B; Montplaisir, Jacques; Latreille, Véronique; Panisset, Michel; Chouinard, Sylvain; Bourgouin, Pierre-Alexandre; Gagnon, Jean-François

    2017-08-01

    REM sleep behavior disorder (RBD) is a parasomnia affecting 33% to 46% of patients with Parkinson's disease (PD). The existence of a unique and specific impaired cognitive profile in PD patients with RBD is still controversial. We extensively assessed cognitive functions to identify whether RBD is associated with more severe cognitive deficits in nondemented patients with PD. One hundred sixty-two participants, including 53 PD patients with RBD, 40 PD patients without RBD, and 69 healthy subjects, underwent polysomnography, a neurological assessment and an extensive neuropsychological exam to assess attention, executive functions, episodic learning and memory, visuospatial abilities, and language. PD patients with RBD had poorer and clinically impaired performance in several cognitive tests compared to PD patients without RBD and healthy subjects. These two latter groups were similar on all cognitive measures. Mild cognitive impairment (MCI) diagnosis frequency was almost threefold higher in PD patients with RBD compared to PD patients without RBD (66% vs. 23%, p < .001). Moreover, subjective cognitive decline was reported in 89% of PD patients with RBD compared to 58% of PD patients without RBD (p = .024). RBD in PD is associated with a more impaired cognitive profile and higher MCI diagnosis frequency, suggesting more severe and widespread neurodegeneration. This patient subgroup and their caregivers should receive targeted medical attention to better detect and monitor impairment and to enable the development of management interventions for cognitive decline and its consequences. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  17. Utility and limitations of Addenbrooke's Cognitive Examination-Revised for detecting mild cognitive impairment in Parkinson's disease.

    Science.gov (United States)

    Komadina, Natalie C; Terpening, Zoe; Huang, Yue; Halliday, Glenda M; Naismith, Sharon L; Lewis, Simon J G

    2011-01-01

    To evaluate the utility of the Addenbrooke's Cognitive Examination-Revised (ACE-R) as a screening tool for mild cognitive impairment in Parkinson's disease (PD-MCI). PD patients underwent comprehensive neuropsychological and neurological evaluations and ACE-R assessment. The ACE-R was superior to the Mini-Mental State Exam (MMSE) in detecting PD-MCI, with a cutoff score of ≤93 offering a sensitivity of 61% and a specificity of 64%. The utility of the ACE-R in detecting PD-MCI is largely influenced by the fluency sub-domain score, and has optimal discriminability when utilized in patients with lower levels of education (≤12 years of formal schooling). The ACE-R must be used cautiously as a screening tool for PD-MCI, with results being most influenced by its fluency sub-domain score and patient education levels. Copyright © 2011 S. Karger AG, Basel.

  18. Resting-state abnormalities in amnestic mild cognitive impairment: a meta-analysis.

    Science.gov (United States)

    Lau, W K W; Leung, M-K; Lee, T M C; Law, A C K

    2016-04-26

    Amnestic mild cognitive impairment (aMCI) is a prodromal stage of Alzheimer's disease (AD). As no effective drug can cure AD, early diagnosis and intervention for aMCI are urgently needed. The standard diagnostic procedure for aMCI primarily relies on subjective neuropsychological examinations that require the judgment of experienced clinicians. The development of other objective and reliable aMCI markers, such as neural markers, is therefore required. Previous neuroimaging findings revealed various abnormalities in resting-state activity in MCI patients, but the findings have been inconsistent. The current study provides an updated activation likelihood estimation meta-analysis of resting-state functional magnetic resonance imaging (fMRI) data on aMCI. The authors searched on the MEDLINE/PubMed databases for whole-brain resting-state fMRI studies on aMCI published until March 2015. We included 21 whole-brain resting-state fMRI studies that reported a total of 156 distinct foci. Significant regional resting-state differences were consistently found in aMCI patients relative to controls, including the posterior cingulate cortex, right angular gyrus, right parahippocampal gyrus, left fusiform gyrus, left supramarginal gyrus and bilateral middle temporal gyri. Our findings support that abnormalities in resting-state activities of these regions may serve as neuroimaging markers for aMCI.

  19. Prevalence of Mild Cognitive Impairment and Dementia in Saudi Arabia: A Community-Based Study.

    Science.gov (United States)

    Alkhunizan, Muath; Alkhenizan, Abdullah; Basudan, Loay

    2018-01-01

    The age of the population in Saudi Arabia is shifting toward elderly, which can lead to an increased risk of mild cognitive impairment (MCI) and dementia. The aim of this study is to determine the prevalence of cognitive impairment (MCI and dementia) among elderly patients in a community-based setting in Riyadh, Saudi Arabia. In this cross-sectional study, we included patients aged 60 years and above who were seen in the Family Medicine Clinics affiliated with King Faisal Specialist Hospital and Research Centre. Patients with delirium, active depression, and patients with a history of severe head trauma in the past 3 months were excluded. Patients were interviewed during their regular visit by a trained physician to collect demographic data and to administer the validated Arabic version of the Montreal Cognitive Assessment (MoCA) test. One hundred seventy-one Saudi patients were recruited based on a calculated sample size for the aim of this study. The mean age of included sample was 67 ± 6 years. The prevalence of cognitive impairment was 45%. The prevalence of MCI was 38.6% and the prevalence of dementia was 6.4%. Age, low level of education, hypertension, and cardiovascular disease were risk factors for cognitive impairment. Prevalence of MCI and dementia in Saudi Arabia using MoCA were in the upper range compared to developed and developing countries. The high rate of risk factors for cognitive impairment in Saudi Arabia is contributing to this finding.

  20. Memory evaluation in mild cognitive impairment using recall and recognition tests.

    Science.gov (United States)

    Bennett, Ilana J; Golob, Edward J; Parker, Elizabeth S; Starr, Arnold

    2006-11-01

    Amnestic mild cognitive impairment (MCI) is a selective episodic memory deficit that often indicates early Alzheimer's disease. Episodic memory function in MCI is typically defined by deficits in free recall, but can also be tested using recognition procedures. To assess both recall and recognition in MCI, MCI (n = 21) and older comparison (n = 30) groups completed the USC-Repeatable Episodic Memory Test. Subjects memorized two verbally presented 15-item lists. One list was used for three free recall trials, immediately followed by yes/no recognition. The second list was used for three-alternative forced-choice recognition. Relative to the comparison group, MCI had significantly fewer hits and more false alarms in yes/no recognition, and were less accurate in forced-choice recognition. Signal detection analysis showed that group differences were not due to response bias. Discriminant function analysis showed that yes/no recognition was a better predictor of group membership than free recall or forced-choice measures. MCI subjects recalled fewer items than comparison subjects, with no group differences in repetitions, intrusions, serial position effects, or measures of recall strategy (subjective organization, recall consistency). Performance deficits on free recall and recognition in MCI suggest a combination of both tests may be useful for defining episodic memory impairment associated with MCI and early Alzheimer's disease.

  1. Emotional face recognition deficit in amnestic patients with mild cognitive impairment: behavioral and electrophysiological evidence

    Directory of Open Access Journals (Sweden)

    Yang L

    2015-08-01

    Full Text Available Linlin Yang, Xiaochuan Zhao, Lan Wang, Lulu Yu, Mei Song, Xueyi Wang Department of Mental Health, The First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, People’s Republic of China Abstract: Amnestic mild cognitive impairment (MCI has been conceptualized as a transitional stage between healthy aging and Alzheimer’s disease. Thus, understanding emotional face recognition deficit in patients with amnestic MCI could be useful in determining progression of amnestic MCI. The purpose of this study was to investigate the features of emotional face processing in amnestic MCI by using event-related potentials (ERPs. Patients with amnestic MCI and healthy controls performed a face recognition task, giving old/new responses to previously studied and novel faces with different emotional messages as the stimulus material. Using the learning-recognition paradigm, the experiments were divided into two steps, ie, a learning phase and a test phase. ERPs were analyzed on electroencephalographic recordings. The behavior data indicated high emotion classification accuracy for patients with amnestic MCI and for healthy controls. The mean percentage of correct classifications was 81.19% for patients with amnestic MCI and 96.46% for controls. Our ERP data suggest that patients with amnestic MCI were still be able to undertake personalizing processing for negative faces, but not for neutral or positive faces, in the early frontal processing stage. In the early time window, no differences in frontal old/new effect were found between patients with amnestic MCI and normal controls. However, in the late time window, the three types of stimuli did not elicit any old/new parietal effects in patients with amnestic MCI, suggesting their recollection was impaired. This impairment may be closely associated with amnestic MCI disease. We conclude from our data that face recognition processing and emotional memory is

  2. Whole-brain voxel-based morphometry of white matter in mild cognitive impairment

    International Nuclear Information System (INIS)

    Wang Zhiqun; Guo Xiaojuan; Qi Zhigang; Yao Li; Li Kuncheng

    2010-01-01

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in mild cognitive impairment (MCI). Materials and methods: We studied 14 patients with MCI and 14 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The data were collected on a 3T MR system and analyzed by SPM2 to generate white matter volume maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MCI prominently including the bilateral temporal gyrus, the right anterior cingulate, the bilateral superior and medial frontal gyrus and right parietal angular gyrus. White matter reduction was more prominent in anterior regions than that in posterior regions. Conclusion: Whole-brain white matter reduction in MCI patients detected with VBM has special distribution which is in line with the white matter pathology of MCI.

  3. Whole-brain voxel-based morphometry of white matter in mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Wang Zhiqun [Department of Radiology, Xuanwu Hospital of Capital Medical University, 100053, Beijing (China); Guo Xiaojuan [College of Information Science and Technology, Beijing Normal University, 100875, Beijing (China); National Key Laboratory for Cognitive Neuroscience and Learning, Beijing Normal University, 100875, Beijing (China); Qi Zhigang [Department of Radiology, Xuanwu Hospital of Capital Medical University, 100053, Beijing (China); Yao Li [College of Information Science and Technology, Beijing Normal University, 100875, Beijing (China); National Key Laboratory for Cognitive Neuroscience and Learning, Beijing Normal University, 100875, Beijing (China); Li Kuncheng, E-mail: likuncheng@xwh.ccmu.edu.c [Department of Radiology, Xuanwu Hospital of Capital Medical University, 100053, Beijing (China)

    2010-08-15

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in mild cognitive impairment (MCI). Materials and methods: We studied 14 patients with MCI and 14 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The data were collected on a 3T MR system and analyzed by SPM2 to generate white matter volume maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MCI prominently including the bilateral temporal gyrus, the right anterior cingulate, the bilateral superior and medial frontal gyrus and right parietal angular gyrus. White matter reduction was more prominent in anterior regions than that in posterior regions. Conclusion: Whole-brain white matter reduction in MCI patients detected with VBM has special distribution which is in line with the white matter pathology of MCI.

  4. Memory for the 2008 Presidential election in healthy aging and Mild Cognitive Impairment

    Science.gov (United States)

    Waring, Jill D.; Seiger, Ashley N.; Solomon, Paul R.; Budson, Andrew E.; Kensinger, Elizabeth A.

    2014-01-01

    Objective The present study examined memory accuracy and confidence for personal and public event details of the 2008 Presidential election in healthy older adults and those with Mild Cognitive Impairment (MCI). Method Participants completed phone interviews within a week after the election and after a 10-month delay. Results MCI patients and healthy older adults had comparable emotional reactions to learning the outcome of the election, with most people finding it to be a positive experience. After the delay period, details about the election were better remembered by all participants than a less emotionally arousing comparison event. However, MCI patients had more difficulty than healthy older adults correctly recalling details of public information about the election, although often the MCI patients could recognize the correct details. Conclusion This is the first study to show that MCI patients’ memory can benefit from emotionally arousing positive events, complementing the literature demonstrating similar effects for negative events. PMID:24533684

  5. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

    International Nuclear Information System (INIS)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G.; Zauner, H.

    2009-01-01

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  6. Association Between Olfactory Dysfunction and Amnestic Mild Cognitive Impairment and Alzheimer Disease Dementia.

    Science.gov (United States)

    Roberts, Rosebud O; Christianson, Teresa J H; Kremers, Walter K; Mielke, Michelle M; Machulda, Mary M; Vassilaki, Maria; Alhurani, Rabe E; Geda, Yonas E; Knopman, David S; Petersen, Ronald C

    2016-01-01

    To increase the opportunity to delay or prevent mild cognitive impairment (MCI) or Alzheimer disease (AD) dementia, markers of early detection are essential. Olfactory impairment may be an important clinical marker and predictor of these conditions and may help identify persons at increased risk. To examine associations of impaired olfaction with incident MCI subtypes and progression from MCI subtypes to AD dementia. Participants enrolled in the population-based, prospective Mayo Clinic Study of Aging between 2004 and 2010 were clinically evaluated at baseline and every 15 months through 2014. Participants (N = 1630) were classified as having normal cognition, MCI (amnestic MCI [aMCI] and nonamnestic MCI [naMCI]), and dementia. We administered the Brief Smell Identification Test (B-SIT) to assess olfactory function. Mild cognitive impairment, AD dementia, and longitudinal change in cognitive performance measures. Of the 1630 participants who were cognitively normal at the time of the smell test, 33 died before follow-up and 167 were lost to follow-up. Among the 1430 cognitively normal participants included, the mean (SD) age was 79.5 (5.3) years, 49.4% were men, the mean duration of education was 14.3 years, and 25.4% were APOE ε4 carriers. Over a mean 3.5 years of follow-up, there were 250 incident cases of MCI among 1430 cognitively normal participants. We observed an association between decreasing olfactory identification, as measured by a decrease in the number of correct responses in B-SIT score, and an increased risk of aMCI. Compared with the upper B-SIT quartile (quartile [Q] 4, best scores), hazard ratios (HRs) (95% CI) were 1.12 (0.65-1.92) for Q3 (P = .68); 1.95 (1.25-3.03) for Q2 (P = .003); and 2.18 (1.36-3.51) for Q1 (P = .001) (worst scores; P for trend dementia cases among 221 prevalent MCI cases. The B-SIT score also predicted progression from aMCI to AD dementia, with a significant dose-response with worsening B-SIT quartiles

  7. Late-onset Alzheimer's risk variants in memory decline, incident mild cognitive impairment, and Alzheimer's disease.

    Science.gov (United States)

    Carrasquillo, Minerva M; Crook, Julia E; Pedraza, Otto; Thomas, Colleen S; Pankratz, V Shane; Allen, Mariet; Nguyen, Thuy; Malphrus, Kimberly G; Ma, Li; Bisceglio, Gina D; Roberts, Rosebud O; Lucas, John A; Smith, Glenn E; Ivnik, Robert J; Machulda, Mary M; Graff-Radford, Neill R; Petersen, Ronald C; Younkin, Steven G; Ertekin-Taner, Nilüfer

    2015-01-01

    We tested association of nine late-onset Alzheimer's disease (LOAD) risk variants from genome-wide association studies (GWAS) with memory and progression to mild cognitive impairment (MCI) or LOAD (MCI/LOAD) in older Caucasians, cognitively normal at baseline and longitudinally evaluated at Mayo Clinic Rochester and Jacksonville (n>2000). Each variant was tested both individually and collectively using a weighted risk score. APOE-e4 associated with worse baseline memory and increased decline with highly significant overall effect on memory. CLU-rs11136000-G associated with worse baseline memory and incident MCI/LOAD. MS4A6A-rs610932-C associated with increased incident MCI/LOAD and suggestively with lower baseline memory. ABCA7-rs3764650-C and EPHA1-rs11767557-A associated with increased rates of memory decline in subjects with a final diagnosis of MCI/LOAD. PICALM-rs3851179-G had an unexpected protective effect on incident MCI/LOAD. Only APOE-inclusive risk scores associated with worse memory and incident MCI/LOAD. The collective influence of the nine top LOAD GWAS variants on memory decline and progression to MCI/LOAD appears limited. Discovery of biologically functional variants at these loci may uncover stronger effects on memory and incident disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Naming of objects, faces and buildings in mild cognitive impairment.

    Science.gov (United States)

    Ahmed, Samrah; Arnold, Robert; Thompson, Sian A; Graham, Kim S; Hodges, John R

    2008-06-01

    Accruing evidence suggests that the cognitive deficits in very early Alzheimer's Disease (AD) are not confined to episodic memory, with a number of studies documenting semantic memory deficits, especially for knowledge of people. To investigate whether this difficulty in naming famous people extends to other proper names based information, three naming tasks - the Graded Naming Test (GNT), which uses objects and animals, the Graded Faces Test (GFT) and the newly designed Graded Buildings Test (GBT) - were administered to 69 participants (32 patients in the early prodromal stage of AD, so-called Mild Cognitive Impairment (MCI), and 37 normal control participants). Patients were found to be impaired on all three tests compared to controls, although naming of objects was significantly better than naming of faces and buildings. Discriminant analysis successfully predicted group membership for 100% controls and 78.1% of patients. The results suggest that even in cases that do not yet fulfil criteria for AD naming of famous people and buildings is impaired, and that both these semantic domains show greater vulnerability than general semantic knowledge. A semantic deficit together with the hallmark episodic deficit may be common in MCI, and that the use of graded tasks tapping semantic memory may be useful for the early identification of patients with MCI.

  9. Molecular imaging of serotonin degeneration in mild cognitive impairment.

    Science.gov (United States)

    Smith, Gwenn S; Barrett, Frederick S; Joo, Jin Hui; Nassery, Najlla; Savonenko, Alena; Sodums, Devin J; Marano, Christopher M; Munro, Cynthia A; Brandt, Jason; Kraut, Michael A; Zhou, Yun; Wong, Dean F; Workman, Clifford I

    2017-09-01

    areas typically affected by Alzheimer's disease pathology, as well as in sensory and motor areas, striatum and thalamus that are relatively spared in Alzheimer's disease. The reduction of the serotonin transporter in mild cognitive impairment was greater than grey matter atrophy or reductions in regional cerebral blood flow compared to controls. Lower cortical serotonin transporters were associated with worse performance on tests of auditory-verbal and visual-spatial memory in mild cognitive impairment, not in controls. The serotonin system may represent an important target for prevention and treatment of MCI, particularly the post-synaptic receptors (5-HT4 and 5-HT6), which may not be as severely affected as presynaptic aspects of the serotonin system, as indicated by the observation of lower serotonin transporters in MCI relative to healthy controls. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Long-Term Interrelationship between Brain Metabolism and Amyloid Deposition in Mild Cognitive Impairment

    DEFF Research Database (Denmark)

    Kemppainen, Nina; Joutsa, Juho; Johansson, Jarkko

    2015-01-01

    The aim of this longitudinal positron emission tomography (PET) study was to evaluate the interrelationship between brain metabolism and amyloid accumulation during the disease process from mild cognitive impairment (MCI) to Alzheimer's disease (AD). Nine MCI patients, who converted to AD between...... especially in the temporal-parietal regions in MCI compared to controls at baseline, and widely over the cortex at the 5-year follow-up. The reduction in metabolism during the follow-up was significant in the posterior brain regions. In addition, brain amyloid load was positively associated with metabolism...

  11. Apathy and Emotion-Based Decision-Making in Amnesic Mild Cognitive Impairment and Alzheimer's Disease

    OpenAIRE

    Bayard, Sophie; Jacus, Jean-Pierre; Raffard, Stéphane; Gely-Nargeot, Marie-Christine

    2014-01-01

    Background. Apathy and reduced emotion-based decision-making are two behavioral modifications independently described in Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). Objectives. The aims of this study were to investigate decision-making based on emotional feedback processing in AD and aMCI and to study the impact of reduced decision-making performances on apathy. Methods. We recruited 20 patients with AD, 20 participants with aMCI, and 20 healthy controls. All parti...

  12. Critical appraisal of questionnaires to assess functional impairment in individuals with mild cognitive impairment.

    Science.gov (United States)

    Kaur, Navaldeep; Belchior, Patricia; Gelinas, Isabelle; Bier, Nathalie

    2016-09-01

    Mild deficits in instrumental activities of daily living (IADLs) have consistently been reported in the individuals with mild cognitive impairment (MCI). A variety of functional assessment tools, including self-and informant report questionnaires and performance-based measures, have been employed in MCI. Previously, a limited focus has been directed at appraising the quality of questionnaires. The goal of this study was to identify the questionnaires that have been validated in the MCI population. Additionally, the quality of validation studies and psychometric attributes of these questionnaires were appraised. Relevant articles were systematically searched in PsychINFO, Ovid MEDLINE, and CINAHL against specific eligibility criteria. To evaluate the methodology of the psychometric studies, the COSMIN checklist was employed. Also, the psychometric properties of the assessment tools were evaluated based upon Terwee's criteria. A total of five psychometric studies and questionnaires were critically evaluated. Varying psychometric properties were available for the chosen tools. None of the studies received the best possible rating for their methodological quality. It was found that questionnaires with high discriminative ability to distinguish MCI from other diagnostic groups were: Disability Assessment in Dementia-6 (DAD-6), Functional Activity Questionnaire (FAQ), and Alzheimer's Disease Cooperative Study/Activities of Daily Living scale adapted for MCI patients (ADCS-MCI-ADL-24). Psychometric studies with strong methodological rigor are required in the future. Considering the fact that IADL decline has been associated with dementia, early detection of functional difficulties in MCI needs to be encouraged as it will allow suitable and timely interventions to prolong functional independence of affected individuals.

  13. High prevalence of cognitive impairment after intracerebral hemorrhage.

    Directory of Open Access Journals (Sweden)

    Mélanie Planton

    Full Text Available Cognitive impairment seems to be frequent in intracerebral hemorrhage (ICH survivors, but remains widely understudied. In this study, we investigated the frequency and patterns of vascular cognitive disorders (VCDs in patients with cerebral amyloid angiopathy (CAA-related and deep ICH compared to patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD and healthy controls.We prospectively recruited 20 patients with CAA-related lobar ICH, 20 with deep ICH, 20 with MCI-AD and 17 healthy controls. Patients with cognitive decline pre-ICH were excluded from the analysis. Each participant underwent a comprehensive neuropsychological assessment and a structural brain MRI. Cognitive assessment was performed at a median delay of 4 months after the acute phase in ICH patients, and more than 6 months after the first complaint in MCI-AD patients. Cognitive profiles were compared between groups. The prevalence of VCDs in the ICH groups was estimated using the recent VASCOG criteria."Mild" and "major VCDs" were respectively observed in 87.5% and 2.5% of all ICH patients. Every patient in the CAA group had mild VCDs. No significant difference was observed in cognitive functioning between CAA-related and deep ICH patients. The most impaired process in the CAA group was naming, with a mean (±standard deviation z-score of -5.2 ±5.5, followed by processing speed (-4.1±3.3, executive functioning (-2.6 ±2.5, memory (-2.4 ±3.5 and attention (-0.9 ±1.3. This cognitive pattern was different from the MCI-AD patients, but the groups were only different in gestural praxis, and by construction, in memory processes.VCDs are frequent after ICH. Cognitive patterns of patients with deep or CAA-related ICH did not differ, but there was impaired performance in specific domains distinct from the effects of Alzheimer's disease.URL: http://www.clinicaltrials.gov. Unique identifier: NCT01619709.

  14. Cognitive impairment in anxiety disorders

    Directory of Open Access Journals (Sweden)

    B. A. Volel

    2018-01-01

    Full Text Available Anxiety disorders are an important biomedical problem due to the high prevalence and significant negative impact on the quality of life and the course of concomitant somatic and neurological diseases. Cognitive impairment (CI is one of the most intensively studied aspects of pathological anxiety. Impairments in attention, executive functions, memory, cognitive deficit, as well as abnormal cognitions and metacognitions are identified in anxiety disorders. Moreover, the treatment of the latter with the most frequently used drugs (antidepressants, atypical antipsychotics, anticonvulsants, tranquilizers does not lead to a significant improvement in cognitive functions, and often contributes to their worsening. In this connection, in addition to psychotherapy, cognitive function-improving agents play a large role in treating anxiety diseases associated with cognitive dysfunction. Ginkgo Biloba extract (EGb 761, Tanakan® that positively affects cognitive functions, especially in the domains of memory, concentration and attention deserves special attention.

  15. Disrupted Brain Network in Progressive Mild Cognitive Impairment Measured by Eigenvector Centrality Mapping is Linked to Cognition and Cerebrospinal Fluid Biomarkers.

    Science.gov (United States)

    Qiu, Tiantian; Luo, Xiao; Shen, Zhujing; Huang, Peiyu; Xu, Xiaojun; Zhou, Jiong; Zhang, Minming

    2016-10-18

    Mild cognitive impairment (MCI) is a heterogeneous condition associated with a high risk of progressing to Alzheimer's disease (AD). Although functional brain network alterations have been observed in progressive MCI (pMCI), the underlying pathological mechanisms of network alterations remain unclear. In the present study, we evaluated neuropsychological, imaging, and cerebrospinal fluid (CSF) data at baseline across a cohort of: 21 pMCI patients, 33 stable MCI (sMCI) patients, and 29 normal controls. Fast eigenvector centrality mapping (fECM) based on resting-state functional MRI (rsfMRI) was used to investigate brain network organization differences among these groups, and we further assessed its relation to cognition and AD-related pathology. Our results demonstrated that pMCI had decreased eigenvector centrality (EC) in left temporal pole and parahippocampal gyrus, and increased EC in left middle frontal gyrus compared to sMCI. In addition, compared to normal controls, patients with pMCI showed decreased EC in right hippocampus and bilateral parahippocampal gyrus, and sMCI had decreased EC in right middle frontal gyrus and superior parietal lobule. Correlation analysis showed that EC in the left temporal pole was related to Wechsler Memory Scale-Revised Logical Memory (WMS-LM) delay score (r = 0.467, p = 0.044) and total tau (t-tau) level in CSF (r = -0.509, p = 0.026) in pMCI. Our findings implicate EC changes of different brain network nodes in the prognosis of pMCI and sMCI. Importantly, the association between decreased EC of brain network node and pathological changes may provide a deeper understanding of the underlying pathophysiology of pMCI.

  16. Clinical relevance of specific cognitive complaints in determining Mild Cognitive Impairment from Cognitively Normal States in a study of Healthy Elderly Controls

    Directory of Open Access Journals (Sweden)

    Marina Avila Villanueva

    2016-10-01

    Full Text Available Introduction: Subjective memory complaints in the elderly have been suggested as an early sign of dementia. This study aims at investigating whether specific cognitive complaints are more useful than others to discriminate Mild Cognitive Impairment (MCI by examining the dimensional structure of the Everyday Memory Questionnaire (EMQ.Material and Methods: A sample of community-dwelling elderly individuals was recruited (766 controls and 78 MCI. The Everyday Memory Questionnaire (EMQ was administered to measure self-perception of cognitive complaints. All participants also underwent a comprehensive clinical and neuropsychological battery. Combined exploratory factor analysis and item response theory were performed to identify the underlying structure of the EMQ. Furthermore, logistic regression analyses were conducted to study whether single cognitive complaints were able to predict MCI.Results: A suitable five-factor solution was found. Each factor focused on a different cognitive domain. Interestingly, just three of them, namely forgetfulness of immediate information, executive functions and prospective memory proved to be effective in distinguishing between cognitively healthy individuals and MCI. Based on these results we propose a shortened EMQ version comprising 10 items (EMQ-10.Discussion: Not all cognitive complaints have the same clinical relevance. Only subjective complaints on specific cognitive domains are able to discriminate MCI. We encourage clinicians to the EMQ-10 as a useful tool to quantify and monitor the progression of individuals who report cognitive complaints.

  17. Driving with Mild Cognitive Impairment or Dementia: Cognitive Test Performance and Proxy Report of Daily Life Function in Older Women.

    Science.gov (United States)

    Vaughan, Leslie; Hogan, Patricia E; Rapp, Stephen R; Dugan, Elizabeth; Marottoli, Richard A; Snively, Beverly M; Shumaker, Sally A; Sink, Kaycee M

    2015-09-01

    To investigate associations between proxy report of cognitive and functional limitations and cognitive performance and current or former driving status in older women with mild cognitive impairment (MCI) and all-cause dementia. Cross-sectional data analysis of retrospectively identified older women with adjudicated MCI and all-cause dementia in the Women's Health Initiative Memory Study-Epidemiology of Cognitive Health Outcomes (WHIMS-ECHO). Academic medical center. Women (mean age ± standard deviation 83.7 ± 3.5) adjudicated with MCI or dementia during Year 1, 2, 3, or 4 of the WHIMS-ECHO follow-up period (N = 385). The telephone-administered cognitive battery included tests of attention, verbal learning and memory, verbal fluency, executive function, working memory, and global cognitive function plus self-report measures of depressive symptomatology. The Dementia Questionnaire (DQ) was administered to a knowledgeable proxy (family member, friend). Sixty percent of women with MCI and 40% of those with dementia are current drivers. Proxy reports of functional limitations in instrumental activities of daily living (IADLs) are associated with current driving status in women with MCI, whereas performance-based cognitive tests are not. In women with dementia, proxy reports of functional limitations in IADLs and performance-based cognitive tests are associated with current driving status, as expected. These findings have clinical implications for the importance of evaluating driving concurrently with other instrumental functional abilities in MCI and dementia. Additional work is needed to determine whether proxy report of cognitive and functional impairments should help guide referrals for driving assessment and rehabilitation or counseling for driving transition. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  18. Japanese version of the Montreal Cognitive Assessment cut-off score to clarify improvement of mild cognitive impairment after exercise training in community-dwelling older adults.

    Science.gov (United States)

    Nara, Marina; Sugie, Masamitsu; Takahashi, Tetsuya; Koyama, Teruyuki; Sengoku, Renpei; Fujiwara, Yoshinori; Obuchi, Shuichi; Harada, Kazumasa; Kyo, Shunei; Ito, Hideki

    2018-02-02

    Physical exercise improves cognitive function in people with mild cognitive impairment (MCI). However, information about whether the degree of MCI before exercise training affects improvement in cognitive function is lacking. Therefore, we aimed to investigate the cut-off value in a MCI screening tool that predicts reversal to normal cognitive function after exercise training in older adults with MCI. Participants included 112 Japanese community-dwelling older adult outpatients (37 men, 75 women; mean age 76.3 years). We administered the Japanese version of the Montreal Cognitive Assessment (MoCA-J) before and after exercise training. MCI was defined as a MoCA-J score cognitive function. The MoCA-J cut-off score to predict cognitive function potentially reversible to normal was 23, with receiver operating characteristic analysis showing an area under the curve of 0.80, sensitivity of 79.4% and specificity of 69.2%. Multiple logistic regression analysis to predict non-MCI after exercise training showed that MoCA-J score ≥23 (OR 6.9, P cognitive function that is potentially reversible to normal among community-dwelling Japanese older adults with MCI. Geriatr Gerontol Int 2018; ••: ••-••. © 2018 The Authors Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

  19. Conversion to dementia in mild cognitive impairment diagnosed with DSM-5 criteria and with Petersen's criteria.

    Science.gov (United States)

    Marcos, G; Santabárbara, J; Lopez-Anton, R; De-la-Cámara, C; Gracia-García, P; Lobo, E; Pírez, G; Menchón, J M; Palomo, T; Stephan, B C M; Brayne, C; Lobo, A

    2016-05-01

    In a background of revision of criteria for states of increased risk for progression to dementia, we compare the conversion rate to dementia and Alzheimer's disease (AD) of mild cognitive impairment (MCI) as diagnosed using DSM-5 (DSM-5-MCI) and Petersen's (P-MCI) criteria. A population representative cohort of 4057 dementia-free individuals 55+ years of age was followed up at 2.5 and 4.5 years in Zaragoza, Spain (ZARADEMP). Using the Geriatric Mental State- AGECAT for assessment, research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. 'Conversion rate' (CR), 'annual conversion rate' (ACR), and incidence rate (IR) were calculated along with incidence rate ratio (IRR) to compare the performance of the intermediate cognitive definitions. At 4.5-year follow-up, in individuals aged 65+ years, ACRs for non-cases, P-MCI, and DSM-5-MCI were 0.8, 1.9 and 3.4, respectively, for global dementia. The IRRs were 2.9 and 5.3 for P-MCI and DSM5-MCI, respectively, being the non-cases the reference category. The corresponding values were slightly lower for AD. Conversion rate to dementia and AD was higher using DSM-5-MCI criteria than using Petersen's criteria. However, prediction of the construct still has some way to go, as most MCI individuals did not convert at 4.5-year follow-up. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Network Disruption in the Preclinical Stages of Alzheimer's Disease: From Subjective Cognitive Decline to Mild Cognitive Impairment.

    Science.gov (United States)

    López-Sanz, David; Garcés, Pilar; Álvarez, Blanca; Delgado-Losada, María Luisa; López-Higes, Ramón; Maestú, Fernando

    2017-12-01

    Subjective Cognitive Decline (SCD) is a largely unknown state thought to represent a preclinical stage of Alzheimer's Disease (AD) previous to mild cognitive impairment (MCI). However, the course of network disruption in these stages is scarcely characterized. We employed resting state magnetoencephalography in the source space to calculate network smallworldness, clustering, modularity and transitivity. Nodal measures (clustering and node degree) as well as modular partitions were compared between groups. The MCI group exhibited decreased smallworldness, clustering and transitivity and increased modularity in theta and beta bands. SCD showed similar but smaller changes in clustering and transitivity, while exhibiting alterations in the alpha band in opposite direction to those showed by MCI for modularity and transitivity. At the node level, MCI disrupted both clustering and nodal degree while SCD showed minor changes in the latter. Additionally, we observed an increase in modular partition variability in both SCD and MCI in theta and beta bands. SCD elders exhibit a significant network disruption, showing intermediate values between HC and MCI groups in multiple parameters. These results highlight the relevance of cognitive concerns in the clinical setting and suggest that network disorganization in AD could start in the preclinical stages before the onset of cognitive symptoms.

  1. The effects of bioactive compounds on Alzheimer’s disease and Mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Brian McAnany

    2016-06-01

    Full Text Available As the prevalence and rate of Alzheimer’s disease are increasing around world, identifying effective treatments to manage cognitive impairment and neurodegeneration has become a global health priority. Decades of scientific research have led to a more comprehensive understanding of Alzheimer’s Disease and Mild Cognitive Impairment (MCI, a transitional stage of accelerated cognitive decline. This understanding has enabled researchers to envision and develop novel Alzheimer’s Disease therapies, including the use of bioactive compounds found in plants and animals. Within the past 15 years, a significant amount of clinical research has been published documenting the effects specific bioactive compounds have on patients with Alzheimer’s Disease and MCI. This article reviews the results of this research, along with relevant epidemiological studies, measures of cognition, and disease pathologies to discuss whether sufficient evidence exists to support the use of specific bioactive compounds by individuals diagnosed with Alzheimer’s Disease and MCI. The results of clinical trials within the last 15 years do not conclusively prove that the studied quantities of vitamin B, Omega-3 fatty acids, or bioactive compounds within Fortasyn Connect are beneficial for use in the management of Alzheimer’s Disease or MCI. Additionally, the documented effects of these bioactive compounds do not warrant development of a functional food product to help manage AD or MCI. Conclusion: The results of clinical trials within the last 15 years do not conclusively prove that the specified quantities of vitamin B, Omega-3 fatty acids, or bioactive compounds within Fortasyn Connect, are beneficial for use in the management of AD or MCI. Additionally, the documented effects of these bioactive compounds do not warrant development of a functional food product utilizing the previously specified quantities to help manage AD or MCI. The effects bioactive compound

  2. Social relationships and risk of incident mild cognitive impairment in U.S. Alzheimer's disease centers.

    Science.gov (United States)

    Brenowitz, Willa D; Kukull, Walter A; Beresford, Shirley A A; Monsell, Sarah E; Williams, Emily C

    2014-01-01

    Social relationships are hypothesized to prevent or slow cognitive decline. We sought to evaluate associations between social relationships and mild cognitive impairment (MCI). Participants from the National Alzheimer's Coordinating Center database who were cognitively normal, aged 55 and older at baseline, and had at least 2 in-person visits (n=5335) were included. Multivariable Cox proportional hazard models evaluated the association between 4 social relationships at baseline (marital status, living situation, having children, and having siblings) and risk of developing MCI (on the basis of clinician diagnosis following established criteria). Primary models were adjusted for baseline demographics. Participants were followed, on average, for 3.2 years; 15.2% were diagnosed with MCI. Compared with married participants, risk of MCI was significantly lower for widowed participants (hazard ratio: 0.87; 95% confidence interval: 0.76, 0.99) but not for divorced/separated or never-married participants. Compared with living with a spouse/partner, risk of MCI was significantly higher for living with others (hazard ratio: 1.35; 95% confidence interval: 1.03, 1.77) but not for living alone. Risk of MCI was not associated with having children or having siblings. These results did not consistently identify social relationships as a strong risk factor for, or independent clinical predictor of, MCI.

  3. Olfactory evaluation in Mild Cognitive Impairment: correlation with neurocognitive performance and endothelial function.

    Science.gov (United States)

    Tonacci, Alessandro; Bruno, Rosa M; Ghiadoni, Lorenzo; Pratali, Lorenza; Berardi, Nicoletta; Tognoni, Gloria; Cintoli, Simona; Volpi, Leda; Bonuccelli, Ubaldo; Sicari, Rosa; Taddei, Stefano; Maffei, Lamberto; Picano, Eugenio

    2017-05-01

    Mild Cognitive Impairment (MCI) is an intermediate condition between normal aging and dementia, associated with an increased risk of progression into the latter within months or years. Olfactory impairment, a well-known biomarker for neurodegeneration, might be present in the condition early, possibly representing a signal for future pathological onset. Our study aimed at evaluating olfactory function in MCI and healthy controls in relation to neurocognitive performance and endothelial function. A total of 85 individuals with MCI and 41 healthy controls, matched for age and gender, were recruited. Olfactory function was assessed by Sniffin' Sticks Extended Test (Burghart, Medizintechnik, GmbH, Wedel, Germany). A comprehensive neurocognitive assessment was performed. Endothelial function was assessed by flow-mediated dilation (FMD) of the brachial artery by ultrasound. MCI individuals showed an impaired olfactory function compared to controls. The overall olfactory score is able to predict MCI with a good sensitivity and specificity (70.3 and 77.4% respectively). In MCI, olfactory identification score is correlated with a number of neurocognitive abilities, including overall cognitive status, dementia rating, immediate and delayed memory, visuospatial ability and verbal fluency. FMD was reduced in MCI (2.90 ± 2.15 vs. 3.66 ± 1.96%, P = 0.016) and was positively associated with olfactory identification score (ρ s =0.219, P = 0.025). The association remained significant after controlling for age, gender, and smoking. In conclusion, olfactory evaluation is able to discriminate between MCI and healthy individuals. Systemic vascular dysfunction might be involved, at least indirectly, in olfactory dysfunction in MCI. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

  4. Cognitive decline and amyloid accumulation in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Koivunen, Jaana; Karrasch, Mira; Scheinin, Noora M

    2012-01-01

    Background/Aims: The relationship between baseline (11)C-Pittsburgh compound B ((11)C-PIB) uptake and cognitive decline during a 2-year follow-up was studied in 9 patients with mild cognitive impairment (MCI) who converted to Alzheimer's disease (AD) and 7 who remained with MCI. Methods: (11)C......: At baseline, there were statistically significant differences in (11)C-PIB uptake, but not in cognitive test performances between the converters and nonconverters. Memory and executive function declined only in the converters during follow-up. In the converters, lower baseline frontal (11)C-PIB uptake...... was associated with faster decline in verbal learning. Higher baseline uptake in the caudate nucleus was related to faster decline in memory consolidation, and higher temporal uptake was associated with decline in executive function. Conclusion: Higher (11)C-PIB uptake in the caudate nucleus and temporal lobe...

  5. The Memory Alteration Test Discriminates between Cognitively Healthy Status, Mild Cognitive Impairment and Alzheimer's Disease

    Science.gov (United States)

    Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Nuñez del Prado, Liza; Parodi, José; Guevara-Silva, Erik; Castro-Suarez, Sheila; Montesinos, Rosa; Cortijo, Patricia

    2014-01-01

    Background/Aims Dementia is a worldwide public health problem and there are several diagnostic tools for its assessment. The aim of this study was to evaluate the performance of the Memory Alteration Test (M@T) to discriminate between patients with early Alzheimer's disease (AD), patients with amnestic mild cognitive impairment (a-MCI), and subjects with a cognitively healthy status (CHS). Methods The discriminative validity was assessed in a sample of 90 patients with AD, 45 patients with a-MCI, and 180 subjects with CHS. Clinical, functional, and cognitive studies were independently performed in a blinded fashion and the gold standard diagnosis was established by consensus on the basis of these results. The test performance was assessed by means of a receiver operating characteristic curve analysis as area under the curve (AUC). Results M@T mean scores were 17.7 (SD = 5.7) in AD, 30.8 (SD = 2.3) in a-MCI, and 44.5 (SD = 3.1) in CHS. A cutoff score of 37 points had a sensitivity of 98.3% and a specificity of 97.8% to differentiate a-MCI from CHS (AUC = 0.999). A cutoff score of 27 points had a sensitivity of 100% and a specificity of 98.9% to differentiate mild AD from a-MCI and from CHS (AUC = 1.000). Conclusions The M@T had a high performance in the discrimination between early AD, a-MCI and CHS. PMID:25298775

  6. Parkinson's disease-cognitive rating scale: psychometrics for mild cognitive impairment.

    Science.gov (United States)

    Fernández de Bobadilla, Ramón; Pagonabarraga, Javier; Martínez-Horta, Saül; Pascual-Sedano, Berta; Campolongo, Antonia; Kulisevsky, Jaime

    2013-09-01

    Lack of validated data on cutoff scores for mild cognitive impairment (MCI) and sensitivity to change in predementia stages of Parkinson's disease (PD) limit the utility of instruments measuring global cognition as screening and outcome measures in therapeutic trials. Investigators who were blinded to PD-Cognitive Rating Scale (PD-CRS) scores classified a cohort of prospectively recruited, nondemented patients into a PD with normal cognition (PD-NC) group and a PD with MCI (PD-MCI) group using Clinical Dementia Rating (CDR) and the Mattis Dementia Rating Scale-2 (MDRS-2). The discriminative power of the PD-CRS for PD-MCI was examined in a representative sample of 234 patients (145 in the PD-NC group; 89 in the PD-MCI group) and in a control group of 98 healthy individuals. Sensitivity to change in the PD-CRS score (the minimal clinically important difference was examined with the Clinical Global Impression of Change scale and was calculated with a combination of distribution-based and anchor-based approaches) was explored in a 6-month observational multicenter trial involving a subset of 120 patients (PD-NC, 63; PD-MCI, 57). Regression analysis demonstrated that PD-CRS total scores (P < 0.001) and age (P = 0.01) independently differentiated PD-NC from PD-MCI. Area under the receiver operating characteristic curve (AUC) analysis (AUC, 0.85; 95% confidence interval, 0.80-0.90) indicated that a score ≤ 81 of 134 was the optimal cutoff point on the total score for the PD-CRS (sensitivity, 79%; specificity, 80%; positive predictive value, 59%; negative predictive value, 91%). A range of change from 10 to 13 points on the PD-CRS total score was indicative of clinically significant change. These findings suggest that the PD-CRS is a useful tool to identify PD-MCI and to track cognitive changes in nondemented patients with PD. © 2013 International Parkinson and Movement Disorder Society.

  7. Cognitive impairment is associated with Hoehn and Yahr stages in early, de novo Parkinson disease patients.

    Science.gov (United States)

    Siciliano, Mattia; De Micco, Rosa; Trojano, Luigi; De Stefano, Manuela; Baiano, Chiara; Passaniti, Carla; De Mase, Antonio; Russo, Antonio; Tedeschi, Gioacchino; Tessitore, Alessandro

    2017-08-01

    The relationship between motor impairment and cognitive deterioration has long been described in Parkinson's disease (PD). The aim of the study was to compare cognitive performance of de novo PD patients in relation to the motor impairment severity according to Hoehn and Yahr (HY) stages. Forty de novo PD patients at HY stage I and 40 patients at HY stage II completed a standardized neuropsychological battery. A multivariate analysis of covariance was used to compare cognitive performance between HY groups. Odds ratios (ORs) were employed to explore the risk of cognitive impairment between HY stages. Finally, the prevalence of mild cognitive impairment (MCI) was estimated for patients in HY stage I and II. Patients at HY stage I obtained better scores on neuropsychological tests than patients at HY stage II (p = 0.001). Univariate analysis of covariance revealed significant differences between HY stages on Rey's auditory verbal learning test -immediate recall (p cognitive impairment were greater for HY stage II than stage I group. MCI occurred in 7.5% of patients in HY stage I, and in 42.5% of patients in HY stage II. In de novo PD patients, the severity of motor impairment at the diagnosis is associated to cognitive deficits and higher risk of MCI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Arterial stiffness and cognitive impairment.

    Science.gov (United States)

    Li, Xiaoxuan; Lyu, Peiyuan; Ren, Yanyan; An, Jin; Dong, Yanhong

    2017-09-15

    Arterial stiffness is one of the earliest indicators of changes in vascular wall structure and function and may be assessed using various indicators, such as pulse-wave velocity (PWV), the cardio-ankle vascular index (CAVI), the ankle-brachial index (ABI), pulse pressure (PP), the augmentation index (AI), flow-mediated dilation (FMD), carotid intima media thickness (IMT) and arterial stiffness index-β. Arterial stiffness is generally considered an independent predictor of cardiovascular and cerebrovascular diseases. To date, a significant number of studies have focused on the relationship between arterial stiffness and cognitive impairment. To investigate the relationships between specific arterial stiffness parameters and cognitive impairment, elucidate the pathophysiological mechanisms underlying the relationship between arterial stiffness and cognitive impairment and determine how to interfere with arterial stiffness to prevent cognitive impairment, we searched PUBMED for studies regarding the relationship between arterial stiffness and cognitive impairment that were published from 2000 to 2017. We used the following key words in our search: "arterial stiffness and cognitive impairment" and "arterial stiffness and cognitive impairment mechanism". Studies involving human subjects older than 30years were included in the review, while irrelevant studies (i.e., studies involving subjects with comorbid kidney disease, diabetes and cardiac disease) were excluded from the review. We determined that arterial stiffness severity was positively correlated with cognitive impairment. Of the markers used to assess arterial stiffness, a higher PWV, CAVI, AI, IMT and index-β and a lower ABI and FMD were related to cognitive impairment. However, the relationship between PP and cognitive impairment remained controversial. The potential mechanisms linking arterial stiffness and cognitive impairment may be associated with arterial pulsatility, as greater arterial pulsatility

  9. Interaction between memory impairment and depressive symptoms can exacerbate anosognosia: a comparison of Alzheimer's disease with mild cognitive impairment.

    Science.gov (United States)

    Oba, Hikaru; Matsuoka, Teruyuki; Imai, Ayu; Fujimoto, Hiroshi; Kato, Yuka; Shibata, Keisuke; Nakamura, Kaeko; Narumoto, Jin

    2018-03-12

    To investigate the effects of interactions between memory impairment, depressive symptoms, and anosognosia. Anosognosia for memory impairment was assessed in 118 patients with Alzheimer's disease (AD), 47 patients with mild cognitive impairment (MCI), and 17 non-diagnosed controls (NC) using a questionnaire and evaluation of the anosognosia score as the discrepancy between ratings of the patient and a relative. Demographic characteristics, such as the relationship of the patient with the relative and the activities of daily living (ADL) were evaluated. Memory impairment was evaluated with the Rivermead Behavioral Memory Test (RBMT), depressive symptoms were evaluated using the Geriatric Depression Scale (GDS) 15 items version. In the MCI group, a stepwise multiple regression analysis showed an interaction between RBMT and GDS scores, and simple slope analysis indicated that scores for RBMT at low GDS (-1 standard deviation) were positively correlated with self-rated memory impairment. In the AD group, the relationship of the patient with the relative, ADL, and GDS and RBMT scores were associated with the anosognosia score. Patients with MCI who have no depressive symptoms may be able to more accurately evaluate their memory impairment than those who have depressive symptoms and patients with AD. The evaluation by relatives, depressive symptoms or ADL of patients may distort evaluation of anosognosia for memory impairment in patients with AD or MCI. It seems necessary to include not only depression scale scores but also results of objective memory tests in the patients' medical information for the correct assessment of anosognosia.

  10. Cognitive Impairment in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Farnaz Etesam

    2014-01-01

    Full Text Available Cognitive impairment can emerge in the earliest phases of multiple sclerosis. It strongly impacts different aspects of Multiple Sclerosis (MS patients' lives, like employment, social relationships and the overall quality of life; thus, its on-time recognition and treatment is mandatory. This paper discusses issues, diagnostic methods and treatment options for cognitive dysfunctions in MS. This paper is a descriptive review of the related studies in the recent 10 years, performing a keyword search in the main databases4T. Cognitive impairment mostly involves aspects of information processing, memory and executive functioning in MS. Neuropsychological tests like MACFIMS and BRB-N are recommended for its assessment. Still, there is no fully efficient treatment for cognitive impairment. Researchers have shown some positive effects, using disease-modifying therapies and cognitive rehabilitation. Depression, pain, fatigue and other factors influencing cognitive functions must be paid attention to4T. Recognizing cognitive impairment as a major symptom for MS, makes studying this subject one of the priorities in dealing with the disease. Therefore, a consecutive research for identification and management of this part of quality of life in MS patients is obligatory4T.4T

  11. Cognitive impairment in Chinese neuromyelitis optica

    NARCIS (Netherlands)

    Zhang, N.; Li, Y.J.; Fu, Y.; Shao, J.H.; Luo, L.L.; Yang, L.; Shi, F.D.; Liu, Y.

    2015-01-01

    Background: Cognitive dysfunction is frequently seen in neuromyelitis optica (NMO). However, the features and influencing factors of cognitive impairment of Chinese NMO patients are unclear. Objective: To investigate the patterns of cognitive impairment in Chinese NMO patients, and correlate the

  12. Episodic, but not semantic, autobiographical memory is reduced in amnestic mild cognitive impairment.

    Science.gov (United States)

    Murphy, Kelly J; Troyer, Angela K; Levine, Brian; Moscovitch, Morris

    2008-11-01

    Amnestic mild cognitive impairment (aMCI) is characterized by decline in anterograde memory as measured by the ability to learn and remember new information. We investigated whether retrograde memory for autobiographical information was affected by aMCI. Eighteen control (age 66-84 years) and 17 aMCI (age 66-84 years) participants described a personal event from each of the five periods across the lifespan. These events were transcribed and scored according to procedures that separate episodic (specific happenings) from semantic (general knowledge) elements of autobiographical memory. Although both groups generated protocols of similar length, the composition of autobiographical recall differentiated the groups. The aMCI group protocols were characterized by reduced episodic and increased semantic information relative to the control group. Both groups showed a similar pattern of recall across time periods, with no evidence that the aMCI group had more difficulty recalling recent, rather than remote, life events. These results indicate that episodic and semantic autobiographical memories are differentially affected by the early brain changes associated with aMCI. Reduced autobiographical episodic memories in aMCI may be the result of medial temporal lobe dysfunction, consistent with multiple trace theory, or alternatively, could be related to dysfunction of a wider related network of neocortical structures. In contrast, the preservation of autobiographical semantic memories in aMCI suggests neural systems, such as lateral temporal cortex, that support these memories, may remain relatively intact.

  13. Cognitive impairment and driving safety.

    Science.gov (United States)

    Eby, David W; Molnar, Lisa J

    2012-11-01

    As the populations of many countries continue to age, cognitive impairment will likely become more common. Individuals with cognitive impairment pose special challenges for families, health professionals, driving safety professionals, and the larger community, particularly if these older adults depend on driving as their primary means of community mobility. It is vital that we continue to extend our knowledge about the driving behavior of individuals' with cognitive impairment, as well as try to develop effective means of screening and assessing these individuals for fitness to drive and help facilitate their transition to non-driving when appropriate. This special issue is intended to provide researchers and practitioners an opportunity to present the most recent research findings on driving-related issues among older adults with cognitive impairment. The issue contains 11 original contributions from seven countries. The topics covered by these papers are: crash risks; screening, assessment, and fitness to drive; driving performance using a driving simulator; and driving behaviors and driving-related decisions of people with cognitive impairments. Copyright © 2012. Published by Elsevier Ltd.

  14. Mild cognitive impairment: a concept and diagnostic entity in need of input from neuropsychology.

    Science.gov (United States)

    Bondi, Mark W; Smith, Glenn E

    2014-02-01

    This virtual issue consists of studies previously published in the Journal of the International Neuropsychological Society and selected on the basis of their content related to one of the most highly researched concepts in behavioral neurology and neuropsychology over the past decade: mild cognitive impairment (MCI). The reliance on cognitive screening measures, staging-based rating scales, and limited neuropsychological testing in diagnosing MCI across most research studies may miss individuals with subtle cognitive declines or mis-diagnose MCI in those who are otherwise cognitively normal on a broader neuropsychological battery of tests. The assembled articles highlight the perils of relying on these conventional criteria for MCI diagnosis and reveal how the reliability of diagnosis is improved when sound neuropsychological approaches are adopted. When these requirements are met, we illustrate with a second series of articles that neuropsychological measures associate strongly with biomarkers and often reflect pathology beyond or instead of typical AD distributions. The final set of articles reveal that people with MCI demonstrate mild but identifiable functional difficulties, and a challenge for neuropsychology is how to incorporate this information to better define MCI and distinguish it from early dementia. Neuropsychology is uniquely positioned to improve upon the state of the science in MCI research and practice by providing critically important empirical information on the specific cognitive domains affected by the predominant neurodegenerative disorders of late life as well as on the diagnostic decision-making strategies used in studies. When such efforts to more comprehensively assess neuropsychological functions are undertaken, better characterizations of spared and impaired cognitive and functional abilities result and lead to more convincing associations with other biomarkers as well as to prediction of clinical outcomes.

  15. Comparison of the Quick Mild Cognitive Impairment (Qmci) screen to the Montreal Cognitive Assessment (MoCA) in an Australian geriatrics clinic.

    Science.gov (United States)

    Clarnette, Roger; O'Caoimh, Rónán; Antony, Deanna N; Svendrovski, Anton; Molloy, D William

    2017-06-01

    The Montreal Cognitive Assessment (MoCA) accurately differentiates mild cognitive impairment (MCI) from mild dementia and normal controls (NC). While the MoCA is validated in multiple clinical settings, few studies compare it with similar tests also designed to detect MCI. We sought to investigate how the shorter Quick Mild Cognitive Impairment (Qmci) screen compares with the MoCA. Consecutive referrals presenting with cognitive complaints to a teaching hospital geriatric clinic (Fremantle, Western Australia) underwent a comprehensive assessment and were classified as MCI (n = 72) or dementia (n = 109). NC (n = 41) were a sample of convenience. The Qmci and MoCA were scored by trained geriatricians, in random order, blind to the diagnosis. Median Qmci scores for NC, MCI and dementia were 69 (+/-19), 52.5 (+/-12) and 36 (+/-14), respectively, compared with 27 (+/-5), 22 (+/-4) and 15 (+/-7) for the MoCA. The Qmci more accurately identified cognitive impairment (MCI or dementia), area under the curve (AUC) 0.97, than the MoCA (AUC 0.92), p = 0.04. The Qmci was non-significantly more accurate in distinguishing MCI from controls (AUC 0.91 vs 0.84, respectively = 0.16). Both instruments had similar accuracy for differentiating MCI from dementia (AUC of 0.91 vs 0.88, p = 0.35). At the optimal cut-offs, calculated from receiver operating characteristic curves, the Qmci (≤57) had a sensitivity of 91% and specificity of 93% for cognitive impairment, compared with 87% sensitivity and 80% specificity for the MoCA (≤23). While both instruments are accurate in detecting MCI, the Qmci is shorter and arguably easier to complete, suggesting that it is a useful instrument in an Australian geriatric outpatient population. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  16. Connectivity features for identifying cognitive impairment in presymptomatic carotid stenosis.

    Directory of Open Access Journals (Sweden)

    Chun-Jen Lin

    Full Text Available Severe asymptomatic stenosis of the internal carotid artery (ICA leads to increased incidence of mild cognitive impairment (MCI likely through silent embolic infarcts and/or chronic hypoperfusion, but the brain dysfunction is poorly understood and difficult to diagnose. Thirty cognitively intact subjects with asymptomatic, severe (≥ 70%, unilateral stenosis of the ICA were compared with 30 healthy controls, matched for age, sex, cardiovascular risk factors and education level, on a battery of neuropsychiatric tests, voxel-based morphometry of magnetic resonance imaging (MRI, diffusion tensor imaging and brain-wise, seed-based analysis of resting-state functional MRI. Multivariate regression models and multivariate pattern classification (support vector machines were computed to assess the relationship between connectivity measures and neurocognitive performance. The patients had worse dizziness scores and poorer verbal memory, executive function and complex visuo-spatial performance than controls. Twelve out of the 30 patients (40% were considered to have MCI. Nonetheless, the leukoaraiosis Sheltens scores, hippocampal and brain volumes were not different between groups. Their whole-brain mean fractional anisotropy (FA was significantly reduced and regional functional connectivity (Fc was significantly impaired in the dorsal attention network (DAN, frontoparietal network, sensorimotor network and default mode network. In particular, the Fc strength at the insula of the DAN and the mean FA were linearly related with attention performance and dizziness severity, respectively. The multivariate pattern classification gave over 90% predictive accuracy of individuals with MCI or severe dizziness. Cognitive decline in stroke-free individuals with severe carotid stenosis may arise from nonselective widespread disconnections of long-range, predominantly interhemispheric non-hippocampal pathways. Connectivity measures may serve as both predictors for

  17. Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease.

    Science.gov (United States)

    Cholerton, Brenna; Johnson, Catherine O; Fish, Brian; Quinn, Joseph F; Chung, Kathryn A; Peterson-Hiller, Amie L; Rosenthal, Liana S; Dawson, Ted M; Albert, Marilyn S; Hu, Shu-Ching; Mata, Ignacio F; Leverenz, James B; Poston, Kathleen L; Montine, Thomas J; Zabetian, Cyrus P; Edwards, Karen L

    2018-05-01

    Identification of factors associated with progression of cognitive symptoms in Parkinson's disease (PD) is important for treatment planning, clinical care, and design of future clinical trials. The current study sought to identify whether prediction of cognitive progression is aided by examining baseline cognitive features, and whether this differs according to stage of cognitive disease. Participants with PD in the Pacific Udall Center Clinical Consortium who had longitudinal data available and were nondemented at baseline were included in the study (n = 418). Logistic and Cox regression models were utilized to examine the relationship between cognitive, demographic, and clinical variables with risk and time to progression from no cognitive impairment to mild cognitive impairment (PD-MCI) or dementia (PDD), and from PD-MCI to PDD. Processing speed (OR = 1.05, p = 0.009) and working memory (OR = 1.01, p = 0.03) were associated with conversion to PDD among those with PD-MCI at baseline, over and above demographic variables. Conversely, the primary predictive factor in the transition from no cognitive impairment to PD-MCI or PDD was male sex (OR = 4.47, p = 0.004), and males progressed more rapidly than females (p = 0.01). Further, among females with shorter disease duration, progression was slower than for their male counterparts, and poor baseline performance on semantic verbal fluency was associated with shorter time to cognitive impairment in females but not in males. This study provides evidence for sex differences in the progression to cognitive impairment in PD, while specific cognitive features become more important indicators of progression with impending conversion to PDD. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Different perception of cognitive impairment, behavioral disturbances, and functional disabilities between persons with mild cognitive impairment and mild Alzheimer's disease and their caregivers.

    Science.gov (United States)

    Onor, M L; Trevisiol, M; Negro, C; Aguglia, E

    2006-01-01

    Insight in dementia is a multifaceted concept and ability, which includes the persons' perception of their behavioral and cognitive symptoms and functional disability. This ability seems to deteriorate as dementia progresses. The aim of this study was to evaluate the level of insight in the cognitive, behavioral, and functional disorders in a group of persons with mild cognitive impairment (MCI) or mild AD (Alzheimer's disease) and to compare their perception of their illness with that of their caregivers. The study involved a group of 121 persons with MCI and mild AD and their caregivers. The persons with MCI and mild AD were administered the tests Mini-Mental State Examination, Instrumental Activities of Daily Living, Activities of Daily Living, Neuropsychiatric Inventory, Schedule for the Assessment of Insight, Clinical Insight Rating Scale, and a short interview. Major differences were identified between how the persons with MCI or mild AD and their caregivers perceived the persons' cognitive and behavioral disorders. The group with MCI or mild AD underestimated their deficits, which were considered serious and disabling by their caregivers.

  19. Neurological soft signs in persons with amnestic mild cognitive impairment and the relationships to neuropsychological functions

    Directory of Open Access Journals (Sweden)

    Li Hui-jie

    2012-06-01

    Full Text Available Abstract Background Neurological abnormalities have been reported in people with amnestic mild cognitive impairment (aMCI. The current study aimed to examine the prevalence of neurological soft signs (NSS in this clinical group and to examine the relationship of NSS to other neuropsychological performances. Methods Twenty-nine people with aMCI and 28 cognitively healthy elderly people were recruited for the present study. The NSS subscales (motor coordination, sensory integration, and disinhibition of the Cambridge Neurological Inventory and a set of neuropsychological tests were administered to all the participants. Results People with aMCI exhibited significantly more motor coordination signs, disinhibition signs, and total NSS than normal controls. Correlation analysis showed that the motor coordination subscale score and total score of NSS were significantly inversely correlated with the combined Z-score of neuropsychological tests in aMCI group. Conclusions These preliminary findings suggested that people with aMCI demonstrated a higher prevalence of NSS compared to healthy elderly people. Moreover, NSS was found to be inversely correlated with the neuropsychological performances in persons with aMCI. When taken together, these findings suggested that NSS may play a potential important role and serve as a tool to assist in the early detection of aMCI.

  20. Insulin Resistance Predicts Medial Temporal Hypermetabolism in Mild Cognitive Impairment Conversion to Alzheimer Disease

    Science.gov (United States)

    Willette, Auriel A.; Modanlo, Nina

    2015-01-01

    Alzheimer disease (AD) is characterized by progressive hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans. Peripheral insulin resistance (IR) increases AD risk. No studies have examined associations between FDG metabolism and IR in mild cognitive impairment (MCI) and AD, as well as MCI conversion to AD. We studied 26 cognitively normal (CN), 194 MCI (39 MCI-progressors, 148 MCI-stable, 2 years after baseline), and 60 AD subjects with baseline FDG-PET from the Alzheimer’s Disease Neuroimaging Initiative. Mean FDG metabolism was derived for AD-vulnerable regions of interest (ROIs), including lateral parietal and posteromedial cortices, medial temporal lobe (MTL), hippocampus, and ventral prefrontal cortices (vPFC), as well as postcentral gyrus and global cerebrum control regions. The homeostasis model assessment of IR (HOMA-IR) was used to measure IR. For AD, higher HOMA-IR predicted lower FDG in all ROIs. For MCI-progressors, higher HOMA-IR predicted higher FDG in the MTL and hippocampus. Control regions showed no associations. Higher HOMA-IR predicted hypermetabolism in MCI-progressors and hypometabolism in AD in medial temporal regions. Future longitudinal studies should examine the pathophysiologic significance of the shift from MTL hyper- to hypometabolism associated with IR. PMID:25576061

  1. Alteration patterns of brain glucose metabolism: comparisons of healthy controls, subjective memory impairment and mild cognitive impairment.

    Science.gov (United States)

    Song, In-Uk; Choi, Eun Kyoung; Oh, Jin Kyoung; Chung, Yong-An; Chung, Sung-Woo

    2016-01-01

    Some groups have focused on the detection and management of subjective memory impairment (SMI) as the stage that precedes mild cognitive impairment (MCI). However, there have been few clinical studies that have examined biomarkers of SMI to date. To investigate the differences in glucose metabolism as a prodromal marker of dementia in patients with SMI, MCI, and healthy controls using brain F-18 fluoro-2-deoxyglucose positron emission tomography (FDG-PET). Sixty-eight consecutive patients with SMI, 47 patients with MCI, and 42 age-matched healthy subjects were recruited. All subjects underwent FDG-PET and detailed neuropsychological testing. FDG-PET images were analyzed using the statistical parametric mapping (SPM) program. FDG-PET analysis showed glucose hypometabolism in the periventricular regions of patients with SMI and in the parietal, precentral frontal, and periventricular regions of patients with MCI compared with healthy controls. Interestingly, hypometabolism on FDG-PET was noted in the parietal and precentral frontal regions in MCI patients compared to SMI patients. The results suggest that hypometabolism in the periventricular regions as seen on FDG-PET may play a role as a predictive biomarker of pre-dementia, and the extension of reduced glucose metabolism into parietal regions likely reflects progression of cognitive deterioration. © The Foundation Acta Radiologica 2014.

  2. Spatiotemporal Gait Characteristics Associated with Cognitive Impairment: A Multicenter Cross-Sectional Study, the Intercontinental "Gait, cOgnitiOn & Decline" Initiative.

    Science.gov (United States)

    Beauchet, Olivier; Blumen, Helena M; Callisaya, Michele L; De Cock, Anne-Marie; Kressig, Reto W; Srikanth, Velandai; Steinmetz, Jean-Paul; Verghese, Joe; Allali, Gilles

    2018-01-23

    The study aims to determine the spatiotemporal gait parameters and/or their combination(s) that best differentiate between cognitively healthy individuals (CHI), patients with mild cognitive impairment (MCI) and those with mild and moderate dementia, regardless of the etiology of cognitive impairment. A total of 2099 participants (1015 CHI, 478 patients with MCI, 331 patients with mild dementia and 275 with moderate dementia) were selected from the intercontinental "Gait, cOgnitiOn & Decline" (GOOD) initiative, which merged different databases from seven cross-sectional studies. Mean values and coefficients of variation (CoV) of spatiotemporal gait parameters were recorded during usual walking with the GAITRite® system. The severity of cognitive impairment was associated with worse performance on all gait parameters. Stride velocity had the strongest association with cognitive impairment, regardless of cognitive status. High mean value and CoV of stride length characterized moderate dementia, whereas increased CoV of stride time was specific to MCI status. The findings support the existence of specific cognitive impairment-related gait disturbances with differences related to stages of cognitive impairment, which may be used to screen individuals with cognitive impairment. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  3. The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration.

    Directory of Open Access Journals (Sweden)

    Perminder S Sachdev

    Full Text Available Changes in criteria and differences in populations studied and methodology have produced a wide range of prevalence estimates for mild cognitive impairment (MCI.Uniform criteria were applied to harmonized data from 11 studies from USA, Europe, Asia and Australia, and MCI prevalence estimates determined using three separate definitions of cognitive impairment.The published range of MCI prevalence estimates was 5.0%-36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%-10.8%; Clinical Dementia Rating of 0.5 (1.8%-14.9%; Mini-Mental State Examination score of 24-27 (2.1%-20.7%. Prevalences using the first definition were 5.9% overall, and increased with age (P < .001 but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese. Not completing high school increased the likelihood of MCI (P ≤ .01.Applying uniform criteria to harmonized data greatly reduced the variation in MCI prevalence internationally.

  4. Mild Cognitive Impairment

    Science.gov (United States)

    ... more: Key Types of Dementia , What Is Alzheimer's? , Alzheimer's Risk Factors Symptoms back to top Experts classify Mild cognitive ... in Chronic Traumatic Encephalopathy 2014 Thor Stein Genetic Risk Factors Underlying Chronic Trauma and Alzheimer's Disease Pathology 2014 Kun Ping Lu Validation of ...

  5. Mild cognitive impairment. Diagnostic value of different MR techniques

    International Nuclear Information System (INIS)

    Hauser, T.; Stieltjes, B.; Essig, M.; Thomann, P.A.

    2011-01-01

    In view of an increasingly aging population the prevalence of dementia is also expected to increase rapidly. As well as clinical, neuropsychological and laboratory procedures magnetic resonance imaging (MRI) plays an important role in the early diagnosis of dementia which is important in the precursor stage of mild cognitive impairment (MCI). On the one hand this stage is associated with an increased risk of dementia and on the other hand an early treatment in this stage could attenuate development of the disease. In addition to morphological changes different functional MRI techniques can help in the early diagnosis of dementia and the precursor stages. Moreover, it is important to detect those MCI patients who are at particularly risk for developing dementia. In the differentiation of converters to non-converters initial studies suggest that particularly voxel-based morphometry, MR spectroscopy and diffusion tensor imaging can provide important additional information. (orig.) [de

  6. Impairment in Proverb Interpretation as an Executive Function Deficit in Patients with Amnestic Mild Cognitive Impairment and Early Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Thomas Leyhe

    2011-01-01

    Full Text Available Background/Aims: Proverb interpretation is assumed to reflect executive functions. We hypothesized that proverb interpretation is impaired in patients with amnestic mild cognitive impairment (aMCI diagnosed as single-domain impairment by common neuropsychological testing. Methods: We compared performance in a proverb interpretation test in single-domain aMCI patients and patients with early Alzheimer’s disease (EAD. Results: The groups with aMCI and EAD performed significantly worse than healthy controls. Both patient groups gave concrete answers with a similar frequency. However, patients with EAD tended to give senseless answers more frequently. Conclusions: Our data suggest that in patients diagnosed as single-domain aMCI, deterioration of executive functions is detectable with subtle and appropriate neuropsychological testing. Implementation of these procedures may improve the early prediction of AD.

  7. Semantic memory impairment for biological and man-made objects in individuals with amnestic mild cognitive impairment or late-life depression.

    Science.gov (United States)

    Callahan, Brandy L; Joubert, Sven; Tremblay, Marie-Pier; Macoir, Joël; Belleville, Sylvie; Rousseau, François; Bouchard, Rémi W; Verret, Louis; Hudon, Carol

    2015-06-01

    Amnestic mild cognitive impairment (aMCI) and late-life depression (LLD) both increase the risk of developing Alzheimer disease (AD). Very little is known about the similarities and differences between these syndromes. The present study addresses this issue by examining the nature of semantic memory impairment (more precisely, object-based knowledge) in patients at risk of developing AD. Participants were 17 elderly patients with aMCI, 18 patients with aMCI plus depressive symptoms (aMCI/D+), 15 patients with LLD, and 29 healthy controls. All participants were aged 55 years or older and were administered a semantic battery designed to assess semantic knowledge for 16 biological and 16 man-made items. Overall performance of aMCI/D+ participants was significantly worse than the 3 other groups, and performance for questions assessing knowledge for biological items was poorer than for questions relating to man-made items. This study is the first to show that aMCI/D+ is associated with object-based semantic memory impairment. These results support the view that semantic deficits in aMCI are associated with concomitant depressive symptoms. However, depressive symptoms alone do not account exclusively for semantic impairment, since patients with LLD showed no semantic memory deficit. © The Author(s) 2014.

  8. Impact of Depressive Symptoms on Memory for Emotional Words in Mild Cognitive Impairment and Late-Life Depression.

    Science.gov (United States)

    Callahan, Brandy L; Simard, Martine; Mouiha, Abderazzak; Rousseau, François; Laforce, Robert; Hudon, Carol

    2016-03-22

    Amnestic mild cognitive impairment (aMCI) and late-life depression (LLD) are associated with increased risk of Alzheimer's disease (AD). This is also true for aMCI with concomitant depressive symptoms (aMCI/D+), but few studies have investigated this syndrome. We aimed to clarify the association between cognitive and depressive symptoms in individuals at risk for AD by examining episodic memory for emotional stimuli in aMCI, aMCI/D+, and LLD. Participants were 34 patients with aMCI, 20 patients with aMCI/D+, 19 patients with LLD, and 28 healthy elderly adults. In an implicit encoding task, participants rated the emotional valence of 12 positive, 12 negative, and 12 neutral words. Immediately and 20 minutes later, participants recalled as many words as possible. They were also asked to identify previously presented words during a yes/no recognition trial. At immediate recall, aMCI participants displayed better recall of emotional words, particularly positive words. aMCI/D+ and control participants displayed better recall of positive and negative words compared to neutral words. LLD participants recalled more negative than neutral words. At delayed recall, emotional words were generally better-remembered than neutral words by all groups. At recognition, all subjects responded more liberally to emotional than to neutral words. We find that the type of emotional information remembered by aMCI patients at immediate recall depends on the presence or absence of depressive symptoms. These findings contribute to identifying sources of heterogeneity in individuals at risk for AD, and suggest that the cognitive profile of aMCI/D+ is different from that of aMCI and LLD. Future studies should systematically consider the presence of depressive symptoms in elderly at-risk individuals.

  9. Subjective memory complaints, depressive symptoms and instrumental activities of daily living in mild cognitive impairment.

    Science.gov (United States)

    Ryu, Seon Young; Lee, Sang Bong; Kim, Tae Woo; Lee, Taek Jun

    2016-03-01

    The diagnostic relevance of subjective memory complaints (SMCs) in mild cognitive impairment (MCI) remains to be unresolved. The aim of this study is to determine clinical correlates of SMCs in MCI. Furthermore, we examined whether there are the differences due to different aspects of complaints (i.e. prospective memory (PM) versus retrospective memory (RM) complaints). We examined the cross-sectional associations between SMCs and depressive symptoms, instrumental activities of daily living (IADL), and cognitive measures in sixty-six individuals with MCI (mean age: 65.7 ± 8.01 years). The criteria for MCI included SMCs, objective cognitive impairment, normal general cognitive function, largely intact functional activities, and absence of dementia. SMCs were assessed using the Prospective and Retrospective Memory Questionnaire (PRMQ), which contains 16 items describing everyday memory failure of both PM and RM. SMC severity (i.e. PRMQ total score) was associated with stronger depressive symptoms and worse IADL performance. SMCs were not related to cognitive measures. For PM and RM subscores, both depressive symptoms and IADL were related to the PRMQ-PM and -RM scores. The main contributors to these PM and RM scores were depressive symptoms and IADL impairment, respectively. This study suggests that SMCs are more associated with depressive symptoms and IADL problems than with cognitive performance in individuals with MCI. Furthermore, while PM and RM complaints are related to both depressive symptoms and IADL, the differences between these main contributors suggest that RM complaints based on IADL could be more associated with the organically driven pathological features of MCI.

  10. The association between APOE genotype and memory dysfunction in subjects with mild cognitive impairment is related to age and Alzheimer pathology

    NARCIS (Netherlands)

    Ramakers, I.H.G.B.; Visser, P.J.; Aalten, P.; Bekers, O.; Sleegers, K.; van Broeckhoven, C.L.; Jolles, J.; Verhey, F. R. J.

    2008-01-01

    Background: Memory problems are a main feature of mild cognitive impairment (MCI) and may be related to the apolipoprotein E (APOE) ε4 allele. We investigated whether the effect of the APOE genotype on memory in subjects with MCI was dependent on age and underlying Alzheimer disease (AD) pathology.

  11. Decline in Weight and Incident Mild Cognitive Impairment: Mayo Clinic Study of Aging

    Science.gov (United States)

    Alhurani, Rabe E.; Vassilaki, Maria; Aakre, Jeremiah; Mielke, Michelle M.; Kremers, Walter K.; Machulda, Mary M.; Geda, Yonas E.; Knopman, David S.; Peterson, Ronald C.; Roberts, Rosebud O.

    2016-01-01

    IMPORTANCE Unintentional weight loss has been associated with risk of dementia. Since mild cognitive impairment (MCI) is a prodromal stage for dementia, we sought to evaluate whether changes in weight and body mass index (BMI) may predict incident MCI. OBJECTIVE To investigate the association of change in weight and BMI with risk of MCI. DESIGN, SETTING, AND PARTICIPANTS A population-based, prospective study of participants aged 70 years and older from the Mayo Clinic Study of Aging. Maximum weight and height in midlife (aged 40 to 65 years old) were retrospectively ascertained from the medical records of participants using a medical records linkage system. MAIN OUTCOMES MEASURES Participants were evaluated for cognitive outcomes of normal cognition, MCI, or dementia at baseline and prospectively assessed for incident events at each 15-month evaluation. The association of rate of change in weight and body mass index with risk of MCI was investigated using proportional hazards models. RESULTS Over a mean follow-up of 4.4 years, 524 of 1895 cognitively normal participants developed incident MCI. The mean (standard deviation) rate of weight change per decade from midlife to study entry was greater for individuals who developed incident MCI vs. those who remained cognitively normal (−2.0 (5.1) vs. −1.2 (4.9) kg; p = 0.006). A greater decline in weight per decade was associated with an increased risk of incident MCI (hazard ratio [HR] 95% confidence interval [CI], 1.04 [1.02, 1.06], p weight loss of 5 kg/decade corresponds to a 24% increase in risk of MCI (HR=1.24). Higher decline in BMI per decade was also associated with incident MCI (HR, 1.08, 95% CI = [1.03, 1.13], p = 0.003). CONCLUSIONS AND RELEVANCE These findings suggest that declining weight from midlife to late-life is a marker for MCI and may help identify persons at increased risk for MCI. PMID:26831542

  12. Cognitive impairment of dementias

    OpenAIRE

    Medina, L. D.; Rodríguez-Agudelo, Yaneth

    2012-01-01

    Dementia is a clinical syndrome characterized by a loss of cognitive and emotional abilities of sufficient severity to infer with social or occupational functioning, or both. Although the causes of dementia and characteristics are not always fully understood, it is understood that it is not a natural part of aging. Definitive diagnosis of dementia is made only through the autopsy and although the diagnosis of probable or possible dementia is complex is achieved by the intervention of several ...

  13. Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

    Directory of Open Access Journals (Sweden)

    Ya-Ting Chang

    2018-01-01

    Full Text Available Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI, we investigated the clinical significance of salience network (SN in depression and cognitive performance.Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS: PD-MCI with depression (PD-MCI-D or without depression (PD-MCI-ND. The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores.Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046.Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

  14. Salience Network and Depressive Severities in Parkinson’s Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis

    Science.gov (United States)

    Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

    2018-01-01

    Purpose: In Parkinson’s disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI. PMID:29375361

  15. Salience Network and Depressive Severities in Parkinson's Disease with Mild Cognitive Impairment: A Structural Covariance Network Analysis.

    Science.gov (United States)

    Chang, Ya-Ting; Lu, Cheng-Hsien; Wu, Ming-Kung; Hsu, Shih-Wei; Huang, Chi-Wei; Chang, Wen-Neng; Lien, Chia-Yi; Lee, Jun-Jun; Chang, Chiung-Chih

    2017-01-01

    Purpose: In Parkinson's disease with mild cognitive impairment (PD-MCI), we investigated the clinical significance of salience network (SN) in depression and cognitive performance. Methods: Seventy seven PD-MCI patients that fulfilled multi-domain and non-amnestic subtype were included. Gray matter structural covariance networks were constructed by 3D T1-magnetic resonance imaging and seed based analysis. The patients were divided into two groups by psychiatric interviews and screening of Geriatric Depression Scale (GDS): PD-MCI with depression (PD-MCI-D) or without depression (PD-MCI-ND). The seed or peak cluster volume, or the significant differences in the regression slopes in each seed-peak cluster correlation, were used to evaluate the significance with the neurobehavioral scores. Results: This study is the first to demonstrate that the PD-MCI-ND group presented a larger number of voxels of structural covariance in SN than the PD-MCI-D group. The right fronto-insular seed volumes and the peak cluster of left lingual gyrus showed significant inverse correlation with the Geriatric Depression Scale (GDS; r = -0.231, P = 0.046). Conclusions: This study is the first to validate the clinical significance of the SN in PD-MCI-D. The right insular seed value and the SN correlated with the severity of depression in PD-MCI.

  16. Spatial working memory in aging and mild cognitive impairment: effects of task load and contextual cueing.

    NARCIS (Netherlands)

    Kessels, R.P.C.; Meulenbroek, O.V.; Fernandez, G.S.E.; Olde Rikkert, M.G.M.

    2010-01-01

    Mild Cognitive Impairment (MCI) is characterized by episodic memory deficits, while aspects of working memory may also be implicated, but studies into this latter domain are scarce and results are inconclusive. Using a computerized search paradigm, this study compares 25 young adults, 25 typically

  17. Spatial Working Memory in Aging and Mild Cognitive Impairment: Effects of Task Load and Contextual Cueing

    NARCIS (Netherlands)

    Kessels, R.P.C.; Meulenbroek, O.V.; Fernandez, G.S.E.; Olde Rikkert, M.G.M.

    2010-01-01

    Mild Cognitive Impairment (MCI) is characterized by episodic memory deficits, while aspects of working memory may also be implicated, but studies into this latter domain are scarce and results are inconclusive. Using a computerized search paradigm, this study compares 25 young adults, 25 typically

  18. Morphometric connectivity analysis to distinguish normal, mild cognitive impaired, and Alzheimer subjects based on brain MRI

    DEFF Research Database (Denmark)

    Erleben, Lene Lillemark; Sørensen, Lauge; Mysling, Peter

    2013-01-01

    This work investigates a novel way of looking at the regions in the brain and their relationship as possible markers to classify normal control (NC), mild cognitive impaired (MCI), and Alzheimer Disease (AD) subjects. MRI scans from a subset of 101 subjects from the ADNI study at baseline was used...

  19. Propositional Density in Spoken and Written Language of Czech-Speaking Patients with Mild Cognitive Impairment

    Science.gov (United States)

    Smolík, Filip; Stepankova, Hana; Vyhnálek, Martin; Nikolai, Tomáš; Horáková, Karolína; Matejka, Štepán

    2016-01-01

    Purpose Propositional density (PD) is a measure of content richness in language production that declines in normal aging and more profoundly in dementia. The present study aimed to develop a PD scoring system for Czech and use it to compare PD in language productions of older people with amnestic mild cognitive impairment (aMCI) and control…

  20. Biological Factors Contributing to the Response to Cognitive Training in Mild Cognitive Impairment.

    Science.gov (United States)

    Peter, Jessica; Schumacher, Lena V; Landerer, Verena; Abdulkadir, Ahmed; Kaller, Christoph P; Lahr, Jacob; Klöppel, Stefan

    2018-01-01

    In mild cognitive impairment (MCI), small benefits from cognitive training were observed for memory functions but there appears to be great variability in the response to treatment. Our study aimed to improve the characterization and selection of those participants who will benefit from cognitive intervention. We evaluated the predictive value of disease-specific biological factors for the outcome after cognitive training in MCI (n = 25) and also considered motivation of the participants. We compared the results of the cognitive intervention group with two independent control groups of MCI patients (local memory clinic, n = 20; ADNI cohort, n = 302). The primary outcome measure was episodic memory as measured by verbal delayed recall of a 10-word list. Episodic memory remained stable after treatment and slightly increased 6 months after the intervention. In contrast, in MCI patients who did not receive an intervention, episodic memory significantly decreased during the same time interval. A larger left entorhinal cortex predicted more improvement in episodic memory after treatment and so did higher levels of motivation. Adding disease-specific biological factors significantly improved the prediction of training-related change compared to a model based simply on age and baseline performance. Bootstrapping with resampling (n = 1000) verified the stability of our finding. Cognitive training might be particularly helpful in individuals with a bigger left entorhinal cortex as individuals who did not benefit from intervention showed 17% less volume in this area. When extended to alternative treatment options, stratification based on disease-specific biological factors is a useful step towards individualized medicine.

  1. Source Memory for Self and Other in Patients With Mild Cognitive Impairment due to Alzheimer’s Disease

    Science.gov (United States)

    Deason, Rebecca G.; Budson, Andrew E.; Gutchess, Angela H.

    2016-01-01

    Objectives. The present study examined the role of enactment in source memory in a cognitively impaired population. As seen in healthy older adults, it was predicted that source memory in people with mild cognitive impairment due to Alzheimer’s disease (MCI-AD) would benefit from the self-reference aspect of enactment. Method. Seventeen participants with MCI-AD and 18 controls worked in small groups to pack a picnic basket and suitcase and were later tested for their source memory for each item. Results. For item memory, self-referencing improved corrected recognition scores for both MCI-AD and control participants. The MCI-AD group did not demonstrate the same benefit as controls in correct source memory for self-related items. However, those with MCI-AD were relatively less likely to misattribute new items to the self and more likely to misattribute new items to others when committing errors, compared with controls. Discussion. The enactment effect and self-referencing did not enhance accurate source memory more than other referencing for patients with MCI-AD. However, people with MCI-AD benefited in item memory and source memory, being less likely to falsely claim new items as their own, indicating some self-reference benefit occurs for people with MCI-AD. PMID:24904049

  2. Association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment in type 2 diabetic patients.

    Science.gov (United States)

    Huang, Rong; Han, Jing; Tian, Sai; Cai, Rongrong; Sun, Jie; Shen, Yanjue; Wang, Shaohua

    2017-02-28

    People with insulin resistance and type 2 diabetes mellitus (T2DM) are at increased risks of cognitive impairment. We aimed to investigate the association of plasma ghrelin levels and ghrelin rs4684677 polymorphism with mild cognitive impairment (MCI) in T2DM patients. In addition to elevated glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG) and homeostasis model assessment of insulin resistance (HOMA-IR), T2DM patients with MCI had decreased plasma ghrelin levels compared with their healthy-cognition subjects (all p ghrelin level was one of independent factors for MCI in T2DM patients (p ghrelin levels were positively associated with the scores of Montreal Cognitive Assessment (r = 0.196, p = 0.041) and Auditory Verbal Learning Test-delayed recall (r = 0.197, p = 0.040) after adjustment for HbA1c, FBG and HOMA-IR, wherein the latter represented episodic memory functions. No significant differences were found for the distributions of genotype and allele of ghrelin rs4684677 polymorphism between MCI and control group. A total of 218 T2DM patients, with 112 patients who satisfied the MCI diagnostic criteria and 106 who exhibited healthy cognition, were enrolled in this study. Demographic characteristics, clinical variables and cognitive performances were extensively assessed. Plasma ghrelin levels and ghrelin rs4684677 polymorphism were also determined. Our results suggest that decreased ghrelin levels are associated with MCI, especially with episodic memory dysfunction in T2DM populations.

  3. Validation of the Chinese version of Addenbrooke's cognitive examination-revised for screening mild Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Fang, Rong; Wang, Gang; Huang, Yue; Zhuang, Jun-Peng; Tang, Hui-Dong; Wang, Ying; Deng, Yu-Lei; Xu, Wei; Chen, Sheng-Di; Ren, Ru-Jing

    2014-01-01

    As a suitable test to screen for Alzheimer's disease (AD) or mild cognitive impairment (MCI), studies to validate the Chinese version of Addenbrooke's Cognitive Examination-Revised (ACE-R) are rare. A total of 151 subjects were recruited and the neuropsychological assessments were employed. One-way analysis of variance and Bonferroni correction were used to compare scores of different psychometric scales. Intraclass correlation coefficient (ICC) and Cronbach's coefficient α were used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for mild AD and amnestic subtype of MCI (a-MCI) was assessed by receiver operating characteristic (ROC) curves. The Chinese ACE-R had good reliability (inter-rater ICC = 0.994; test-retest ICC = 0.967) as well as reliable internal consistency (Cronbach's coefficient α = 0.859). With its cutoff of 67/68, the sensitivity (0.920) and specificity (0.857) were lower than for the Mini-Mental State Examination (MMSE) cutoff (sensitivity 1.000 and specificity 0.937) to screen for mild AD. However, the sensitivity of ACE-R to screen for a-MCI was superior to the MMSE with a cutoff of 85/86. The specificity of ACE-R was lower than that of the MMSE to screen for a-MCI. The area under the ROC curve of ACE-R was much larger than that of the MMSE (0.836 and 0.751) for detecting a-MCI rather than mild AD. The Chinese ACE-R is a reliable assessment tool for cognitive impairment. It is more sensitive and accurate in screening for a-MCI rather than for AD compared to the MMSE.

  4. Frontal lobe hypoperfusion in mild cognitive impairment patients

    International Nuclear Information System (INIS)

    Liao, S.Q.; Chung, C.P.; Liao, Y.C.; Wang, P.N.; Lee, Y.C.; Liu, H.C.; Liu, R.S.

    2004-01-01

    Objective: Mild cognitive impairement (MCI) refers to the clinical state of individuals who are memory impaired subjectively but are functioning well and do not meet the criteria of dementia. MCI subjects have a high risk of progressing to Alzheimer's disease (AD). It is important to detect the earliest evidence of AD for clinicians to recognize the high risk subjects and to implicate the therapy. The aim of this study was to assess the early change of regional cerebral blood flow (rCBF) in MCI with high risk of AD by SPECT. Methods: Subjects complained of memory impairment with normal cognitive function and intact daily activities were enrolled. Each patient underwent 99mTc-HMPAO SPECT at the time of initial evaluation. Patients were followed for one to five years. The diagnosis of AD was based on the criteria of the Alzheimer's Disease and Related Disorders Association. There were 8 patients (4 males, 4 females; age range, 64-80 yrs; mean, 73.5 yrs) progressing to AD within one year. Ten gender and age matched normal control subjects (NC) were also included. The SPECT images were analyzed by using SPM 99. The image data were transformed into a standard stereotactic space, using a 12-parameter linear and 2x2x2 nonlinear spatial normalization with the template image. Group comparisons of the SPECT images between the 8 rapid AD converters and 10 NCs were performed on a voxel-by-voxel basis using t test. The t statistics was transformed to a normal statistic yielding a Z score for every voxel. Results: In 8 rapid AD converters, rCBF in the right medial frontal gyms (Brodmann area 10; BA 10), anterior cingulated gyms (BA 32) and middle frontal gyms (BA 46) was significantly lower than in NCs (p<0.001). The neuropsychological performances of these 8 cases revealed decrement in short-term memory, mental manipulation and list-generation frequency. Conclusions: rCBF is decreased in right medial frontal, anterior cingulated and middle frontal gyms in MCI patients who

  5. Anxiety and behavioural disturbance as markers of prodromal Alzheimer's disease in patients with mild cognitive impairment.

    LENUS (Irish Health Repository)

    Gallagher, Damien

    2011-02-01

    Depression and anxiety have been reported to be independently predictive of conversion to Alzheimer\\'s disease (AD) in patients with mild cognitive impairment (MCI). Anxiety symptoms have been less well studied and findings in this regard have been inconsistent. The objectives of this study are to determine which symptoms among a range of neuropsychiatric symptoms known to commonly occur in patients with MCI are predictive of later conversion to AD. We also wish to determine whether these symptoms track existing measures of declining cognitive and functional status or may be considered distinct and sensitive biomarkers of evolving Alzheimer\\'s pathology.

  6. Reduced 5-HT2A receptor binding in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Hasselbalch, S G; Madsen, K; Svarer, C

    2008-01-01

    cerebral 5-HT(2A) receptor binding in patients with mild cognitive impairment (MCI) and related 5-HT(2A) receptor binding to clinical symptoms. Sixteen patients with MCI of the amnestic type (mean age 73, mean MMSE 26.1) and 17 age and sex matched control subjects were studied with MRI and [(18)F......Previous studies of patients with Alzheimer's disease (AD) have described reduced brain serotonin 2A (5-HT(2A)) receptor density. It is unclear whether this abnormality sets in early in the course of the disease and whether it is related to early cognitive and neuropsychiatric symptoms. We assessed...

  7. Event-related potentials elicited during working memory are altered in mild cognitive impairment.

    Science.gov (United States)

    López Zunini, Rocío A; Knoefel, Frank; Lord, Courtney; Dzuali, Fiatsogbe; Breau, Michael; Sweet, Lisa; Goubran, Rafik; Taler, Vanessa

    2016-11-01

    Persons with Mild Cognitive Impairment (MCI) can experience deficits in working memory. In the present study, we investigated working memory in persons with MCI and cognitively healthy older adults using event-related potentials (ERPs). Participants performed an n-back working memory task with baseline (0-back), low load (1-back), and high load (2-back) working memory conditions. MCI participants' performance was less accurate than that of healthy older adults in both the 1-back and 2-back conditions, and reaction times were longer in MCI than control participants in the 0-back, 1-back and 2-back conditions. ERP analyses revealed delayed P200 and N200 latencies and smaller P300 amplitudes in MCI relative to control participants in the 0-back, 1-back and 2-back conditions. Deterioration in working memory performance concomitant with marked electrophysiological alterations suggests that persons with MCI exhibit deficits in several cognitive processes that include early attention, stimulus discrimination and classification, and updating and manipulation of information held in working memory. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Acetylcholine esterase activity in mild cognitive impairment and Alzheimer's disease

    International Nuclear Information System (INIS)

    Herholz, Karl

    2008-01-01

    Impairment of cholinergic neurotransmission is a well-established fact in Alzheimer's disease (AD), but there is controversy about its relevance at the early stages of the disease and in mild cognitive impairment (MCI). In vivo positron emission tomography imaging of cortical acetylcholine esterase (AChE) activity as a marker of cholinergic innervation that is expressed by cholinergic axons and cholinoceptive neurons has demonstrated a reduction of this enzyme activity in manifest AD. The technique is also useful to measure the inhibition of cerebral AChE induced by cholinesterase inhibitors for treatment of dementia symptoms. A reduction of cortical AchE activity was found consistently in all studies of AD and in few cases of MCI who later concerted to AD. The in vivo findings in MCI and very mild AD are still preliminary, and studies seem to suggest that cholinergic innervation and AChE as the main degrading enzyme are both reduced, which might result in partial compensation of their effect. (orig.)

  9. Current therapy for cognitive impairments

    OpenAIRE

    Natalia Vasilyevna Vakhnina

    2011-01-01

    Cognitive impairments (CIs) are a highly common type of neurological disorders particularly in elderly patients. Choice of a therapeutic strategy for CI is determined by the etiology of abnormalities and their degree. Measures to prevent CI progression and dementia: adequate treatment of existing cardiovascular diseases, prevention of stroke, balanced nutrition, moderate physical and intellectual exercises, and combatting overweight and low activity are of ba...

  10. Mortality in Mild Cognitive Impairment Diagnosed with DSM-5 Criteria and with Petersen's Criteria: A 17-Year Follow-Up in a Community Study.

    Science.gov (United States)

    Santabárbara, Javier; Gracia-García, Patricia; Pírez, Guillermo; López-Antón, Raúl; De La Cámara, Concepcion; Ventura, Tirso; Pérez-Sastre, Marina; Lobo, Elena; Saz, Pedro; Marcos, Guillermo; Lobo, Antonio

    2016-11-01

    To explore the possibility that the mortality risk of mild cognitive impairment (MCI) as diagnosed using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria (DSM-5-MCI) will be higher than using Petersen's criteria (P-MCI) and to report the population-attributable fraction (PAF) of mortality due to MCI. A representative community sample of 4,803 individuals aged 55 or more years was interviewed and then followed for 17 years. Standardized instruments were used in the assessment, including the Geriatric Mental State-AGECAT, and research psychiatrists diagnosed P-MCI and DSM-5-MCI cases following operationalized criteria. Mortality information was obtained from the official population registry. Kaplan-Meier age-adjusted survival curves were built for the MCI diagnostic groups, and Cox proportional hazards regression models were used to calculate the hazard ratio of death in participants with MCI relative to those without. We also estimated the PAF of mortality due to specific MCI diagnostic groups. Compared with noncases, the mortality rate ratio was approximately double in DSM-5-MCI individuals (2.3) than in P-MCI individuals (1.2). In the multivariate statistical analysis, a significant association between each diagnostic category and mortality was observed but was only maintained in the final model in DSM-5-MCI cases (hazard ratio: 1.24). The PAF of mortality due to MCI was approximately 1% in both MCI categories. The mortality risk in comparison with noncases was higher in DSM-5-MCI than in P-MCI. The PAF of mortality in DSM-5-MCI individuals was ~ 1% over a 17-year period. Copyright © 2016. Published by Elsevier Inc.

  11. Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: A review of the literature

    Directory of Open Access Journals (Sweden)

    Eliane Correa Miotto

    Full Text Available Abstract Neuropsychological rehabilitation is related to the treatment or optimization of disabilities, handicaps and cognitive deficiencies including emotional, behavioral and personality alterations, aiming at the best cognitive, neurobiological and social re-adaptation. Objective: The main aim of this paper is to review scientific studies published over the last five years on cognitive training with rehabilitation, focusing on elderly subjects with cognitive complaints and patients diagnosed with MCI. Methods: Data were generated from Medline, PsychoInfo and EMBASE including publications from 2002 to 2007 using the search terms "Mild Cognitive Impairment", "Cognitive Complaints", "Rehabilitation" and "Intervention Studies". Data collection criteria were restricted to the quality of evidence Class I. Results: Eight articles out of sixty eight previously selected were chosen because of their randomized studies, including techniques of cognitive rehabilitation in patients with cognitive complaints, MCI and neuropsychological training. Conclusions: The studies showing generalization of rehabilitation techniques to practical real life situations and use of an errorless learning approach were considered more effective in terms of maintaining treatment follow up, although further studies are recommended.

  12. Brief screening for mild cognitive impairment in subcortical ischemic vascular disease: a comparison study of the Montreal Cognitive Assessment with the Mini-Mental State Examination.

    Science.gov (United States)

    Xu, Qun; Cao, Wen-wei; Mi, Jian-hua; Yu, Ling; Lin, Yan; Li, Yan-sheng

    2014-01-01

    To assess the validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in the detection of vascular mild cognitive impairment (VaMCI) in patients with subcortical ischemic vascular disease (SIVD). Among 102 SIVD patients, both cutoff scores of the MMSE and MoCA for differentiating VaMCI from no cognitive impairment (NCI) or differentiating VaMCI from vascular dementia (VaD) were determined by the receiver operator characteristic (ROC) analysis. Optimal sensitivity with specificity of cutoff scores was obtained after the raw scores were adjusted for education. After adjusting for education, the MoCA cutoff score for differentiating VaMCI from NCI was at 24/25 and that for differentiating VaMCI from VaD was at 18/19. After applying the adjusted MoCA scores from 19 to 24 to identify VaMCI in all SIVD patients, sensitivity was at 76.7% and specificity was at 81.4% (κ = 0.579). The adjusted cutoff score of the MMSE for differentiating VaMCI from NCI was at 28/29 and that for differentiating VaMCI from VaD was at 25/26. The sensitivity and specificity of the adjusted MMSE was at 58.1 and 71.2%, respectively, when using the score from 26 to 28 to identify VaMCI in SIVD patients (κ = 0.294). The MoCA detected subcortical VaMCI better than the MMSE. © 2013 S. Karger AG, Basel.

  13. Spatial working memory in aging and mild cognitive impairment: effects of task load and contextual cueing.

    Science.gov (United States)

    Kessels, Roy P C; Meulenbroek, Olga; Fernández, Guillén; Olde Rikkert, Marcel G M

    2010-09-01

    Mild Cognitive Impairment (MCI) is characterized by episodic memory deficits, while aspects of working memory may also be implicated, but studies into this latter domain are scarce and results are inconclusive. Using a computerized search paradigm, this study compares 25 young adults, 25 typically aging older adults and 15 amnestic MCI patients as to their working-memory capacities for object-location information and potential differential effects of memory load and additional context cues. An age-related deficit in visuospatial working-memory maintenance was found that became more pronounced with increasing task demands. The MCI group additionally showed reduced maintenance of bound information, i.e., object-location associations, again especially at elevated memory load. No effects of contextual cueing were found. The current findings indicate that working memory should be considered when screening patients for suspected MCI and monitoring its progression.

  14. Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease.

    Science.gov (United States)

    Julayanont, Parunyou; Brousseau, Mélanie; Chertkow, Howard; Phillips, Natalie; Nasreddine, Ziad S

    2014-04-01

    To assess the usefulness of the Montreal Cognitive Assessment (MoCA) total score (MoCA-TS) and Memory Index Score (MoCA-MIS) in predicting conversion to Alzheimer's disease (AD) in individuals with mild cognitive impairment (MCI). Retrospective chart review. Community-based memory clinic. Individuals meeting Petersen's MCI criteria (N = 165). Baseline MoCA scores at MCI diagnosis were collected from charts of eligible individuals with MCI, and MoCA-TS, MoCA-MIS, and a cognitive domain index score were calculated to assess their prognostic value in predicting conversion to AD. One hundred fourteen participants progressed to AD (MCI-AD), and 51 did not (nonconverters; MCI-NC); 90.5% of participants with MCI with a MoCA-TS less than 20/30 and a MoCA-MIS less than 7/15 at baseline converted to AD within the average follow-up period of 18 months, compared with 52.7% of participants with MCI above the cutoffs on both scores. Individuals with multiple-domain amnestic MCI had the highest AD conversion rates (73.9%). Identifying individuals with MCI at high risk of conversion to AD is important clinically and for selecting appropriate subjects for therapeutic trials. Individuals with MCI with a low MoCA-TS and a low newly devised memory index score (MoCA-MIS) are at greater risk of short-term conversion to AD. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  15. Executive functions in mild cognitive impairment: emergence and breakdown of neural plasticity.

    Science.gov (United States)

    Clément, Francis; Gauthier, Serge; Belleville, Sylvie

    2013-05-01

    Our goal was to test the effect of disease severity on the brain activation associated with two executive processes: manipulation and divided attention. This was achieved by administrating a manipulation task and a divided attention task using functional magnetic resonance imaging to 24 individuals with mild cognitive impairment (MCI) and 14 healthy controls matched for age, sex and education. The Mattis Dementia Rating Scale was used to divide persons with MCI into those with better and worse cognitive performances. Both tasks were associated with more brain activation in the MCI group with higher cognition than in healthy controls, particularly in the left frontal areas. Correlational analyses indicated that greater activation in a frontostriatal network hyperactivated by the higher-cognition group was related with better task performance, suggesting that these activations may support functional reorganization of a compensatory nature. By contrast, the lower-cognition group failed to show greater cerebral hyperactivation than controls during the divided attention task and, during the manipulation task, and showed less brain activation than controls in the left ventrolateral cortex, a region commonly hypoactivated in patients with Alzheimer's disease. These findings indicate that, during the early phase of MCI, executive functioning benefits from neural reorganization, but that a breakdown of this brain plasticity characterizes the late stages of MCI. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Dual-tasking and gait in people with Mild Cognitive Impairment. The effect of working memory

    Directory of Open Access Journals (Sweden)

    Phillips Natalie A

    2009-09-01

    Full Text Available Abstract Background Cognition and mobility in older adults are closely associated and they decline together with aging. Studies evaluating associations between cognitive factors and gait performance in people with Mild Cognitive Impairment (MCI are scarce. In this study, our aim was to determine whether specific cognitive factors have a more identifiable effect on gait velocity during dual-tasking in people with MCI. Methods Fifty-five participants, mean age 77.7 (SD = 5.9, 45% women, with MCI were evaluated for global cognition, working memory, executive function, and attention. Gait Velocity (GV was measured under a single-task condition (single GV and under two dual-task conditions: 1 while counting backwards (counting GV, 2 while naming animals (verbal GV. Multivariable linear regression analysis was used to examine associations with an alpha-level of 0.05. Results Participants experienced a reduction in GV while engaging in dual-task challenges (p Conclusion In older adults with MCI, low working memory performance was associated with slow GV. Dual-task conditions showed the strongest associations with gait slowing. Our findings suggest that cortical control of gait is associated with decline in working memory in people with MCI.

  17. Oxidative stress and APO E polymorphisms in Alzheimer's disease and in mild cognitive impairment.

    Science.gov (United States)

    Chico, L; Simoncini, C; Lo Gerfo, A; Rocchi, A; Petrozzi, L; Carlesi, C; Volpi, L; Tognoni, G; Siciliano, G; Bonuccelli, U

    2013-08-01

    A number of evidences indicates oxidative stress as a relevant pathogenic factor in Alzheimer's disease (AD) and mild cognitive impairment (MCI). Considering its recognized major genetic risk factors in AD, apolipoprotein (APO E) has been investigated in several experimental settings regarding its role in the process of reactive oxygen species (ROS) generation. The aim of this work has been to evaluate possible relationships between APO E genotype and plasma levels of selected oxidative stress markers in both AD and MCI patients. APO E genotypes were determined using restriction enzyme analysis. Plasma levels of oxidative markers, advanced oxidation protein products, iron-reducing ability of plasma and, in MCI, activity of superoxide dismutases were evaluated using spectrophotometric analysis. We found, compared to controls, increased levels of oxidized proteins and decreased values of plasma-reducing capacity in both AD patients (p < 0.0001) and MCI patients (p < 0.001); the difference between AD and MCI patients was significant only for plasma-reducing capacity (p < 0.0001), the former showing the lowest values. Superoxide dismutase activity was reduced, although not at statistical level, in MCI compared with that in controls. E4 allele was statistically associated (p < 0.05) with AD patients. When comparing different APO E genotype subgroups, no difference was present, as far as advanced oxidation protein products and iron-reducing ability of plasma levels were concerned, between E4 and non-E4 carriers, in both AD and MCI; on the contrary, E4 carriers MCI patients showed significantly decreased (p < 0.05) superoxide dismutase activity with respect to non-E4 carriers. This study, in confirming the occurrence of oxidative stress in AD and MCI patients, shows how it can be related, at least for superoxide dismutase activity in MCI, to APO E4 allele risk factor.

  18. Role of inflammatory markers in Elderly Type 2 Diabetic Patients with Mild Cognitive Impairment.

    Science.gov (United States)

    Hosny, Salwa S; Bahaaeldin, Ahmed M; Khater, Mohamed S; Bekhet, Meram M; Hebah, Hayam A; Hasanin, Ghada A

    2018-04-22

    Type 2 diabetes (T2DM) is a risk factor for Alzheimer's disease and mild cognitive impairment. The etiology of cognitive impairment in people with T2DM is uncertain but, chronic hyperglycemia, cerebral micro vascular disease, severe hypoglycemia, and increased prevalence of macro vascular disease are implicated. to determine the serum levels of soluble vascular adhesion molecule (sVCAM-1) and highly sensitive C-reactive protein (hs-CRP) in elderly type 2 diabetics with mild cognitive impairment (MCI). Our study was conducted on 90 elderly subjects (aged 60 years old or more). They were divided into Group І, 30 patients with T2DM and mild cognitive impairment, group ІІ, 30 patients with T2DM without cognitive impairment and group III, 30 healthy subjects as a control group. They were subjected to history taking, full clinical examination, anthropometric measurement, the Addenbrooke's Cognitive Examination III (ACE---III 2012), Fasting plasma glucose, 2 hours plasma glucose, HbA1c, lipid profile, protein/creatinine ratio, serum sVCAM-1 and hs-CRP. Serum levels of sVCAM-1 in diabetic elderly patients with MCI were significantly higher (946.7 ± 162.01 ng/ml) than diabetic elderly patients without cognitive impairment (479.06 ± 65.27 ng/ml) and control (263.7 ± 72.05 ng/ml) with (P=0.002). Serum levels of Hs-CRP in diabetic elderly patients with MCI were significantly higher than as diabetic elderly patients without cognitive impairment and control with (P=0.005). Elderly diabetic patients with mild cognitive impairment, have higher levels of soluble adhesion molecules and markers of low-grade systemic inflammation than other groups. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  19. Skin Autofluorescence Examination as a Diagnostic Tool for Mild Cognitive Impairment in Healthy People.

    Science.gov (United States)

    Igase, Michiya; Ohara, Maya; Igase, Keiji; Kato, Takeaki; Okada, Yoko; Ochi, Masayuki; Tabara, Yasuharu; Kohara, Katsuhiko; Ohyagi, Yasumasa

    2017-01-01

    Accumulation of advanced glycation endproducts (AGEs) is thought to be involved in the pathogenesis of dementia, especially Alzheimer's disease. Tissue AGE accumulation can be estimated using the relative simple noninvasive measurement of skin autofluorescence (SAF), a method based on the fluorescent properties of some AGEs. However, possible involvement of tissue AGE accumulation in mild cognitive impairment (MCI) has not been fully investigated. We investigated whether tissue AGE accumulation estimated by SAF is associated with mild cognitive impairment. We analyzed 226 community-dwelling subjects. In addition to several atherosclerosis-related clinical parameters, MCI screening test, assessment of brain atrophy, and SAF were performed on people aged > 40 years. MCI was assessed using the Japanese version of the MCI screening method. Atrophy of the brain was assessed by examining the temporal horn area (THA) by brain MRI. SAF was significantly higher in participants with MCI than in those with normal cognitive function (2.56±0.55 versus 2.10±0.41; p  2.27 was significantly related to the presence of MCI (odds, 6.402; 95% CI, 1.590-25.773, p = 0.009). We found an association between SAF and MCI, which was independent of brain atrophy, in healthy subjects.

  20. Structural brain differences between monolingual and multilingual patients with mild cognitive impairment and Alzheimer disease: Evidence for cognitive reserve.

    Science.gov (United States)

    Duncan, Hilary D; Nikelski, Jim; Pilon, Randi; Steffener, Jason; Chertkow, Howard; Phillips, Natalie A

    2018-01-31

    Two independent lines of research provide evidence that speaking more than one language may 1) contribute to increased grey matter in healthy younger and older adults and 2) delay cognitive symptoms in mild cognitive impairment (MCI) or Alzheimer disease (AD). We examined cortical thickness and tissue density in monolingual and multilingual MCI and AD patients matched (within Diagnosis Groups) on demographic and cognitive variables. In medial temporal disease-related (DR) areas, we found higher tissue density in multilingual MCIs versus monolingual MCIs, but similar or lower tissue density in multilingual AD versus monolingual AD, a pattern consistent with cognitive reserve in AD. In areas related to language and cognitive control (LCC), both multilingual MCI and AD patients had thicker cortex than the monolinguals. Results were largely replicated in our native-born Canadian MCI participants, ruling out immigration as a potential confound. Finally, multilingual patients showed a correlation between cortical thickness in LCC regions and performance on episodic memory tasks. Given that multilinguals and monolinguals were matched on memory functioning, this suggests that increased gray matter in these regions may provide support to memory functioning. Our results suggest that being multilingual may contribute to increased gray matter in LCC areas and may also delay the cognitive effects of disease-related atrophy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Apraxia for differentiating Alzheimer’s disease from subcortical vascular dementia and mild cognitive impairment

    Directory of Open Access Journals (Sweden)

    Ozkan S

    2013-07-01

    Full Text Available Serhat Ozkan,1 Demet Ozbabalik Adapinar,1 Nese Tuncer Elmaci,2 Didem Arslantas31Department of Neurology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey; 2Department of Neurology, Marmara University Medical Faculty, Istanbul, Turkey; 3Department of Public Health, Eskisehir Osmangazi University Medical Faculty, Eskisehir, TurkeyAbstract: Although ideomotor limb apraxia is considered to be a typical sign of cortical pathologies such as Alzheimer’s disease (AD, it has been also reported in subcortical neurodegenerative diseases and vascular lesions. We aimed to investigate the difference between AD, subcortical vascular dementia (SVaD and mild cognitive impairment (MCI patients by means of ideomotor limb apraxia frequency and severity. Ninety-six AD, 72 SVaD, and 84 MCI patients were assessed with the mini-mental status examination (MMSE, clinical dementia rating (CDR and the apraxia screening test of TULIA (AST. Apraxia was significantly more frequent in the AD patients (32.3% than in both of the SVaD (16.7% and MCI (4.8% patients. The frequency of apraxia was also significantly higher in SVaD patients than in MCI patients. AD patients had significantly lower apraxia scores than both SVaD and MCI patients. In addition, a significant difference was found between SVaD and MCI patients in terms of apraxia scores. These results suggest that the widespread belief of the association between apraxia and cortical dementias is not exactly correct. The significant difference between both of the dementia groups and the MCI patients suggests that the absence of apraxia can be an indicator for MCI diagnosis.Keywords: apraxia, Alzheimer’s disease, subcortical vascular dementia, mild cognitive impairment

  2. Improved multimodal biomarkers for Alzheimer's disease and mild cognitive impairment diagnosis: data from ADNI

    Science.gov (United States)

    Martinez-Torteya, Antonio; Treviño-Alvarado, Víctor; Tamez-Peña, José

    2013-02-01

    The accurate diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI) confers many clinical research and patient care benefits. Studies have shown that multimodal biomarkers provide better diagnosis accuracy of AD and MCI than unimodal biomarkers, but their construction has been based on traditional statistical approaches. The objective of this work was the creation of accurate AD and MCI diagnostic multimodal biomarkers using advanced bioinformatics tools. The biomarkers were created by exploring multimodal combinations of features using machine learning techniques. Data was obtained from the ADNI database. The baseline information (e.g. MRI analyses, PET analyses and laboratory essays) from AD, MCI and healthy control (HC) subjects with available diagnosis up to June 2012 was mined for case/controls candidates. The data mining yielded 47 HC, 83 MCI and 43 AD subjects for biomarker creation. Each subject was characterized by at least 980 ADNI features. A genetic algorithm feature selection strategy was used to obtain compact and accurate cross-validated nearest centroid biomarkers. The biomarkers achieved training classification accuracies of 0.983, 0.871 and 0.917 for HC vs. AD, HC vs. MCI and MCI vs. AD respectively. The constructed biomarkers were relatively compact: from 5 to 11 features. Those multimodal biomarkers included several widely accepted univariate biomarkers and novel image and biochemical features. Multimodal biomarkers constructed from previously and non-previously AD associated features showed improved diagnostic performance when compared to those based solely on previously AD associated features.

  3. Recognizing mild cognitive impairment based on network connectivity analysis of resting EEG with zero reference

    International Nuclear Information System (INIS)

    Xu, Peng; Xiong, Xiu Chun; Tian, Yin; Zhang, Rui; Li, Pei Yang; Yao, De Zhong; Xue, Qing; Wang, Yu Ping; Peng, Yueheng

    2014-01-01

    The diagnosis of mild cognitive impairment (MCI) is very helpful for early therapeutic interventions of Alzheimer's disease (AD). MCI has been proven to be correlated with disorders in multiple brain areas. In this paper, we used information from resting brain networks at different EEG frequency bands to reliably recognize MCI. Because EEG network analysis is influenced by the reference that is used, we also evaluate the effect of the reference choices on the resting scalp EEG network-based MCI differentiation. The conducted study reveals two aspects: (1) the network-based MCI differentiation is superior to the previously reported classification that uses coherence in the EEG; and (2) the used EEG reference influences the differentiation performance, and the zero approximation technique (reference electrode standardization technique, REST) can construct a more accurate scalp EEG network, which results in a higher differentiation accuracy for MCI. This study indicates that the resting scalp EEG-based network analysis could be valuable for MCI recognition in the future. (paper)

  4. Neuropsychological profiles and verbal abilities in lifelong bilinguals with mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Kowoll, Magdalena Eva; Degen, Christina; Gladis, Saskia; Schröder, Johannes

    2015-01-01

    Bilingualism is associated with enhanced executive functioning and delayed onset of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Here, we investigated neuropsychological differences between mono- and bilingual patients with MCI and AD as well as the respective effects of dementia on the dominant and non-dominant language of bilinguals. 69 patients with MCI (n = 22) or AD (n = 47) and 17 healthy controls were included. 41 subjects were classified as lifelong bilinguals (mean age: 73.6; SD = 11.5) and 45 as monolinguals (mean age: 78.1; SD = 10.9). Neuropsychological performance was assessed on the CERAD-NP, the clock-drawing test, and the logical memory subscale of the Wechsler Memory Scale. Neuropsychological profiles showed only minor nonsignificant differences between mono- and bilingual subjects when compared between diagnostic groups. Bilingual MCI patients scored significantly lower on the verbal fluency and picture naming task in their dominant language than bilingual controls. Bilingual AD patients showed a reduced performance in their nondominant language when compared to bilingual MCI patients and bilingual controls (main effect language dominance: verbal fluency task p Bilingual MCI and AD patients show a similar pattern of neuropsychological deficits as monolingual patients do. The dominant language appears to be compromised first in bilingual MCI patients, while severe deficits of the nondominant language develop later in the course with manifestation of AD. These findings are important for the diagnostic work up of bilingual patients and the development of improved care concepts for bilingual patients such as migrant populations.

  5. Apathy and emotion-based decision-making in amnesic mild cognitive impairment and Alzheimer's disease.

    Science.gov (United States)

    Bayard, Sophie; Jacus, Jean-Pierre; Raffard, Stéphane; Gely-Nargeot, Marie-Christine

    2014-01-01

    Apathy and reduced emotion-based decision-making are two behavioral modifications independently described in Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). The aims of this study were to investigate decision-making based on emotional feedback processing in AD and aMCI and to study the impact of reduced decision-making performances on apathy. We recruited 20 patients with AD, 20 participants with aMCI, and 20 healthy controls. All participants completed the Lille apathy rating scale (LARS) and the Iowa gambling task (IGT). Both aMCI and AD participants had reduced performances on the IGT and were more apathetic compared to controls without any difference between aMCI and AD groups. For the entire sample, LARS initiation dimension was related to IGT disadvantageous decision-making profile. We provide the first study showing that both aMCI and AD individuals make less profitable decisions than controls, whereas aMCI and AD did not differ. Disadvantageous decision-making profile on the IGT was associated with higher level of apathy on the action initiation dimension. The role of an abnormal IGT performance as a risk factor for the development of apathy needs to be investigated in other clinical populations and in normal aging.

  6. Robustness of reliable change indices to variability in Parkinson's disease with mild cognitive impairment.

    Science.gov (United States)

    Turner, T H; Renfroe, J B; Elm, J; Duppstadt-Delambo, A; Hinson, V K

    2016-01-01

    Ability to identify change is crucial for measuring response to interventions and tracking disease progression. Beyond psychometrics, investigations of Parkinson's disease with mild cognitive impairment (PD-MCI) must consider fluctuating medication, motor, and mental status. One solution is to employ 90% reliable change indices (RCIs) from test manuals to account for account measurement error and practice effects. The current study examined robustness of 90% RCIs for 19 commonly used executive function tests in 14 PD-MCI subjects assigned to the placebo arm of a 10-week randomized controlled trial of atomoxetine in PD-MCI. Using 90% RCIs, the typical participant showed spurious improvement on one measure, and spurious decline on another. Reliability estimates from healthy adults standardization samples and PD-MCI were similar. In contrast to healthy adult samples, practice effects were minimal in this PD-MCI group. Separate 90% RCIs based on the PD-MCI sample did not further reduce error rate. In the present study, application of 90% RCIs based on healthy adults in standardization samples effectively reduced misidentification of change in a sample of PD-MCI. Our findings support continued application of 90% RCIs when using executive function tests to assess change in neurological populations with fluctuating status.

  7. Free and Cued Recall Memory in Parkinson’s Disease Associated with Amnestic Mild Cognitive Impairment

    Science.gov (United States)

    Costa, Alberto; Monaco, Marco; Zabberoni, Silvia; Peppe, Antonella; Perri, Roberta; Fadda, Lucia; Iannarelli, Francesca; Caltagirone, Carlo; Carlesimo, Giovanni A.

    2014-01-01

    The hypothesis has been advanced that memory disorders in individuals with Parkinson’s disease (PD) are related to either retrieval or consolidation failure. However, the characteristics of the memory impairments of PD patients with amnestic mild cognitive impairment have not been clarified. This study was aimed at investigating whether memory deficits in PD patients with amnestic mild cognitive impairment (PDaMCI) are due to failure of retrieval or consolidation processes. Sixteen individuals with PDaMCI, 20 with amnestic mild cognitive impairment without PD (aMCINPD), and 20 healthy controls were recruited. Participants were administered the Free and Cued Selective Reminding Test. An index of cueing was computed for each subject to capture the advantage in retrieval of cued compared to free recall. Individuals with PDaMCI performed worse than healthy controls on the free recall (pcued recall (p>0.10) task, and they performed better than aMCINPD subjects on both recall measures (p0.10) but it was significantly higher than that of the aMCINPD sample (precall trials was significantly predicted by scores on a test investigating executive functions (i.e., the Modified Card Sorting Test; p = 0.042). Findings of the study document that, in subjects with amnestic mild cognitive impairment associated to PD, episodic memory impairment is related to retrieval rather than to consolidation failure. The same data suggest that, in these individuals, memory deficits might be due to altered frontal-related executive functioning. PMID:24465977

  8. Use of Speech Analyses within a Mobile Application for the Assessment of Cognitive Impairment in Elderly People.

    Science.gov (United States)

    Konig, Alexandra; Satt, Aharon; Sorin, Alex; Hoory, Ran; Derreumaux, Alexandre; David, Renaud; Robert, Phillippe H

    2018-01-01

    Various types of dementia and Mild Cognitive Impairment (MCI) are manifested as irregularities in human speech and language, which have proven to be strong predictors for the disease presence and progress ion. Therefore, automatic speech analytics provided by a mobile application may be a useful tool in providing additional indicators for assessment and detection of early stage dementia and MCI. 165 participants (subjects with subjective cognitive impairment (SCI), MCI patients, Alzheimer's disease (AD) and mixed dementia (MD) patients) were recorded with a mobile application while performing several short vocal cognitive tasks during a regular consultation. These tasks included verbal fluency, picture description, counting down and a free speech task. The voice recordings were processed in two steps: in the first step, vocal markers were extracted using speech signal processing techniques; in the second, the vocal markers were tested to assess their 'power' to distinguish between SCI, MCI, AD and MD. The second step included training automatic classifiers for detecting MCI and AD, based on machine learning methods, and testing the detection accuracy. The fluency and free speech tasks obtain the highest accuracy rates of classifying AD vs. MD vs. MCI vs. SCI. Using the data, we demonstrated classification accuracy as follows: SCI vs. AD = 92% accuracy; SCI vs. MD = 92% accuracy; SCI vs. MCI = 86% accuracy and MCI vs. AD = 86%. Our results indicate the potential value of vocal analytics and the use of a mobile application for accurate automatic differentiation between SCI, MCI and AD. This tool can provide the clinician with meaningful information for assessment and monitoring of people with MCI and AD based on a non-invasive, simple and low-cost method. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  9. Symptom validity testing in memory clinics: Hippocampal-memory associations and relevance for diagnosing mild cognitive impairment

    NARCIS (Netherlands)

    Rienstra, Anne; Groot, Paul F. C.; Spaan, Pauline E. J.; Majoie, Charles B. L. M.; Nederveen, Aart J.; Walstra, Gerard J. M.; de Jonghe, Jos F. M.; van Gool, Willem A.; Olabarriaga, Silvia D.; Korkhov, Vladimir V.; Schmand, Ben

    2013-01-01

    Patients with mild cognitive impairment (MCI) do not always convert to dementia. In such cases, abnormal neuropsychological test results may not validly reflect cognitive symptoms due to brain disease, and the usual brain-behavior relationships may be absent. This study examined symptom validity in

  10. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    International Nuclear Information System (INIS)

    Spampinato, M.V.; Patrick, K.E.; Collins, H.; Langdon, B.R.; Parker, R.O.; Pravata', E.

    2016-01-01

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  11. Gender, apolipoprotein E genotype, and mesial temporal atrophy: 2-year follow-up in patients with stable mild cognitive impairment and with progression from mild cognitive impairment to Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Spampinato, M.V.; Patrick, K.E.; Collins, H. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Langdon, B.R. [Medical University of South Carolina, Department of Internal Medicine, Charleston, SC (United States); Parker, R.O. [Vanderbilt University, Department of Anesthesiology, Nashville, TN (United States); Pravata' , E. [Medical University of South Carolina, Department of Radiology and Radiological Science, Charleston, SC (United States); Ospedale Regionale di Lugano, Department of Neuroradiology, Neurocenter of Southern Switzerland, Lugano (Switzerland); Collaboration: For the Alzheimer' s Disease Neuroimaging Initiative

    2016-11-15

    This study aimed to examine the relationship between gender, apolipoprotein E (APOE) genotype, and mesial temporal atrophy in mild cognitive impairment (MCI) with and without progression to Alzheimer's disease (AD). We evaluated 236 MCI patients with (n = 121) and without (n = 115) AD progression. Longitudinal MRI-based hippocampal volumes (HV) and entorhinal cortex (ERC) thickness were obtained. The Clinical Dementia Rating Sum of Boxes (CDR-SB) score was used to assess disease severity. We found a significant effect of APOE, gender, and clinical course (stable MCI versus MCI-AD progression) on HV. There was a significant effect of clinical course and APOE, but not gender, on ERC. Baseline HV and APOE4 status predicted MCI-AD progression in women. Baseline ERC and APOE4 status predicted MCI-AD progression in men. There were significant differences in CDR-SB scores between patients with and without MCI-AD progression, but not between males and females, or APOE4 carriers and non-carriers. HV, but not ERC, is strongly influenced by gender in MCI. The effects of gender and APOE4 on neuroimaging biomarkers have potentially important implications in the prediction of MCI-AD progression and should be taken into account in clinical trials. (orig.)

  12. Cognitive Impairment in Infratentorial Strokes

    Directory of Open Access Journals (Sweden)

    Melek Kandemir

    2009-12-01

    Full Text Available OBJECTIVE: Beginning in the mid-1980s, with anatomical, behavioral, and neuropsychological evidence, it was suggested that the role of the cerebellum extends beyond a purely motor domain. A series of articles were published reviewing the potential role of the cerebellum in cognition. Both of these functions are supported by connections of dentate nucleus and frontal cortex through the thalamus. The cognitive profile of isolated subtentorial and cerebellar infarcts is related to the involved frontal circuit (especially executive functions. In this study, we aimed to demonstrate the cognitive profile of cerebellar and subtentorial infarcts. METHODS: Nineteen patients with infratentorial infarcts and 19 neurologically healthy individuals as a control group were included in this study. Neuropsychometric test battery was employed in both of the groups. RESULTS: Age, sex, education, clinical syndrome, and localization had no effect on the cognitive test performances. Performance on the California Verbal Learning Test, a verbal memory test, was worse in the patient group. Patients had difficulties in recognizing the items of the Rey-Osterrieth Complex Figure Test, and spent significantly more time to complete the trail making test part B. The patient group also demonstrated lower performance level in the verbal fluency test when compared to the control group. CONCLUSION: The cognitive impairment pattern of the verbal and visual memory tests and impairment determined on the verbal fluency test and the trail making tests may imply frontal impairment. Our results support the knowledge that cerebellar or brainstem strokes cause mild frontal type cognitive syndrome by damaging cerebello-ponto-thalamo-cortical pathways

  13. The role of social frailty in explaining the association between hearing problems and mild cognitive impairment in older adults.

    Science.gov (United States)

    Bae, Seongryu; Lee, Sangyoon; Lee, Sungchul; Jung, Songee; Makino, Keitaro; Park, Hyuntae; Shimada, Hiroyuki

    2018-06-01

    We examined the role of social frailty in the association between hearing problems and mild cognitive impairment (MCI), and investigated which cognitive impairment domains are most strongly involved. Participants were 4251 older adults (mean age 72.5 ± 5.2 years, 46.1% male) who met the study inclusion criteria. Hearing problems were measured using the Hearing Handicap Inventory for the Elderly. Social frailty was identified using responses to five questions. Participants were divided into four groups depending on the presence of social frailty and hearing problems: control, social frailty, hearing problem, and co-occurrence. We assessed memory, attention, executive function, and processing speed using the National Center for Geriatrics and Gerontology-Functional Assessment Tool. Participants were categorized into normal cognition, single- and multiple-domain MCI, depending on the number of impaired cognitive domains. Participants with multiple-domain MCI exhibited the highest odds ratios (OR) of the co-occurrence group (OR: 3.89, 95% confidence intervals [CI]: 1.96-7.72), followed by the social frailty (OR: 2.65, 95% CI: 1.49-4.67), and hearing problem (OR: 1.90, 95% CI: 1.08-3.34) groups, compared with the control group. However, single-domain MCI was not significantly associated with any group. Cognitive domain analysis revealed that impaired executive function and processing speed were associated with the co-occurrence, hearing problem, and social frailty groups, respectively. Social frailty and hearing problems were independently associated with multiple-domain MCI. Comorbid conditions were more strongly associated with multiple-domain MCI. Longitudinal studies are needed to elucidate the causal role of social frailty in the association between hearing impairment and MCI. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

    Science.gov (United States)

    Duke Han, S.; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

    2015-01-01

    Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

  15. Effects of age and mild cognitive impairment on the pain response system.

    Science.gov (United States)

    Kunz, Miriam; Mylius, Veit; Schepelmann, Karsten; Lautenbacher, Stefan

    2009-01-01

    Both age and dementia have been shown to have an effect on nociception and pain processing. The question arises whether mild cognitive impairment (MCI), which is thought to be a transitional stage between normal ageing and dementia, is also associated with alterations in pain processing. The aim of the present study was to answer this question by investigating the impact of age and MCI on the pain response system. Forty young subjects, 45 cognitively unimpaired elderly subjects and 42 subjects with MCI were investigated by use of an experimental multi-method approach. The subjects were tested for their subjective (pain ratings), motor (RIII reflex), facial (Facial Action Coding System) and their autonomic (sympathetic skin response and evoked heart rate response) responses to noxious electrical stimulation of the nervus suralis. We found significant group differences in the autonomic responses to noxious stimulation. The sympathetic skin response amplitude was significantly reduced in the cognitively unimpaired elderly subjects compared to younger subjects and to an even greater degree in subjects with MCI. The evoked heart rate response was reduced to a similar degree in both groups of aged subjects. Regression analyses within the two groups of the elderly subjects revealed that age and, in the MCI group, cognitive status were significant predictors of the decrease in autonomic responsiveness to noxious stimulation. Except for the autonomic parameters, no other pain parameter differed between the three groups. The pain response system appeared to be quite unaltered in MCI patients compared to cognitively unimpaired individuals of the same age. Only the sympathetic responsiveness qualified as an indicator of early aging effects as well as of pathophysiology associated with MCI, which both seemed to affect the pain system independently from each other.

  16. Screening for Sleep Apnoea in Mild Cognitive Impairment: The Utility of the Multivariable Apnoea Prediction Index

    Directory of Open Access Journals (Sweden)

    Georgina Wilson

    2014-01-01

    Full Text Available Purpose. Mild cognitive impairment (MCI is considered an “at risk” state for dementia and efforts are needed to target modifiable risk factors, of which Obstructive sleep apnoea (OSA is one. This study aims to evaluate the predictive utility of the multivariate apnoea prediction index (MAPI, a patient self-report survey, to assess OSA in MCI. Methods. Thirty-seven participants with MCI and 37 age-matched controls completed the MAPI and underwent polysomnography (PSG. Correlations were used to compare the MAPI and PSG measures including oxygen desaturation index and apnoea-hypopnoea index (AHI. Receiver-operating characteristics (ROC curve analyses were performed using various cut-off scores for apnoea severity. Results. In controls, there was a significant moderate correlation between higher MAPI scores and more severe apnoea (AHI: r=0.47, P=0.017. However, this relationship was not significant in the MCI sample. ROC curve analysis indicated much lower area under the curve (AUC in the MCI sample compared to the controls across all AHI severity cut-off scores. Conclusions. In older people, the MAPI moderately correlates with AHI severity but only in those who are cognitively intact. Development of further screening tools is required in order to accurately screen for OSA in MCI.

  17. Reduced Frontal Activations at High Working Memory Load in Mild Cognitive Impairment: Near-Infrared Spectroscopy.

    Science.gov (United States)

    Yeung, Michael K; Sze, Sophia L; Woo, Jean; Kwok, Timothy; Shum, David H K; Yu, Ruby; Chan, Agnes S

    2016-01-01

    Some functional magnetic resonance imaging studies have reported altered activations in the frontal cortex during working memory (WM) performance in individuals with mild cognitive impairment (MCI), but the findings have been mixed. The objective of the present study was to utilize near-infrared spectroscopy (NIRS), an alternative imaging technique, to examine neural processing during WM performance in individuals with MCI. Twenty-six older adults with MCI (7 males; mean age 69.15 years) were compared with 26 age-, gender-, handedness-, and education-matched older adults with normal cognition (NC; 7 males; mean age 68.87 years). All of the participants undertook an n-back task with a low (i.e., 0-back) and a high (i.e., 2-back) WM load condition while their prefrontal dynamics were recorded by a 16-channel NIRS system. Although behavioral results showed that the two groups had comparable task performance, neuroimaging results showed that the MCI group, unlike the NC group, did not exhibit significantly increased frontal activations bilaterally when WM load increased. Compared to the NC group, the MCI group had similar frontal activations at low load (p > 0.05 on all channels) but reduced activations at high load (p load in individuals with MCI. © 2016 S. Karger AG, Basel.

  18. Comparison between mini mental state examination (MMSE) and Montreal cognitive assessment Indonesian version (MoCA-Ina) as an early detection of cognitive impairments in post-stroke patients

    Science.gov (United States)

    Lestari, S.; Mistivani, I.; Rumende, C. M.; Kusumaningsih, W.

    2017-08-01

    Mild cognitive impairment (MCI) is defined as cognitive impairment that may never develop into dementia. Cognitive impairment is one long-term complication of a stroke. The Mini Mental State Examination (MMSE), which is commonly used as a screening tool for cognitive impairment, has a low sensitivity to detect cognitive impairment, especially MCI. Alternatively, the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) has been reported to have a higher sensitivity than the MMSE. The aim of this study was to compare the proportion of MCI identified between the MMSE and MoCA-Ina in stroke patients. This was a cross-sectional study of stroke outpatients who attended the Polyclinic Neuromuscular Division, Rehabilitation Department, and Polyclinic Stroke, Neurology Department Cipto Mangunkusumo General Hospital, Jakarta. The proportion of MCI identified using the MMSE was 31.03% compared to 72.41% when using the MoCA-Ina. This difference was statistically significant (Fisher’s exact test, p = 0.033). The proportion of MCI in stroke patients was higher when using the MoCA-Ina compared to the MMSE. The MoCA-Ina should be used as an alternative in the early detection of MCI in stroke patients, especially those undergoing rehabilitation.

  19. Comparative Effects of Education and Bilingualism on the Onset of Mild Cognitive Impairment.

    Science.gov (United States)

    Ramakrishnan, Subasree; Mekala, Shailaja; Mamidipudi, Annapurna; Yareeda, Sireesha; Mridula, Rukmini; Bak, Thomas H; Alladi, Suvarna; Kaul, Subhash

    2017-01-01

    Increasing evidence suggests that life course factors such as education and bilingualism may have a protective role against dementia due to Alzheimer disease. This study aimed to compare the effects of education and bilingualism on the onset of cognitive decline at the stage of mild cognitive impairment (MCI). A total of 115 patients with MCI evaluated in a specialty memory clinic in Hyderabad, India, formed the cohort. MCI was diagnosed according to Petersen's criteria following clinical evaluation and brain imaging. Age at onset of MCI was compared between bilinguals and monolinguals, and across subjects with high and low levels of education, adjusting for possible confounding variables. The bilingual MCI patients were found to have a clinical onset of cognitive complaints 7.4 years later than monolinguals (65.2 vs. 58.1 years; p = 0.004), while years of education was not associated with delayed onset (1-10 years of education, 59.1 years; 11-15 years of education, 62.6 years; >15 years of education, 62.2 years; p = 0.426). The effect of bilingualism is protective against cognitive decline, and lies along a continuum from normal to pathological states. In comparison, the role of years of education is less robust. © 2017 S. Karger AG, Basel.

  20. Effect of PICALM rs3851179 polymorphism on the default mode network function in mild cognitive impairment.

    Science.gov (United States)

    Sun, Ding-Ming; Chen, Hai-Feng; Zuo, Qi-Long; Su, Fan; Bai, Feng; Liu, Chun-Feng

    2017-07-28

    Alterations in default mode network (DMN) functional connectivity (FC) might accompany the dysfunction of Alzheimer's disease (AD). Indeed, episodic memory impairment is a hallmark of AD, and mild cognitive impairment (MCI) has been associated with a high risk for AD. Phosphatidylinositol-binding clathrin assembly protein (PICALM) (rs3851179) has been associated with AD; in particular, the A allele may serve a protective role, while the G allele serves as a strong genetic risk factor. Therefore, the identification of genetic polymorphisms associated with the DMN is required in MCI subjects. In all, 32 MCI subjects and 32 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging (rs-fMRI) and a genetic imaging approach. Subjects were divided into four groups according to the diagnosis (i.e., MCI and HCs) and the PICALM rs3851179 polymorphism (i.e., AA/AG genotype and GG genotype). The differences in FC within the DMN between the four subgroups were explored. Furthermore, we examined the relationship between our neuroimaging measures and cognitive performance. The regions associated with the genotype-by-disease interaction were in the left middle temporal gyrus (LMTG) and left middle frontal gyrus (LMFG). These changes in LMFG FC were generally manifested as an "inverse U-shaped curve", while a "U-shaped curve" was associated with the LMTG FC between these four subgroups (all Pthe LMFG was related to better episodic memory performance (i.e., AVLT 20min DR, rho=0.72, P=0.044) for the MCI subgroups with the GG genotype. The PICALM rs3851179 polymorphism significantly affects the DMN network in MCI. The LMFG and LMTG may be associated with opposite patterns. However, the altered LMFG FC in MCI patients with the GG genotype was more sensitive to episodic memory impairment, which is more likely to lead to a high risk of AD. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. 'It's definitely not Alzheimer's': Perceived benefits and drawbacks of a mild cognitive impairment diagnosis.

    Science.gov (United States)

    Gomersall, Tim; Smith, Sarah Kate; Blewett, Charlotte; Astell, Arlene

    2017-11-01

    To understand the perceived benefits and drawbacks of a mild cognitive impairment (MCI) diagnosis from the perspective of those living with the label. Participants were included if they had recently (within 6 months) received a MCI diagnosis. We also recruited close family members to gain their perspectives. Each was interviewed separately with a semi-structured topic guide covering three areas: (1) experience of cognitive impairments and changes in the individual; (2) impact of cognitive impairment(s) on daily activities and social relationships; and (3) experience of the diagnosis process and living with the label. Transcribed interviews were stored in Nvivo ® . Grounded theory procedures of memo writing, open coding, constant comparison, and focused coding were used to derive conceptual themes. Eighteen dyads were interviewed. The overarching themes surrounding diagnosis benefits and drawbacks were as follows: (1) emotional impact of the diagnosis; (2) practical benefits and limitations of the diagnosis, in terms of (a) understanding one's symptoms and (b) access to clinical support. Although participants were glad to have clinical support in place, they expressed frustration at the lack of clarity, and the lack of available treatments for MCI. Consequently, living with MCI can be characterized as an ambivalent experience. As a clinical label, MCI appears to have little explanatory power for people living with cognitive difficulties. Work is needed to clarify how clinicians and patients communicate about MCI, and how people can be helped to live well with the label. Despite an emerging body of prognostic studies, people with MCI are likely to continue living with significant uncertainty. Statement of contribution What is already known on this subject? Mild cognitive impairment is a state of cognitive decline between normal cognitive ageing and dementia. This clinical category has been an important domain of academic debate over recent years. From a clinical

  2. Validation of the Dutch version of the quick mild cognitive impairment screen (Qmci-D).

    Science.gov (United States)

    Bunt, Steven; O'Caoimh, Rónán; Krijnen, Wim P; Molloy, D William; Goodijk, Geert Pieter; van der Schans, Cees P; Hobbelen, Hans J S M

    2015-10-02

    Differentiating mild cognitive impairment (MCI) from dementia is important, as treatment options differ. There are few short (Dutch language. The Quick Mild Cognitive Impairment (Qmci) screen is sensitive and specific in differentiating MCI from NC and mild dementia. Given this, we adapted the Qmci for use in Dutch-language countries and validated the Dutch version, the Qmci-D, against the Dutch translation of the Standardised Mini-Mental State Examination (SMMSE-D). The Qmci was translated into Dutch with a combined qualitative and quantitative approach. In all, 90 participants were recruited from a hospital geriatric clinic (25 with dementia, 30 with MCI, 35 with NC). The Qmci-D and SMMSE-D were administered sequentially but randomly by the same trained rater, blind to the diagnosis. The Qmci-D was more sensitive than the SMMSE-D in discriminating MCI from dementia, with a significant difference in the area under the curve (AUC), 0.73 compared to 0.60 (p = 0.024), respectively, and in discriminating dementia from NC, with an AUC of 0.95 compared to 0.89 (p = 0.006). Both screening instruments discriminated MCI from NC with an AUC of 0.86 (Qmci-D) and 0.84 (SMMSE-D). The Qmci-D shows similar,(good) accuracy as the SMMSE-D in separating NC from MCI; greater,(albeit fair), accuracy differentiating MCI from dementia, and significantly greater accuracy in separating dementia from NC. Given its brevity and ease of administration, the Qmci-D seems a useful cognitive screen in a Dutch population. Further study with a suitably powered sample against more sensitive screens is now required.

  3. Influence of Different Cut-Off Values on the Diagnosis of Mild Cognitive Impairment in Parkinson's Disease

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    Inga Liepelt-Scarfone

    2011-01-01

    Full Text Available Comparable to Alzheimer's disease, mild cognitive impairment in Parkinson's disease (PD-MCI is associated with an increased risk for dementia. However different definitions of PD-MCI may have varying predictive accuracy for dementia. In a cohort of 101 nondemented Parkinson patients who underwent neuropsychological testing, the frequency of PD-MCI subjects and PD-MCI subtypes (i.e., amnestic/nonamnestic was determined by use of varying healthy population-based cut-off values. We also investigated the association between defined PD-MCI groups and ADL scales. Varying cut-off values for the definition of PD-MCI were found to affect frequency of PD-MCI subjects (9.9%–92.1% and, maybe more important, lead to a “shift” of proportion of detected PD-MCI subtypes especially within the amnestic single-domain subtype. Models using a strict cut-off value were significantly associated with lower ADL scores. Thus, the use of defined cut-off values for the definition of PD-MCI is highly relevant for comparison purposes. Strict cut-off values may have a higher predictive value for dementia.

  4. Abnormal Resting-State Functional Connectivity Strength in Mild Cognitive Impairment and Its Conversion to Alzheimer’s Disease

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    Yuxia Li

    2016-01-01

    Full Text Available Individuals diagnosed with mild cognitive impairment (MCI are at high risk of transition to Alzheimer’s disease (AD. However, little is known about functional characteristics of the conversion from MCI to AD. Resting-state functional magnetic resonance imaging was performed in 25 AD patients, 31 MCI patients, and 42 well-matched normal controls at baseline. Twenty-one of the 31 MCI patients converted to AD at approximately 24 months of follow-up. Functional connectivity strength (FCS and seed-based functional connectivity analyses were used to assess the functional differences among the groups. Compared to controls, subjects with MCI and AD showed decreased FCS in the default-mode network and the occipital cortex. Importantly, the FCS of the left angular gyrus and middle occipital gyrus was significantly lower in MCI-converters as compared with MCI-nonconverters. Significantly decreased functional connectivity was found in MCI-converters compared to nonconverters between the left angular gyrus and bilateral inferior parietal lobules, dorsolateral prefrontal and lateral temporal cortices, and the left middle occipital gyrus and right middle occipital gyri. We demonstrated gradual but progressive functional changes during a median 2-year interval in patients converting from MCI to AD, which might serve as early indicators for the dysfunction and progression in the early stage of AD.

  5. Increased Amplitude of the P3a ERP Component as a Neurocognitive Marker for Differentiating Amnestic Subtypes of Mild Cognitive Impairment

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    Kenia S. Correa-Jaraba

    2018-02-01

    Full Text Available The event-related potential (ERP technique has been shown to be useful for evaluating changes in brain electrical activity associated with different cognitive processes, particularly in Alzheimer’s disease (AD. Longitudinal studies have shown that a high proportion of people with amnestic mild cognitive impairment (aMCI go on to develop AD. aMCI is divided into two subtypes according to the presence of memory impairment only (single-domain aMCI: sdaMCI or impairment of memory and other cognitive domains (multi-domain aMCI: mdaMCI. The main aim of this study was to examine the effects of sdaMCI and mdaMCI on the P3a ERP component associated with the involuntary orientation of attention toward unattended infrequent novel auditory stimuli. Participants performed an auditory-visual distraction-attention task, in which they were asked to ignore the auditory stimuli (standard, deviant, and novel and to attend to the visual stimuli (responding to some of them: Go stimuli. P3a was identified in the Novel minus Standard difference waveforms, and reaction times (RTs and hits (in response to Go stimuli were also analyzed. Participants were classified into three groups: Control, 20 adults (mean age (M: 65.8 years; sdaMCI, 19 adults (M: 67 years; and mdaMCI, 11 adults (M: 71 years. In all groups, the RTs were significantly longer when Go stimuli were preceded by novel (relative to standard auditory stimuli, suggesting a distraction effect triggered by novel stimuli; mdaMCI participants made significantly fewer hits than control and sdaMCI participants. P3a comprised two consecutive phases in all groups: early-P3a (e-P3a, which may reflect the orienting response toward the irrelevant stimuli, and late-P3a (l-P3a, which may be a correlate of subsequent evaluation of these stimuli. The e-P3a amplitude was significantly larger in mdaMCI than in sdaMCI participants, and the l-P3a amplitude was significantly larger in mdaMCI than in sdaMCI and Control

  6. Potential neuroimaging biomarkers of pathologic brain changes in Mild Cognitive Impairment and Alzheimer's disease: a systematic review.

    Science.gov (United States)

    Ruan, Qingwei; D'Onofrio, Grazia; Sancarlo, Daniele; Bao, Zhijun; Greco, Antonio; Yu, Zhuowei

    2016-05-16

    Neuroimaging-biomarkers of Mild Cognitive Impairment (MCI) allow an early diagnosis in preclinical stages of Alzheimer's disease (AD). The goal in this paper was to review of biomarkers for Mild Cognitive Impairment (MCI) and Alzheimer's disease (AD), with emphasis on neuroimaging biomarkers. A systematic review was conducted from existing literature that draws on markers and evidence for new measurement techniques of neuroimaging in AD, MCI and non-demented subjects. Selection criteria included: 1) age ≥ 60 years; 2) diagnosis of AD according to NIAAA criteria, 3) diagnosis of MCI according to NIAAA criteria with a confirmed progression to AD assessed by clinical follow-up, and 4) acceptable clinical measures of cognitive impairment, disability, quality of life, and global clinical assessments. Seventy-two articles were included in the review. With the development of new radioligands of neuroimaging, today it is possible to measure different aspects of AD neuropathology, early diagnosis of MCI and AD become probable from preclinical stage of AD to AD dementia and non-AD dementia. The panel of noninvasive neuroimaging-biomarkers reviewed provides a set methods to measure brain structural and functional pathophysiological changes in vivo, which are closely associated with preclinical AD, MCI and non-AD dementia. The dynamic measures of these imaging biomarkers are used to predict the disease progression in the early stages and improve the assessment of therapeutic efficacy in these diseases in future clinical trials.

  7. Strategies for improving memory: a randomized trial of memory groups for older people, including those with mild cognitive impairment.

    Science.gov (United States)

    Kinsella, Glynda J; Ames, David; Storey, Elsdon; Ong, Ben; Pike, Kerryn E; Saling, Michael M; Clare, Linda; Mullaly, Elizabeth; Rand, Elizabeth

    2016-01-01

    Governments are promoting the importance of maintaining cognitive health into older age to minimize risk of cognitive decline and dementia. Older people with amnestic mild cognitive impairment (aMCI) are particularly vulnerable to memory challenges in daily activities and are seeking ways to maintain independent living. To evaluate the effectiveness of memory groups for improving memory strategies and memory ability of older people, especially those with aMCI. 113 healthy older adults (HOA) and 106 adults with aMCI were randomized to a six-week memory group or a waitlist control condition. Outcome was evaluated through knowledge and use of memory strategies, memory ability (self-report and neuropsychological tests), and wellbeing. Assessments included a six-month follow-up. Using intention to treat analyses, there were intervention effects for HOA and aMCI groups in strategy knowledge (HOA: η2= 0.20; aMCI: η2= 0.06), strategy use (HOA: η2= 0.18; aMCI: η2= 0.08), and wellbeing (HOA: η2= 0.11; aMCI: η2= 0.05). There were also intervention effects in the HOA group, but not the aMCI group, in self-reported memory ability (η2= 0.06) and prospective memory tests (η2= 0.02). By six-month follow-up, gains were found on most HOA outcomes. In the aMCI group gains were found in strategy use, and by this stage, gains in prospective memory were also found. Memory groups can engage older people in techniques for maintaining cognitive health and improve memory performance, but more modest benefits are seen for older adults with aMCI.

  8. Intraindividual Stepping Reaction Time Variability Predicts Falls in Older Adults With Mild Cognitive Impairment

    OpenAIRE

    Bunce, D; Haynes, BI; Lord, SR; Gschwind, YJ; Kochan, NA; Reppermund, S; Brodaty, H; Sachdev, PS; Delbaere, K

    2017-01-01

    Background: Reaction time measures have considerable potential to aid neuropsychological assessment in a variety of health care settings. One such measure, the intraindividual reaction time variability (IIV), is of particular interest as it is thought to reflect neurobiological disturbance. IIV is associated with a variety of age-related neurological disorders, as well as gait impairment and future falls in older adults. However, although persons diagnosed with Mild Cognitive Impairment (MCI)...

  9. Operationalizing the Diagnostic Criteria for Mild Cognitive Impairment: The Salience of Objective Measures in Predicting Incident Dementia.

    Science.gov (United States)

    Brodaty, Henry; Aerts, Liesbeth; Crawford, John D; Heffernan, Megan; Kochan, Nicole A; Reppermund, Simone; Kang, Kristan; Maston, Kate; Draper, Brian; Trollor, Julian N; Sachdev, Perminder S

    2017-05-01

    Mild cognitive impairment (MCI) is considered an intermediate stage between normal aging and dementia. It is diagnosed in the presence of subjective cognitive decline and objective cognitive impairment without significant functional impairment, although there are no standard operationalizations for each of these criteria. The objective of this study is to determine which operationalization of the MCI criteria is most accurate at predicting dementia. Six-year longitudinal study, part of the Sydney Memory and Ageing Study. Community-based. 873 community-dwelling dementia-free adults between 70 and 90 years of age. Persons from a non-English speaking background were excluded. Seven different operationalizations for subjective cognitive decline and eight measures of objective cognitive impairment (resulting in 56 different MCI operational algorithms) were applied. The accuracy of each algorithm to predict progression to dementia over 6 years was examined for 618 individuals. Baseline MCI prevalence varied between 0.4% and 30.2% and dementia conversion between 15.9% and 61.9% across different algorithms. The predictive accuracy for progression to dementia was poor. The highest accuracy was achieved based on objective cognitive impairment alone. Inclusion of subjective cognitive decline or mild functional impairment did not improve dementia prediction accuracy. Not MCI, but objective cognitive impairment alone, is the best predictor for progression to dementia in a community sample. Nevertheless, clinical assessment procedures need to be refined to improve the identification of pre-dementia individuals. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: positional versus object-location recall.

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    Kessels, Roy P C; Rijken, Stefan; Joosten-Weyn Banningh, Liesbeth W A; Van Schuylenborgh-VAN Es, Nelleke; Olde Rikkert, Marcel G M

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been studied in patients with Alzheimer dementia (AD), while studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the Location Learning Test (LLT) in MCI patients (n = 30), AD patients (n = 30), and healthy controls (n = 40). Two scoring methods were compared, aimed at disentangling positional recall (location irrespective of object identity) and object-location binding. The results showed that AD patients performed worse than the MCI patients on the LLT, both on recall of positional information and on recall of the locations of different objects. In addition, both measures could validly discriminate between AD and MCI patients. These findings are in agreement with the notion that visual cued-recall tests may have better diagnostic value than traditional (verbal) free-recall tests in the assessment of patients with suspected MCI or AD.

  11. Measurement of Functional Cognition and Complex Everyday Activities in Older Adults with Mild Cognitive Impairment and Mild Dementia: Validity of the Large Allen's Cognitive Level Screen.

    Science.gov (United States)

    Wesson, Jacqueline; Clemson, Lindy; Crawford, John D; Kochan, Nicole A; Brodaty, Henry; Reppermund, Simone

    2017-05-01

    To explore the validity of the Large Allen's Cognitive Level Screen-5 (LACLS-5) as a performance-based measure of functional cognition, representing an ability to perform complex everyday activities in older adults with mild cognitive impairment (MCI) and mild dementia living in the community. Using cross-sectional data from the Sydney Memory and Ageing Study, 160 community-dwelling older adults with normal cognition (CN; N = 87), MCI (N = 43), or dementia (N = 30) were studied. Functional cognition (LACLS-5), complex everyday activities (Disability Assessment for Dementia [DAD]), Assessment of Motor and Process Skills [AMPS]), and neuropsychological measures were used. Participants with dementia performed worse than CN on all clinical measures, and MCI participants were intermediate. Correlational analyses showed that LACLS-5 was most strongly related to AMPS Process scores, DAD instrumental activities of daily living subscale, Mini-Mental State Exam, Block Design, Logical Memory, and Trail Making Test B. Multiple regression analysis indicated that both cognitive (Block Design) and functional measures (AMPS Process score) and sex predicted LACLS-5 performance. Finally, LACLS-5 was able to adequately discriminate between CN and dementia and between MCI and dementia but was unable to reliably distinguish between CN and MCI. Construct validity, including convergent and discriminative validity, was supported. LACLS-5 is a valid performance-based measure for evaluating functional cognition. Discriminativevalidity is acceptable for identifying mild dementia but requires further refinement for detecting MCI. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  12. Telephone screening for mild cognitive impairment in hispanics using the Alzheimer's questionnaire.

    Science.gov (United States)

    Salazar, Ricardo; Velez, Carlos E; Royall, Donald R

    2014-01-01

    BACKGROUND/STUDY CONTEXT: There is a need for a simple and reliable screening test to detect individuals with mild cognitive impairment (MCI). The authors analyzed the relationship between performance of the Alzheimer's Questionnaire (AQ), an informant-rated measure of dementia-related behaviors, relative to the Telephone Interview for Cognitive Status-modified (TICS-m), Memory Impairment Scale-telephone version (MIS-t), and the Telephone Executive Assessment (TEXAS) as predictors of MCI. Comparative cross-sectional design, with data collected from participants in the Texas Alzheimer's Research and Care Consortium's (TARCC) San Antonio site. One-hundred percent of our sample was Hispanic. The San Antonio subset of TARCC sample is highly enriched with Mexican Americans (MAs). Fifty-five percent of the interviews were conducted in Spanish. Of the 184 persons enrolled, 124 were normal controls (NCs), and 60 participants had MCI. MCI status and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) were determined through clinical consensus and performed blind to telephone assessments. Controlling for age, gender, education, and language of interview, the association between telephone measures and CDR-SOB was evaluated by multivariate regression. AQ scores were not affected by education, gender, and language of interview, but subject's age did show a positive correlation with informant AQ ratings. The AQ predicted CDR-SOB independently of the cognitive measures, adding variance above and beyond demographics. The TICS-m and the TEXAS appear to have additive value in improving the detection of cognitively impaired patients. The MIS-t failed to contribute significantly to CDR-SOB, independent of the other measures. The AQ may have utility as a culture-fair telephone screening for MCI. The AQ was able to modestly distinguish MCI from NCs. The TEXAS adds variance to a model of dementia severity independent of the AQ, suggesting that the latter may weakly assess that

  13. Cognitive Impairment in Heart Failure

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    Efthimios Dardiotis

    2012-01-01

    Full Text Available Cognitive impairment (CI is increasingly recognized as a common adverse consequence of heart failure (HF. Although the exact mechanisms remain unclear, microembolism, chronic or intermittent cerebral hypoperfusion, and/or impaired cerebral vessel reactivity that lead to cerebral hypoxia and ischemic brain damage seem to underlie the development of CI in HF. Cognitive decline in HF is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients’ decision-making capacity and interfere with their ability to comply with treatment requirements, recognize and self-manage disease worsening symptoms. CI may have fluctuations in severity over time, improve with effective HF treatment or progress to dementia. CI is independently associated with disability, mortality, and decreased quality of life of HF patients. It is essential therefore for health professionals in their routine evaluations of HF patients to become familiar with assessment of cognitive performance using standardized screening instruments. Future studies should focus on elucidating the mechanisms that underlie CI in HF and establishing preventive strategies and treatment approaches.

  14. Clock drawing test in screening for Alzheimer's dementia and mild cognitive impairment in clinical practice.

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    Vyhnálek, Martin; Rubínová, Eva; Marková, Hana; Nikolai, Tomáš; Laczó, Jan; Andel, Ross; Hort, Jakub

    2017-09-01

    The clock drawing test (CDT) is a commonly used brief cognitive measure. We evaluated diagnostic accuracy of subjective ratings of CDT by physicians (with/without specialty in cognitive neurology) and neuropsychologists in discriminating amnestic mild cognitive impairment (aMCI), Alzheimer's dementia (AD) and cognitively healthy older adults. We further compared the diagnostic accuracy of subjective categorical ratings with complex scoring of CDT. Three cognitive neurologists, three neuropsychologists and six neurology residents without experience in cognitive neurology blinded to the diagnosis rated 187 CDTs (50 mild AD, 49 aMCI and 88 cognitively healthy older adults) using a "yes" (abnormal) versus "suspected" versus "no" (normal) classification. The rating suspected was combined with yes or no to obtain two sets of sensitivity estimates. We also used a 17-point CDT rating system. When using the categorical rating, neuropsychologists had highest sensitivity (89%) in differentiating patients with mild AD (yes/suspected versus no), followed by neurologic residents (80%) and cognitive neurologists (79%). When differentiating patients with aMCI (yes/suspected versus no), the sensitivity was 84% for neuropsychologists, 64% for cognitive neurologists and 62% for residents. The sensitivity using the complex scoring system was 92% in patients with mild AD and 69% in patients with aMCI. A categorical rating of CDT shows high sensitivity for mild AD even in non-experienced raters. Neuropsychologists outperformed physicians in differentiating patients with aMCI from cognitively healthy older adults (specificity), which was counterbalanced by the lower specificity of their ratings. The diagnostic accuracy was not substantially improved by using complex scoring system. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  15. Classifying MCI Subtypes in Community-Dwelling Elderly Using Cross-Sectional and Longitudinal MRI-Based Biomarkers

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    Hao Guan

    2017-09-01

    Full Text Available Amnestic MCI (aMCI and non-amnestic MCI (naMCI are considered to differ in etiology and outcome. Accurately classifying MCI into meaningful subtypes would enable early intervention with targeted treatment. In this study, we employed structural magnetic resonance imaging (MRI for MCI subtype classification. This was carried out in a sample of 184 community-dwelling individuals (aged 73–85 years. Cortical surface based measurements were computed from longitudinal and cross-sectional scans. By introducing a feature selection algorithm, we identified a set of discriminative features, and further investigated the temporal patterns of these features. A voting classifier was trained and evaluated via 10 iterations of cross-validation. The best classification accuracies achieved were: 77% (naMCI vs. aMCI, 81% (aMCI vs. cognitively normal (CN and 70% (naMCI vs. CN. The best results for differentiating aMCI from naMCI were achieved with baseline features. Hippocampus, amygdala and frontal pole were found to be most discriminative for classifying MCI subtypes. Additionally, we observed the dynamics of classification of several MRI biomarkers. Learning the dynamics of atrophy may aid in the development of better biomarkers, as it may track the progression of cognitive impairment.

  16. Changes in thalamus connectivity in mild cognitive impairment: Evidence from resting state fMRI

    International Nuclear Information System (INIS)

    Wang Zhiqun; Jia Xiuqin; Liang Peipeng; Qi Zhigang; Yang Yanhui; Zhou Weidong; Li Kuncheng

    2012-01-01

    Purpose: The subcortical region such as thalamus was believed to have close relationship with many cerebral cortexes which made it especially interesting in the study of functional connectivity. Here, we used resting state functional MRI (fMRI) to examine changes in thalamus connectivity in mild cognitive impairment (MCI), which presented a neuro-disconnection syndrome. Materials and methods: Data from 14 patients and 14 healthy age-matched controls were analyzed. Thalamus connectivity was investigated by examination of the correlation between low frequency fMRI signal fluctuations in the thalamus and those in all other brain regions. Results: We found that functional connectivity between the left thalamus and a set of regions was decreased in MCI; these regions are: bilateral cuneus, middle occipital gyrus (MOG), superior frontal gyrus (SFG), medial prefrontal cortex (MPFC), precuneus, inferior frontal gyrus (IFG) and precentral gyrus (PreCG). There are also some regions showed reduced connectivity to right thalamus; these regions are bilateral cuneus, MOG, fusiform gyrus (FG), MPFC, paracentral lobe (PCL), precuneus, superior parietal lobe (SPL) and IFG. We also found increased functional connectivity between the left thalamus and the right thalamus in MCI. Conclusion: The decreased connectivity between the thalamus and the other brain regions might indicate reduced integrity of thalamus-related cortical networks in MCI. Furthermore, the increased connectivity between the left and right thalamus suggest compensation for the loss of cognitive function. Briefly, impairment and compensation of thalamus connectivity coexist in the MCI patients.

  17. Dynamic working memory performance in individuals with single-domain amnestic mild cognitive impairment.

    Science.gov (United States)

    Guild, Emma B; Vasquez, Brandon P; Maione, Andrea M; Mah, Linda; Ween, Jon; Anderson, Nicole D

    2014-01-01

    Previous studies have observed poorer working memory performance in individuals with amnestic mild cognitive impairment than in healthy older adults. It is unclear, however, whether these difficulties are true only of the multiple-domain clinical subtype in whom poorer executive functioning is common. The current study examined working memory, as measured by the self-ordered pointing task (SOPT) and an n-back task, in healthy older adults and adults with single-domain amnestic mild cognitive impairment (aMCI). Individuals with single-domain aMCI committed more errors and required longer to develop an organizational strategy on the SOPT. The single-domain aMCI group did not differ from healthy older adults on the 1-back or 2-back, but had poorer discrimination on the 3-back task. This is, to our knowledge, the first characterization of dynamic working memory performance in a single-domain aMCI group. These results lend support for the idea that clinical amnestic MCI subtypes may reflect different stages on a continuum of progression to dementia and question whether standardized measures of working memory (span tasks) are sensitive enough to capture subtle changes in performance.

  18. Treatment of Cognitive Impairment in Multiple Sclerosis

    Science.gov (United States)

    Pierson, Susan H.; Griffith, Nathan

    2006-01-01

    Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the cognitive impairment of multiple sclerosis are reviewed including the effects of disease modifying therapies and the use of physical and cognitive interventions. PMID:16720960

  19. Autonomous unobtrusive detection of mild cognitive impairment in older adults.

    Science.gov (United States)

    Akl, Ahmad; Taati, Babak; Mihailidis, Alex

    2015-05-01

    The current diagnosis process of dementia is resulting in a high percentage of cases with delayed detection. To address this problem, in this paper, we explore the feasibility of autonomously detecting mild cognitive impairment (MCI) in the older adult population. We implement a signal processing approach equipped with a machine learning paradigm to process and analyze real-world data acquired using home-based unobtrusive sensing technologies. Using the sensor and clinical data pertaining to 97 subjects, acquired over an average period of three years, a number of measures associated with the subjects' walking speed and general activity in the home were calculated. Different time spans of these measures were used to generate feature vectors to train and test two machine learning algorithms namely support vector machines and random forests. We were able to autonomously detect MCI in older adults with an area under the ROC curve of 0.97 and an area under the precision-recall curve of 0.93 using a time window of 24 weeks. This study is of great significance since it can potentially assist in the early detection of cognitive impairment in older adults.

  20. The Gesture Imitation in Alzheimer's Disease Dementia and Amnestic Mild Cognitive Impairment.

    Science.gov (United States)

    Li, Xudong; Jia, Shuhong; Zhou, Zhi; Hou, Chunlei; Zheng, Wenjing; Rong, Pei; Jiao, Jinsong

    2016-07-14

    Alzheimer's disease dementia (ADD) has become an important health problem in the world. Visuospatial deficits are considered to be an early symptom besides memory disorder. The gesture imitation test was devised to detect ADD and amnestic mild cognitive impairment (aMCI). A total of 117 patients with ADD, 118 with aMCI, and 95 normal controls were included in this study. All participants were administered our gesture imitation test, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Clinical Dementia Rating Scale (CDR). Patients with ADD performed worse than normal controls on global scores and had a lower success rate on every item (p imitation test scores were positively correlated with the MMSE (r = 0.637, p imitation test is an easy, rapid tool for detecting ADD, and is suitable for the patients suspected of mild ADD and aMCI in outpatient clinics.

  1. Changes of brain structure in Parkinson's disease patients with mild cognitive impairment analyzed via VBM technology.

    Science.gov (United States)

    Gao, Yuyuan; Nie, Kun; Huang, Biao; Mei, Mingjin; Guo, Manli; Xie, Sifen; Huang, Zhiheng; Wang, Limin; Zhao, Jiehao; Zhang, Yuhu; Wang, Lijuan

    2017-09-29

    To analyze changes in cerebral grey matter volume and white matter density in non-dementia Parkinson's disease patients using voxel-based morphometry (VBM) technology; to investigate features of brain structure changes in Parkinson's disease patients with mild cognitive impairment (PD-MCI), and reveal their intrinsic pathological changes. Based on the diagnostic criteria of PD-MCI, 23 PD-MCI patients, 23 Parkinson's disease patients with normal cognition (PD-NC), and 21 age- and gender-matched healthy people were recruited for the study. Scans were performed on all subjects on a 3.0T MR scanner to obtain brain structural magnetic resonance images. Images were preprocessed using the VBM8 tool from SPM8 software package on the Matlab R2008a platform, and data were then analyzed using the SPM statistical software package to compare the differences of grey matter volume and white matter density between groups, and to evaluate the brain structural changes corresponding to the overall cognitive function. Compared to the control group, the PD-NC group suffered from grey matter atrophy, mainly found in the prefrontal lobe, limbic lobe and left temporal gyrus. The PD-MCI group suffered from grey matter atrophy found in the frontal lobe, limbic lobe, basal ganglia and cerebellum. Compared to the PD-NC group, the PD-MCI group suffered from grey matter atrophy found in the left-side middle temporal gyrus, inferior temporal gyrus and frontal lobe. The grey matter regions correlated with MMSE score (mainly memory related) including the right cingulate gyrus and the limbic lobe. The grey matter regions correlated with MoCA score (mainly non-memory related) including the frontal lobe, basal ganglia, parahippocampal gyrus, occipital lobe and the cerebellum. Additionally, overall cognitive function in non-dementia PD was mainly located in the frontal and limbic system, and was dominated by subcortical atrophy. Structural changes in PD-MCI patients are associated with overall

  2. Comparison of performance on neuropsychological tests in amnestic Mild Cognitive Impairment and Alzheimer's disease patients

    Directory of Open Access Journals (Sweden)

    Patrícia Helena Figueirêdo do Vale

    Full Text Available Abstract Mild Cognitive Impairment (MCI can be an intermediate state between normality and dementia in some patients. An early diagnosis, through neuropsychological assessment, could identify individuals at risk of developing dementia. Objective: To verify differences in performance on neuropsychological tests among controls, amnestic MCI (aMCI and Alzheimer’s disease (AD patients. Methods: Sixty-eight AD patients (mean age 73.77±7.24; mean schooling 9.04±4.83; 40 women and 28 men, 34 aMCI patients (mean age 74.44±7.05; mean schooling 12.35±4.01; 20 women and 60 controls (mean age 68.90±7.48; mean schooling 10.72±4.74; 42 women were submitted to a neuropsychological assessment composed of tasks assessing executive functions, language, constructive abilities, reasoning and memory. Results: There were statistically significant differences in performance across all tests among control, aMCI and AD groups, and also between only controls and AD patients. On comparing control and aMCI groups, we found statistically significant differences in memory tasks, except for immediate recall of Visual Reproduction. There were also statistically significant differences between aMCI and AD groups on tasks of constructive and visuoperceptual abilities, attention, language and memory, except for delayed recall of Visual Reproduction. Conclusions: Neuropsychological assessment was able to discriminate aMCI from AD patients in almost all tests except for delayed recall of Visual Reproduction, visual organization (Hooper and executive functions (WCST; and discriminate controls from AD patients in all tests, and controls from aMCI patients in all memory tests except for immediate recall of Visual Reproduction.

  3. Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review.

    Science.gov (United States)

    Jekel, Katrin; Damian, Marinella; Wattmo, Carina; Hausner, Lucrezia; Bullock, Roger; Connelly, Peter J; Dubois, Bruno; Eriksdotter, Maria; Ewers, Michael; Graessel, Elmar; Kramberger, Milica G; Law, Emma; Mecocci, Patrizia; Molinuevo, José L; Nygård, Louise; Olde-Rikkert, Marcel Gm; Orgogozo, Jean-Marc; Pasquier, Florence; Peres, Karine; Salmon, Eric; Sikkes, Sietske Am; Sobow, Tomasz; Spiegel, René; Tsolaki, Magda; Winblad, Bengt; Frölich, Lutz

    2015-01-01

    There is a growing body of evidence that subtle deficits in instrumental activities of daily living (IADL) may be present in mild cognitive impairment (MCI). However, it is not clear if there are IADL domains that are consistently affected across patients with MCI. In this systematic review, therefore, we aimed to summarize research results regarding the performance of MCI patients in specific IADL (sub)domains compared with persons who are cognitively normal and/or patients with dementia. The databases PsycINFO, PubMed and Web of Science were searched for relevant literature in December 2013. Publications from 1999 onward were considered for inclusion. Altogether, 497 articles were retrieved. Reference lists of selected articles were searched for potentially relevant articles. After screening the abstracts of these 497 articles, 37 articles were included in this review. In 35 studies, IADL deficits (such as problems with medication intake, telephone use, keeping appointments, finding things at home and using everyday technology) were documented in patients with MCI. Financial capacity in patients with MCI was affected in the majority of studies. Effect sizes for group differences between patients with MCI and healthy controls were predominantly moderate to large. Performance-based instruments showed slight advantages (in terms of effect sizes) in detecting group differences in IADL functioning between patients with MCI, patients with Alzheimer's disease and healthy controls. IADL requiring higher neuropsychological functioning seem to be most severely affected in patients with MCI. A reliable identification of such deficits is necessary, as patients with MCI with IADL deficits seem to have a higher risk of converting to dementia than patients with MCI without IADL deficits. The use of assessment tools specifically designed and validated for patients with MCI is therefore strongly recommended. Furthermore, the development of performance-based assessment instruments

  4. Everyday episodic memory in amnestic mild cognitive impairment: a preliminary investigation.

    Science.gov (United States)

    Irish, Muireann; Lawlor, Brian A; Coen, Robert F; O'Mara, Shane M

    2011-08-04

    Decline in episodic memory is one of the hallmark features of Alzheimer's disease (AD) and is also a defining feature of amnestic Mild Cognitive Impairment (MCI), which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient's daily life. In order to fully explore the impact of disruption to the episodic memory system on everyday memory in MCI, we examined participants' episodic memory capacity using a battery of experimental tasks with real-world relevance. We investigated episodic acquisition and delayed recall (story-memory), associative memory (face-name pairings), spatial memory (route learning and recall), and memory for everyday mundane events in 16 amnestic MCI and 18 control participants. Furthermore, we followed MCI participants longitudinally to gain preliminary evidence regarding the possible predictive efficacy of these real-world episodic memory tasks for subsequent conversion to AD. The most discriminating tests at baseline were measures of acquisition, delayed recall, and associative memory, followed by everyday memory, and spatial memory tasks, with MCI patients scoring significantly lower than controls. At follow-up (mean time elapsed: 22.4 months), 6 MCI cases had progressed to clinically probable AD. Exploratory logistic regression analyses revealed that delayed associative memory performance at baseline was a potential predictor of subsequent conversion to AD. As a preliminary study, our findings suggest that simple associative memory paradigms with real-world relevance represent an important line of enquiry in future longitudinal studies charting MCI progression over time.

  5. Everyday episodic memory in amnestic mild cognitive impairment: a preliminary investigation

    Directory of Open Access Journals (Sweden)

    Lawlor Brian A

    2011-08-01

    Full Text Available Abstract Background Decline in episodic memory is one of the hallmark features of Alzheimer's disease (AD and is also a defining feature of amnestic Mild Cognitive Impairment (MCI, which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient's daily life. In order to fully explore the impact of disruption to the episodic memory system on everyday memory in MCI, we examined participants' episodic memory capacity using a battery of experimental tasks with real-world relevance. We investigated episodic acquisition and delayed recall (story-memory, associative memory (face-name pairings, spatial memory (route learning and recall, and memory for everyday mundane events in 16 amnestic MCI and 18 control participants. Furthermore, we followed MCI participants longitudinally to gain preliminary evidence regarding the possible predictive efficacy of these real-world episodic memory tasks for subsequent conversion to AD. Results The most discriminating tests at baseline were measures of acquisition, delayed recall, and associative memory, followed by everyday memory, and spatial memory tasks, with MCI patients scoring significantly lower than controls. At follow-up (mean time elapsed: 22.4 months, 6 MCI cases had progressed to clinically probable AD. Exploratory logistic regression analyses revealed that delayed associative memory performance at baseline was a potential predictor of subsequent conversion to AD. Conclusions As a preliminary study, our findings suggest that simple associative memory paradigms with real-world relevance represent an important line of enquiry in future longitudinal studies charting MCI progression over time.

  6. Individual cerebral metabolic deficits in Alzheimer's disease and amnestic mild cognitive impairment: an FDG PET study

    International Nuclear Information System (INIS)

    Del Sole, Angelo; Lecchi, Michela; Lucignani, Giovanni; Clerici, Francesca; Mariani, Claudio; Maggiore, Laura; Chiti, Arturo; Mosconi, Lisa

    2008-01-01

    The purpose of the study was the identification of group and individual subject patterns of cerebral glucose metabolism (CMRGlu) in patients with Alzheimer's disease (AD) and with amnestic mild cognitive impairment (aMCI). [ 18 F]fluorodeoxyglucose positron emission tomography (PET) studies and neuropsychological tests were performed in 16 aMCI patients (ten women, age 75 ± 8 years) and in 14 AD patients (ten women, age 75 ± 9 years). Comparisons between patient subgroups and with a control population were performed using Statistical Parametric Mapping. Clusters of low CMRGlu were observed bilaterally in the posterior cingulate cortex (PCC), in the precuneus, in the inferior parietal lobule and middle temporal gyrus of AD patients. In aMCI patients, reduced CMRGlu was found only in PCC. Areas of low CMRGlu in PCC were wider in AD compared to aMCI and extended to the precuneus, while low CMRGlu was found in the lateral parietal cortex in AD but not in aMCI patients. Individual subject pattern analysis revealed that 86% of AD patients had low CMRGlu in the PCC (including the precuneus in 71%), 71% in the temporal cortex, 64% in the parietal cortex and 35% in the frontal cortex. Among the aMCI patients, 56% had low CMRGlu in the PCC, 44% in the temporal cortex, 18% in the frontal cortex and none in the parietal cortex. This study demonstrates that both AD and aMCI patients have highly heterogeneous metabolic impairment. This potential of individual metabolic PET imaging in patients with AD and aMCI may allow timely identification of brain damage on individual basis and possibly help planning tailored early interventions. (orig.)

  7. Differentiation between mild cognitive impairment, Alzheimer's disease and depression by means of cued recall.

    Science.gov (United States)

    Dierckx, E; Engelborghs, S; De Raedt, R; De Deyn, P P; Ponjaert-Kristoffersen, I

    2007-05-01

    Discriminating Alzheimer's disease (AD) and mild cognitive impairment (MCI) from depression is a challenge in psychogeriatric medicine. A study was set up to ascertain whether cued recall could be useful in differentiating early AD and MCI from depression among elderly individuals. The Visual Association Test (VAT) and the Memory Impairment Screen-plus (MIS-plus) were administered together with the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) to 40 MCI patients, 35 mild AD patients, 46 depressed patients and 52 healthy control subjects. A one-way analysis of variance (ANOVA) followed by post-hoc Scheffé tests showed that AD patients had significantly lower cued recall scores (i.e. combined VAT and MIS-plus scores) than MCI patients, who in turn had lower scores than depressed patients. The scores of depressed patients and controls were not significantly different. Discriminant analysis revealed that 94% of the AD patients and 96% of the depressed patients could be classified correctly by means of the GDS and the cued recall sores. Receiver operating characteristic (ROC) curves identified an optimal cut-off score of 8 (maximum score 12) for differentiating AD and MCI patients from depressed elderly patients and controls. Applying this cut-off, a sensitivity of 83% (58%) and a specificity of 85% (85%) was obtained when differentiating AD (MCI) from depression. Cued recall, operationalized by the combined scores of VAT and MIS-plus, is a useful method for differentiating AD patients from depressed individuals and healthy controls. Probably because of the great heterogeneity among MCI patients, the diagnostic power of cued recall decreases when applied to differentiate MCI from depression.

  8. Everyday episodic memory in amnestic Mild Cognitive Impairment: a preliminary investigation

    LENUS (Irish Health Repository)

    Irish, Muireann

    2011-08-04

    Abstract Background Decline in episodic memory is one of the hallmark features of Alzheimer\\'s disease (AD) and is also a defining feature of amnestic Mild Cognitive Impairment (MCI), which is posited as a potential prodrome of AD. While deficits in episodic memory are well documented in MCI, the nature of this impairment remains relatively under-researched, particularly for those domains with direct relevance and meaning for the patient\\'s daily life. In order to fully explore the impact of disruption to the episodic memory system on everyday memory in MCI, we examined participants\\' episodic memory capacity using a battery of experimental tasks with real-world relevance. We investigated episodic acquisition and delayed recall (story-memory), associative memory (face-name pairings), spatial memory (route learning and recall), and memory for everyday mundane events in 16 amnestic MCI and 18 control participants. Furthermore, we followed MCI participants longitudinally to gain preliminary evidence regarding the possible predictive efficacy of these real-world episodic memory tasks for subsequent conversion to AD. Results The most discriminating tests at baseline were measures of acquisition, delayed recall, and associative memory, followed by everyday memory, and spatial memory tasks, with MCI patients scoring significantly lower than controls. At follow-up (mean time elapsed: 22.4 months), 6 MCI cases had progressed to clinically probable AD. Exploratory logistic regression analyses revealed that delayed associative memory performance at baseline was a potential predictor of subsequent conversion to AD. Conclusions As a preliminary study, our findings suggest that simple associative memory paradigms with real-world relevance represent an important line of enquiry in future longitudinal studies charting MCI progression over time.

  9. Yes/No Versus Forced-Choice Recognition Memory in Mild Cognitive Impairment and Alzheimer’s Disease: Patterns of Impairment and Associations with Dementia Severity

    Science.gov (United States)

    Clark, Lindsay R.; Stricker, Nikki H.; Libon, David J.; Delano-Wood, Lisa; Salmon, David P.; Delis, Dean C.; Bondi, Mark W.

    2012-01-01

    Memory tests are sensitive to early identification of Alzheimer’s disease (AD) but less useful as the disease advances. However, assessing particular types of recognition memory may better characterize dementia severity in later stages of AD. We sought to examine patterns of recognition memory deficits in individuals with AD and mild cognitive impairment (MCI). Memory performance and global cognition data were collected from participants with AD (n=37), MCI (n=37), and cognitively intact older adults (normal controls, NC; n=35). One-way analyses of variance (ANOVAs) examined differences between groups on yes/no and forced-choice recognition measures. Individuals with amnestic MCI performed worse than NC and nonamnestic MCI participants on yes/no recognition, but were comparable on forced-choice recognition. AD patients were more impaired across yes/no and forced-choice recognition tasks. Individuals with mild AD (≥120 Dementia Rating Scale, DRS) performed better than those with moderate-to-severe AD (recognition, but were equally impaired on yes/no recognition. There were differences in the relationships between learning, recall, and recognition performance across groups. Although yes/no recognition testing may be sensitive to MCI, forced-choice procedures may provide utility in assessing severity of anterograde amnesia in later stages of AD. Implications for assessment of insufficient effort and malingering are also discussed. PMID:23030301

  10. Serial position effects in patients with mild cognitive impairment and early and moderate Alzheimer's disease compared with healthy comparison subjects.

    Science.gov (United States)

    Moser, B; Deisenhammer, E A; Marksteiner, J; Papousek, I; Fink, A; Weiss, E M

    2014-01-01

    This study aimed to investigate whether the serial position effects in memory can differentiate patients with different subtypes of mild cognitive impairment (MCI) from healthy controls and patients with different stages of Alzheimer's disease (AD). The serial position effects was tested with the CERAD word list task in 184 persons (39 healthy control subjects, 15 amnestic MCI single domain subjects, 23 amnestic MCI multiple domain subjects, 31 nonamnestic MCI subjects, 45 early or mild AD patients, and 31 moderate AD patients). With progression of dementia, memory deficits increased and the impairment in the primacy effect during the learning trials advanced, whereas the recall of recent items was less impaired. The serial position profile of nonamnestic MCI patients resembled that of healthy control subjects, whereas amnestic MCI patients showed poorer performance in all 3 positions but no significant difference as a function of serial word position. Analyses of the serial position effect may be a useful complement to clinical neuropsychological measures for distinguishing amnestic MCI patients from normal aging and patients with different stages of dementia. © 2013 S. Karger AG, Basel.

  11. Prevalence and conversion to dementia of Mild Cognitive Impairment in an elderly Italian population.

    Science.gov (United States)

    Limongi, Federica; Siviero, Paola; Noale, Marianna; Gesmundo, Antonella; Crepaldi, Gaetano; Maggi, Stefania

    2017-06-01

    Mild Cognitive Impairment (MCI) represents a significant risk factor for dementia but there are only a few Italian population studies on its prevalence and its rate of conversion to dementia. Aim of this study was to assess the prevalence of MCI, its subtypes, and rates of conversion to dementia 1 year later in an elderly Italian population. The data are based on an Italian multicenter population-based cohort study with both cross-sectional and longitudinal components. Two thousand three hundred thirty-seven individuals over 65 underwent screening, clinical confirmation and 1-year follow-up. The prevalence of MCI was 21.6% and the amnestic multiple domain was the most frequent subtype (63.2%). The conversion rate to dementia was 4.1% and was found only in the amnestic multiple domain and in the unclassifiable subjects, persons with cognitive deficit but neither demented nor with MCI. The prevalence of MCI in this population sample was similar to that found in other population studies using Petersen's modified MCI criteria as well as his original criteria. With regard to conversion to dementia, our results emphasize the importance to better classify the unclassifiable subjects at high risk of progression to dementia and also at risk of being undiagnosed and untreated. MCI is characterized by extreme variability and instability. Data on the prevalence and the rate of conversion from MCI to dementia are difficult to compare given the important differences from study to study especially with regard to the diagnostic criteria utilized and their operationalization.

  12. Early identification of MCI converting to AD: a FDG PET study

    International Nuclear Information System (INIS)

    Pagani, Marco; Nobili, Flavio; Arnaldi, Dario; Brugnolo, Andrea; Picco, Agnese; Morbelli, Silvia; Bauckneht, Matteo; Piva, Roberta; Sambuceti, Gianmario; Giuliani, Alessandro; Oeberg, Johanna; Girtler, Nicola; Chincarini, Andrea; Jonsson, Cathrine; De Carli, Fabrizio

    2017-01-01

    Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD. (orig.)

  13. Early identification of MCI converting to AD: a FDG PET study

    Energy Technology Data Exchange (ETDEWEB)

    Pagani, Marco [Institute of Cognitive Sciences and Technologies, CNR, Rome (Italy); Karolinska Hospital Stockholm, Department of Nuclear Medicine, Stockholm (Sweden); Nobili, Flavio; Arnaldi, Dario; Brugnolo, Andrea; Picco, Agnese [University of Genoa and IRCCS AOU San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Genoa (Italy); Morbelli, Silvia; Bauckneht, Matteo; Piva, Roberta; Sambuceti, Gianmario [University of Genoa and IRCCS AOU San Martino-IST, Department of Nuclear Medicine, Department of Health Science (DISSAL), Genoa (Italy); Giuliani, Alessandro [Istituto Superiore di Sanita, Environment and Health Department, Rome (Italy); Oeberg, Johanna [Karolinska Hospital, Department of Hospital Physics, Stockholm (Sweden); Girtler, Nicola [University of Genoa and IRCCS AOU San Martino-IST, Clinical Neurology, Department of Neuroscience (DINOGMI), Genoa (Italy); IRCCS AOU San Martino-IST, Clinical Psychology, Genoa (Italy); Chincarini, Andrea [National Institute of Nuclear Physics (INFN), Genoa section, Genoa (Italy); Jonsson, Cathrine [Karolinska University Hospital, Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology, Stockholm (Sweden); De Carli, Fabrizio [AOU San Martino-IST, Institute of Molecular Bioimaging and Physiology, CNR - Genoa Unit, Genoa (Italy)

    2017-11-15

    Mild cognitive impairment (MCI) is a transitional pathological stage between normal ageing (NA) and Alzheimer's disease (AD). Although subjects with MCI show a decline at different rates, some individuals remain stable or even show an improvement in their cognitive level after some years. We assessed the accuracy of FDG PET in discriminating MCI patients who converted to AD from those who did not. FDG PET was performed in 42 NA subjects, 27 MCI patients who had not converted to AD at 5 years (nc-MCI; mean follow-up time 7.5 ± 1.5 years), and 95 MCI patients who converted to AD within 5 years (MCI-AD; mean conversion time 1.8 ± 1.1 years). Relative FDG uptake values in 26 meta-volumes of interest were submitted to ANCOVA and support vector machine analyses to evaluate regional differences and discrimination accuracy. The MCI-AD group showed significantly lower FDG uptake values in the temporoparietal cortex than the other two groups. FDG uptake values in the nc-MCI group were similar to those in the NA group. Support vector machine analysis discriminated nc-MCI from MCI-AD patients with an accuracy of 89% (AUC 0.91), correctly detecting 93% of the nc-MCI patients. In MCI patients not converting to AD within a minimum follow-up time of 5 years and MCI patients converting within 5 years, baseline FDG PET and volume-based analysis identified those who converted with an accuracy of 89%. However, further analysis is needed in patients with amnestic MCI who convert to a dementia other than AD. (orig.)

  14. Treatment of Cognitive Impairment in Multiple Sclerosis

    OpenAIRE

    Pierson, Susan H.; Griffith, Nathan

    2006-01-01

    Cognitive impairment in multiple sclerosis is an increasingly recognized entity. This article reviews the cognitive impairment of multiple sclerosis, its prevalence, its relationship to different types of multiple sclerosis, and its contribution to long-term functional prognosis. The discussion also focuses on the key elements of cognitive dysfunction in multiple sclerosis which distinguish it from other forms of cognitive impairment. Therapeutic interventions potentially effective for the co...

  15. Evaluating the relationship between education level and cognitive impairment with the Montreal Cognitive Assessment Test.

    Science.gov (United States)

    Yancar Demir, Esra; Özcan, Tuba

    2015-09-01

    Mild cognitive impairment (MCI) is defined as 'a cognitive decline greater than that expected for an individual's age and education level but that does not interfere notably with activities of daily life'. The Montreal Cognitive Assessment (MoCA) is a screening test for MCI. We investigated the performance of the Turkish version of the MoCA in detecting MCI among elderly persons in a rural area, the majority of whom have a low level of education. We evaluated 50 consecutive men referred from an outpatient clinic. Educational level was divided into three categories: group 1, less than primary (5 years). We evaluated the effect of education on MoCA scores and compared subjects' test performance among the different categories of education level. A total of 50 male patients with MCI (mean age: 70.74 ± 7.87) met the inclusion criteria. There were no differences in the total scores based on education or in the subscores for visuospatial/executive function, naming, attention, abstraction and delayed recall. Language was the only domain that showed significant differences between the groups. In post-hoc analysis, differences were found between groups 1 and 3 and between groups 1 and 2. Group 1 had significantly lower scores for language. The repeat subscore for language was significantly lower in group 1 than in group 2. In fluency, there were significant differences between groups 2 and 3 and between group 1 and 3. To our knowledge, this is the first study to analyze the applicability of the Turkish version of MoCA in populations with little education. Our results emphasize the need to adapt the language sections of this test, so it can be easily used in populations with low education levels. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

  16. Type 2 diabetes mellitus might be a risk factor for mild cognitive impairment progressing to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Li W

    2016-09-01

    Full Text Available Wei Li,1,2 Tao Wang,1,2 Shifu Xiao1,2 1Alzheimer’s Disease and Related Disorders Center, 2Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China Background: Mild cognitive impairment (MCI is the prodromal stage of Alzheimer’s disease (AD, so identification of the related risk factors can be helpful. Although the association between type 2 diabetes mellitus (T2DM and these modest changes in cognition is well established, whether T2DM will promote the transformation of MCI into AD is not a unified conclusion.Objective: This study aims to explore the relationship between T2DM and MCI in the elderly population living in the community in Shanghai, People’s Republic of China.Methods: A total of 197 participants were included in the study. They were screened for T2DM, hyperlipidemia, traumatic brain injury, and family history of dementia. The Mini-Mental State Examination and the Montreal Cognitive Assessment were used to assess cognitive function. The diagnosis of AD was made according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, whereas the diagnosis of MCI was made according to Petersen’s criteria. Then, we investigated the relation between T2DM and MCI.Results: A total of 82 (41.6% participants had no cognitive impairment, 82 (41.6% participants had MCI, and 33 (16.8% participants had AD. Multivariate logistic regression models demonstrated that T2DM was a risk factor for AD (odds ratio =49.723, 95% CI =21.173–111.987.Conclusion: T2DM might be a risk factor for MCI progressing into AD. Keywords: T2DM, AD, MCI, risk factor

  17. Social Relationships and Risk of Incident Mild Cognitive Impairment in U.S. Alzheimer’s Disease Centers

    Science.gov (United States)

    Brenowitz, Willa D.; Kukull, Walter A.; Beresford, Shirley A. A.; Monsell, Sarah E.; Williams, Emily C.

    2014-01-01

    Social relationships are hypothesized to prevent or slow cognitive decline. We sought to evaluate associations between social relationships and mild cognitive impairment (MCI). Participants from the National Alzheimer’s Coordinating Center database who were cognitively normal, aged 55 and older at baseline, and had at least two in-person visits (n=5,335) were included. Multivariable Cox proportional hazard models evaluated the association between four social relationships at baseline (marital status, living situation, having children, and having siblings) and risk of developing MCI (based on clinician diagnosis following established criteria). Primary models were adjusted for baseline demographics. Participants were followed, on average, for 3.2 years; 15.2% were diagnosed with MCI. Compared to married participants, risk of MCI was significantly lower for widowed participants (hazard ratio [HR]: 0.87; 95% confidence interval [CI]: 0.76, 0.99) but not for divorced/separated or never married participants. Compared to living with a spouse/partner, risk of MCI was significantly higher for living with others (HR: 1.35; 95% CI: 1.03, 1.77) but not for living alone. Risk of MCI was not associated with having children or having siblings. These results did not consistently identify social relationships as a strong risk factor for, or independent clinical predictor of, MCI. PMID:24577205

  18. ApoE4 effects on automated diagnostic classifiers for mild cognitive impairment and Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Liana G. Apostolova

    2014-01-01

    Full Text Available Biomarkers are the only feasible way to detect and monitor presymptomatic Alzheimer's disease (AD. No single biomarker can predict future cognitive decline with an acceptable level of accuracy. In addition to designing powerful multimodal diagnostic platforms, a careful investigation of the major sources of disease heterogeneity and their influence on biomarker changes is needed. Here we investigated the accuracy of a novel multimodal biomarker classifier for differentiating cognitively normal (NC, mild cognitive impairment (MCI and AD subjects with and without stratification by ApoE4 genotype. 111 NC, 182 MCI and 95 AD ADNI participants provided both structural MRI and CSF data at baseline. We used an automated machine-learning classifier to test the ability of hippocampal volume and CSF Aβ, t-tau and p-tau levels, both separately and in combination, to differentiate NC, MCI and AD subjects, and predict conversion. We hypothesized that the combined hippocampal/CSF biomarker classifier model would achieve the highest accuracy in differentiating between the three diagnostic groups and that ApoE4 genotype will affect both diagnostic accuracy and biomarker selection. The combined hippocampal/CSF classifier performed better than hippocampus-only classifier in differentiating NC from MCI and NC from AD. It also outperformed the CSF-only classifier in differentiating NC vs. AD. Our amyloid marker played a role in discriminating NC from MCI or AD but not for MCI vs. AD. Neurodegenerative markers contributed to accurate discrimination of AD from NC and MCI but not NC from MCI. Classifiers predicting MCI conversion performed well only after ApoE4 stratification. Hippocampal volume and sex achieved AUC = 0.68 for predicting conversion in the ApoE4-positive MCI, while CSF p-tau, education and sex achieved AUC = 0.89 for predicting conversion in ApoE4-negative MCI. These observations support the proposed biomarker trajectory in AD, which postulates

  19. Prospective memory performance in individuals with Parkinson's disease who have mild cognitive impairment.

    Science.gov (United States)

    Costa, Alberto; Peppe, Antonella; Zabberoni, Silvia; Serafini, Francesca; Barban, Francesco; Scalici, Francesco; Caltagirone, Carlo; Carlesimo, Giovanni Augusto

    2015-09-01

    Prospective memory (PM) is the ability to keep in memory and realize future intentions. We aimed at investigating whether in Parkinson's disease (PD) PM deficits are related to mild cognitive impairment (MCI). Other aims were to investigate the cognitive abilities underlying PM performance, and the association between PM performance and measures of daily living functioning. The study included 15 PD patients with single domain MCI, 15 with multiple domain MCI, 17 PD patients without cognitive disorders (PDNC) and 25 healthy controls (HCs). All subjects were administered a PM procedure that included focal (PM cue is processed in the ongoing task) and nonfocal (PM cue is not processed in the ongoing task) conditions. PD patients were administered an extensive neuropsychological battery and scales to assess daily living abilities. PD patients with MCI (both single and multiple domains) showed lower accuracy on all PM conditions than both HC and PDNC patients. This was predicted by their scores on shifting indices. Conversely, PM accuracy of PDNC patients was comparable to HCs. Regression analyses revealed that PD patients' PM performance significantly predicted scores on daily living scales Conclusions: Results suggest that PM efficiency is not tout-court reduced in PD patients, but it specifically depends on the presence of MCI. Moreover, decreased executive functioning, but not episodic memory failure, accounts for a significant proportion of variance in PM performance. Finally, PM accuracy indices were found to be associated with measures of global daily living functioning and management of medication. (c) 2015 APA, all rights reserved).

  20. [Diagnostic value of neuropsychological tests in mild cognitive impairment comorbid with Parkinson's disease].

    Science.gov (United States)

    Laskowska, Ilona; Koczorowski, Andrzej; Koziorowski, Dariusz; Gawryś, Ludwika

    2014-01-01

    Mild cognitive impairment (MCI) is present in on average one-fourth of Parkinson's disease (PD) patients with no dementia diagnosis. Only recently has PD-MCI been treated as a new diagnostic entity. In 2012, unified criteria were adopted which allow both diagnosing MCI in Parkinson's disease (PD-MCI) and further classification taking into account the profile of cognitive dysfunctions and the probability of evolution towards dementia. The diagnostic criteria were presented in the form of stipulations and guidelines assuming that diagnostic process is based on the neuropsychological assessment of the patient. The notion of MCI had been borrowed and for a couple of years had been relying on definitions developed in relation to Alzheimer's disease. For the first time, in the proposed criteria memory dysfunction is not the basis of classification. Only two categories of dysfunctions have been retained, single-domain and multiple-domain. Whether the adopted criteria will contribute to an accurate diagnosis of cognitive dysfunctions and PD-specific dementing processes remains an open question. In spite of some limitations, the presented criteria can certainly improve the efficacy of monitoring the patient's state at the same time allowing the hope for an appropriate therapy and a higher quality of life. Moreover, the unification of diagnostic criteria will be crucial in assessing usefulness ofneuropsychological test instruments as a basic method of investigating neurodegenerative processes not only in PD.

  1. Computer-Based Training Programs for Older People with Mild Cognitive Impairment and/or Dementia

    Directory of Open Access Journals (Sweden)

    Blanka Klimova

    2017-05-01

    Full Text Available Currently, due to the demographic trends, the number of aging population groups is dramatically rising, especially in developed countries. This trend causes serious economic and social issues, but also an increase of aging disorders such as mild cognitive impairment (MCI or dementia in older population groups. MCI and dementia are connected with deterioration of cognitive functions. The aim of this mini review article is therefore to explore whether computer-based training programs might be an effective intervention tool for older people with MCI and/or dementia or not. The methods include a literature search in the world’s acknowledged databases: Web of Science, Scopus, Science Direct, MEDLINE and Springer, and consequently, evaluation of the findings of the relevant studies. The findings from the selected studies are quite neutral with respect to the efficacy of the computer assisted intervention programs on the improvement of basic cognitive functions. On the one hand, they suggest that the computer-based training interventions might generate some positive effects on patients with MCI and/or dementia, such as the improvement of learning and short-term memory, as well as behavioral symptoms. On the other hand, these training interventions seem to be short-term, with small sample sizes and their efficacy was proved only in the half of the detected studies. Therefore more longitudinal randomized controlled trials (RCTs are needed to prove the efficacy of the computer-based training programs among older individuals with MCI and/or dementia.

  2. Dual-task during gait between elderly with mild cognitive impairment and Alzheimer: systematic review

    Directory of Open Access Journals (Sweden)

    Vanessa Santa Rosa Bragatto

    Full Text Available Abstract Introduction: Studies report that mobility changes could be present in early stages of Alzheimer’s disease (AD or even in previous stages, such as mild cognitive impairment (MCI. The use of motor tests, involving dual task, could facilitate screening and differentiation between elderly with AD and MCI. Objective: to verify if gait tests associated with secondary tasks could differentiate elderly with AD and MCI. Methods: We conducted a systematic review in Pubmed, Web of Science, Medline and Scielo databases. Of the articles included, we collected information about year of the study, characteristics of the sample and the dual task test studied. Results: The databases were accessed during November 2014 and August 2015 and a total of 198 scientific papers was obtained. After reading first the summaries and then the full texts, five studies were inserted in the review. Elderly with AD presented a reduction of gait speed and stride length, using executive functions and countdown as secondary cognitive tasks. The type of MCI appears to influence the differentiation with AD. Conclusion: The review showed that some gait tests associated with a secondary task differentiate elderly with AD and MCI. It emphasizes the need of new studies involving this issue in order to obtain cut-off points and facilitate prevention, early diagnosis and observation of cognitive impairment’s evolution in clinical practice of elderly.

  3. Risk Factors for Mild Cognitive Impairment, Dementia and Mortality: The Sydney Memory and Ageing Study.

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    Lipnicki, Darren M; Crawford, John; Kochan, Nicole A; Trollor, Julian N; Draper, Brian; Reppermund, Simone; Maston, Kate; Mather, Karen A; Brodaty, Henry; Sachdev, Perminder S

    2017-05-01

    The nature and commonality of late-life risk factors for mild cognitive impairment (MCI), dementia, and mortality remain unclear. Our aim was to investigate potential risk factors, simultaneously in a single cohort including many individuals initially with normal cognition and followed for 6 years. We classified 873 community-dwelling individuals (70-90 years old and without dementia at baseline) from the Sydney Memory and Ageing Study as cognitively normal (CN), having MCI or dementia, or deceased 6 years after baseline. Associations with baseline demographic, lifestyle, health, and medical factors were investigated, including apolipoprotein (APOE) genotype, MCI at baseline, and reversion from MCI to CN within 2 years of baseline. Eighty-three (9.5%) participants developed dementia and 114 (13%) died within 6 years; nearly 33% had MCI at baseline, of whom 28% reverted to CN within 2 years. A core set of baseline factors was associated with MCI and dementia at 6 years, including older age (per year: odds ratios and 95% confidence intervals = 1.08, 1.01-1.14 for MCI; 1.19, 1.09-1.31 for dementia), MCI at baseline (5.75, 3.49-9.49; 8.23, 3.93-17.22), poorer smelling ability (per extra test point: 0.89, 0.79-1.02; 0.80, 0.68-0.94), slower walking speed (per second: 1.12, 1.00-1.25; 1.21, 1.05-1.39), and being an APOE ε4 carrier (1.84, 1.07-3.14; 3.63, 1.68-7.82). All except APOE genotype were also associated with mortality (age: 1.11, 1.03-1.20; MCI: 3.87, 1.97-7.59; smelling ability: 0.83, 0.70-0.97; walking speed: 1.18, 1.03-1.34). Compared with stable CN participants, individuals reverting from MCI to CN after 2 years were at greater risk of future MCI (3.06, 1.63-5.72). Those who reverted exhibited some different associations between baseline risk factors and 6-year outcomes than individuals with stable MCI. A core group of late-life risk factors indicative of physical and mental frailty are associated with each of dementia, MCI, and mortality after 6

  4. Views on Lifestyle Change From Caregivers of People With Cognitive Impairment in China

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    Y. John Mei

    2013-08-01

    Full Text Available Lifestyle changes such as in physical exercise, social activity, and diet can mitigate cognitive decline and improve quality of life in caregivers and care recipients with cognitive impairment. However, caregiver perspectives on lifestyle change remain largely unexamined. This study compares perspectives among caregivers for those with dementia and those with mild cognitive impairment (MCI. Interviews were conducted with caregivers in two sites in China, and thematic similarities and differences were examined between the two groups. Caregivers from both groups identified exercise, social activity, and diet as healthy ways of life. Differences were found in approaching lifestyle change based on health of the care recipient. Caregivers for patients with dementia found more often that they had no time or possibility for change, while caregivers for individuals with MCI were more often hopeful about change.

  5. [Characteristics of cerebral glucose metabolism in patients with cognitive impairment in Parkinson's disease].

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    Homenko, Ju G; Susin, D S; Kataeva, G V; Irishina, Ju A; Zavolokov, I G

    To study the relationship between early cognitive impairment symptoms and cerebral glucose metabolism in different brain regions (according to the positron emission tomography (PET) data) in Parkinson's disease (PD) in order to increase the diagnostic and treatment efficacy. Two groups of patients with PD (stage I-III), including 11 patients without cognitive disorders and 13 with mild cognitive impairment (MCI), were examined. The control group included 10 age-matched people with normal cognition. To evaluate cognitive state, the Mini mental state examination (MMSE), the Frontal assessment battery (FAB) and the 'clock drawing test' were used. The regional cerebral glucose metabolism rate (CMRglu) was assessed using PET with 18F-fluorodeoxyglucose (FDG). In PD patients, CMRglu were decreased in the frontal (Brodmann areas (BA) 9, 10, 11, 46, 47), occipital (BA 19) and parietal (BA 39), temporal (BA 20, 37), and cingulate cortex (BA 32) compared to the control group. Cerebral glucose metabolism was decreased in the frontal (BA 8, 9, 10, 45, 46, 47), parietal (BA 7, 39, 40) and cingulate cortex (BA 23, 24, 31, 32) in the group of PD patients with MCI compared to PD patients with normal cognition. Hypometabolism in BA 7, 8, 23, 24, 31, 40 was revealed only in comparison of PD and PD-MCI groups, and did not appear in case of comparison of cognitively normal PD patients with the control group. It is possible to suggest that the mentioned above brain areas were associated with cognitive impairment. The revealed glucose hypometabolism pattern possibly has the diagnostic value for the early and preclinical diagnosis of MCI in PD and control of treatment efficacy.

  6. Cerebral metabolic changes accompanying conversion of mild cognitive impairment into Alzheimer's disease: a PET follow-up study

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    Drzezga, Alexander; Willoch, Frode; Schwaiger, Markus [Department of Nuclear Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Strasse 22, 81675, Muenchen (Germany); Lautenschlager, Nicola; Riemenschneider, Matthias; Kurz, Alexander [Department of Psychiatry and Psychotherapy, Technische Universitaet Muenchen, Muenchen (Germany); Siebner, Hartwig [Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, London (United Kingdom); Minoshima, Satoshi [Department of Radiology, University of Washington, Seattle, WA (United States)

    2003-08-01

    A high percentage of patients with mild cognitive impairment (MCI) develop clinical dementia of the Alzheimer type (AD) within 1 year. The aim of this longitudinal study was to identify characteristic patterns of cerebral metabolism at baseline in patients converting from MCI to AD, and to evaluate the changes in these patterns over time. Baseline and follow-up examinations after 1 year were performed in 22 MCI patients (12 males, 10 females, aged 69.8{+-}5.8 years); these examinations included neuropsychological testing, structural cranial magnetic resonance imaging and fluorine-18 fluorodeoxyglucose positron emission tomography (PET) evaluation of relative cerebral glucose metabolic rate (rCMRglc). Individual PET scans were stereotactically normalised with NEUROSTAT software (Univ. of Michigan, Ann Arbor, USA). Subsequently, statistical comparison of PET data with an age-matched healthy control population and between patient subgroups was performed using SPM 99 (Wellcome Dept. of Neuroimaging Sciences, London, UK). After 1 year, eight patients (36%) had developed probable AD (referred to as MCI{sub AD}), whereas 12 (55%) were still classified as having stable MCI (referred to as MCI{sub MCI}). Compared with the healthy control group, a reduced rCMRglc in AD-typical regions, including the temporoparietal and posterior cingulate cortex, was detected at baseline in patients with MCI{sub AD}. Abnormalities in the posterior cingulate cortex reached significance even in comparison with the MCI{sub MCI} group. After 1 year, MCI{sub AD} patients demonstrated an additional bilateral reduction of rCMRglc in prefrontal areas, along with a further progression of the abnormalities in the parietal and posterior cingulate cortex. No such changes were observed in the MCI{sub MCI} group. In patients with MCI, characteristic cerebral metabolic differences can be delineated at the time of initial presentation, which helps to define prognostic subgroups. A newly emerging reduction

  7. Validation of the Telephone Interview of Cognitive Status and Telephone Montreal Cognitive Assessment Against Detailed Cognitive Testing and Clinical Diagnosis of Mild Cognitive Impairment After Stroke.

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    Zietemann, Vera; Kopczak, Anna; Müller, Claudia; Wollenweber, Frank Arne; Dichgans, Martin

    2017-11-01

    Assessment of cognitive status poststroke is recommended by guidelines but follow-up can often not be done in person. The Telephone Interview of Cognitive Status (TICS) and the Telephone Montreal Cognitive Assessment (T-MoCA) are considered useful screening instruments. Yet, evidence to define optimal cut-offs for mild cognitive impairment (MCI) after stroke is limited. We studied 105 patients enrolled in the prospective DEDEMAS study (Determinants of Dementia After Stroke; NCT01334749). Follow-up visits at 6, 12, 36, and 60 months included comprehensive neuropsychological testing and the Clinical Dementia Rating scale, both of which served as reference standards. The original TICS and T-MoCA were obtained in 2 separate telephone interviews each separated from the personal visits by 1 week (1 before and 1 after the visit) with the order of interviews (TICS versus T-MoCA) alternating between subjects. Area under the receiver-operating characteristic curves was determined. Ninety-six patients completed both the face-to-face visits and the 2 interviews. Area under the receiver-operating characteristic curves ranged between 0.76 and 0.83 for TICS and between 0.73 and 0.94 for T-MoCA depending on MCI definition. For multidomain MCI defined by multiple-tests definition derived from comprehensive neuropsychological testing optimal sensitivities and specificities were achieved at cut-offs <36 (TICS) and <18 (T-MoCA). Validity was lower using single-test definition, and cut-offs were higher compared with multiple-test definitions. Using Clinical Dementia Rating as the reference, optimal cut-offs for MCI were <36 (TICS) and approximately 19 (T-MoCA). Both the TICS and T-MoCA are valid screening tools poststroke, particularly for multidomain MCI using multiple-test definition. © 2017 American Heart Association, Inc.

  8. Screening Utility of the King-Devick Test in Mild Cognitive Impairment and Alzheimer Disease Dementia.

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    Galetta, Kristin M; Chapman, Kimberly R; Essis, Maritza D; Alosco, Michael L; Gillard, Danielle; Steinberg, Eric; Dixon, Diane; Martin, Brett; Chaisson, Christine E; Kowall, Neil W; Tripodis, Yorghos; Balcer, Laura J; Stern, Robert A

    2017-01-01

    The King-Devick (K-D) test is a 1 to 2 minute, rapid number naming test, often used to assist with detection of concussion, but also has clinical utility in other neurological conditions (eg, Parkinson disease). The K-D involves saccadic eye and other eye movements, and abnormalities thereof may be an early indicator of Alzheimer disease (AD)-associated cognitive impairment. No study has tested the utility of the K-D in AD and we sought to do so. The sample included 206 [135 controls, 39 mild cognitive impairment (MCI), and 32 AD dementia] consecutive subjects from the Boston University Alzheimer's Disease Center registry undergoing their initial annual evaluation between March 2013 and July 2015. The K-D was administered during this period. Areas under the receiver operating characteristic curves generated from logistic regression models revealed the K-D test distinguished controls from subjects with cognitive impairment (MCI and AD dementia) [area under the curve (AUC)=0.72], MCI (AUC=0.71) and AD dementia (AUC=0.74). K-D time scores between 48 and 52 seconds were associated with high sensitivity (>90.0%) and negative predictive values (>85.0%) for each diagnostic group. The K-D correlated strongly with validated attention, processing speed, and visual scanning tests. The K-D test may be a rapid and simple effective screening tool to detect cognitive impairment associated with AD.

  9. A continuum of executive function deficits in early subcortical vascular cognitive impairment: A systematic review and meta-analysis.

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    Sudo, Felipe Kenji; Amado, Patricia; Alves, Gilberto Sousa; Laks, Jerson; Engelhardt, Eliasz

    2017-01-01

    Subcortical Vascular Cognitive Impairment (SVCI) is a clinical continuum of vascular-related cognitive impairment, including Vascular Mild Cognitive Impairment (VaMCI) and Vascular Dementia. Deficits in Executive Function (EF) are hallmarks of the disorder, but the best methods to assess this function have yet to be determined. The insidious and almost predictable course of SVCI and the multidimensional concept of EF suggest that a temporal dissociation of impairments in EF domains exists early in the disorder. This study aims to review and analyze data from the literature about performance of VaMCI patients on the most used EF tests through a meta-analytic approach. Medline, Web of Knowledge and PsycINFO were searched, using the terms: "vascular mild cognitive impairment" OR "vascular cognitive impairment no dementia" OR "vascular mild neurocognitive disorder" AND "dysexecutive" OR "executive function". Meta-analyses were conducted for each of the selected tests, using random-effect models. Systematic review showed major discrepancies among the results of the studies included. Meta-analyses evidenced poorer performance on the Trail-Making Test part B and the Stroop color test by VaMCI patients compared to controls. A continuum of EF impairments has been proposed in SVCI. Early deficits appear to occur in cognitive flexibility and inhibitory control.

  10. Theta-Gamma Coupling and Working Memory in Alzheimer’s Dementia and Mild Cognitive Impairment

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    Michelle S. Goodman

    2018-04-01

    Full Text Available Working memory deficits are common among individuals with Alzheimer’s dementia (AD or mild cognitive impairment (MCI. Yet, little is known about the mechanisms underlying these deficits. Theta-gamma coupling—the modulation of high-frequency gamma oscillations by low-frequency theta oscillations—is a neurophysiologic process underlying working memory. We assessed the relationship between theta-gamma coupling and working memory deficits in AD and MCI. We hypothesized that: (1 individuals with AD would display the most significant working memory impairments followed by MCI and finally healthy control (HC participants; and (2 there would be a significant association between working memory performance and theta-gamma coupling across all participants. Ninety-eight participants completed the N-back working memory task during an electroencephalography (EEG recording: 33 with AD (mean ± SD age: 76.5 ± 6.2, 34 with MCI (mean ± SD age: 74.8 ± 5.9 and 31 HCs (mean ± SD age: 73.5 ± 5.2. AD participants performed significantly worse than control and MCI participants on the 1- and 2-back conditions. Regarding theta-gamma coupling, AD participants demonstrated the lowest level of coupling followed by the MCI and finally control participants on the 2-back condition. Finally, a linear regression analysis demonstrated that theta-gamma coupling (β = 0.69, p < 0.001 was the most significant predictor of 2-back performance. Our results provide evidence for a relationship between altered theta-gamma coupling and working memory deficits in individuals with AD and MCI. They also provide insight into a potential mechanism underlying working memory impairments in these individuals.

  11. Spatial Navigation Impairment Is Associated with Alterations in Subcortical Intrinsic Activity in Mild Cognitive Impairment: A Resting-State fMRI Study

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    Zhao Qing

    2017-01-01

    Full Text Available Impairment of spatial navigation (SN skills is one of the features of the Alzheimer’s disease (AD already at the stage of mild cognitive impairment (MCI. We used a computer-based battery of spatial navigation tests to measure the SN performance in 22 MCI patients as well as 21 normal controls (NC. In order to evaluate intrinsic activity in the subcortical regions that may play a role in SN, we measured ALFF, fALFF, and ReHo derived within 14 subcortical regions. We observed reductions of intrinsic activity in MCI patients. We also demonstrated that the MCI versus NC group difference can modulate activity-behavior relationship, that is, the correlation slopes between ReHo and allocentric SN task total errors were significantly different between NC and MCI groups in the right hippocampus (interaction F=4.44, p=0.05, pallidum (F=8.97, p=0.005, and thalamus (F=5.95, p=0.02, which were negative in NC (right hippocampus, r=−0.49; right pallidum, r=−0.50; right thalamus, r=−0.45; all p0.2. These findings may provide a novel insight of the brain mechanism associated with SN impairment in MCI and indicated a stage specificity of brain-behavior correlation in dementia. This trial is registered with ChiCTR-BRC-17011316.

  12. Comparison of the Montreal Cognitive Assessment and the Mini-Mental State Examination in detecting multi-domain mild cognitive impairment in a Chinese sub-sample drawn from a population-based study.

    Science.gov (United States)

    Dong, YanHong; Yean Lee, Wah; Hilal, Saima; Saini, Monica; Wong, Tien Yin; Chen, Christopher Li-Hsian; Venketasubramanian, Narayanaswamy; Ikram, Mohammad Kamran

    2013-11-01

    We examined the discriminant validity of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) in detecting multiple-domain mild cognitive impairment (md-MCI) in a Chinese sub-sample drawn from elderly population-based study. This study included Chinese participants from the Epidemiology of Dementia in Singapore (EDIS) study aged ≥ 60 years who underwent cognitive screening with the Abbreviated Mental Test and Progressive Forgetfulness Questionnaire. Screen-positive participants subsequently underwent MoCA, MMSE, and a comprehensive formal neuropsychological battery. MCI was defined by Petersen's criteria and further classified into single-domain MCI (sd-MCI) and md-MCI. Area under the receiver operating characteristic curve (AUC) with 95% confidence intervals (CIs) was computed for the MoCA and the MMSE in detecting md-MCI. A total of 300 participants were recruited: 128 (42.7%) were diagnosed with no cognitive impairment (NCI), 47 (15.7%) with sd-MCI, and 83 (28.0%) with md-MCI. Forty-one participants were excluded, 7 (2.3%) had dementia, and 34 (11.3%) had only objective cognitive impairment without subjective complaints. Although the MoCA had a significantly larger AUC than the MMSE (0.94 (95% CI = 0.91-0.97) vs. 0.91 (95% CI = 0.86-0.95), p= 0.04), at optimal cut-off points, the MoCA (19/20) was equivalent to the MMSE (25/26) in detecting md-MCI (sensitivity: 0.80 vs. 0.87, specificity: 0.92 vs. 0.80). Both screening tests had good discriminant validity and can be used in detecting md-MCI in a sub-sample of Chinese drawn from a population-based study.

  13. Subjective memory complaint only relates to verbal episodic memory performance in mild cognitive impairment

    Science.gov (United States)

    Gifford, Katherine A.; Liu, Dandan; Damon, Stephen M.; Chapman, William G.; Romano, Raymond R.; Samuels, Lauren R.; Lu, Zengqi; Jefferson, Angela L.

    2015-01-01

    Background A cognitive concern from the patient, informant, or clinician is required for the diagnosis of mild cognitive impairment (MCI); however, the cognitive and neuroanatomical correlates of complaint are poorly understood. Objective We assessed how self-complaint relates to cognitive and neuroimaging measures in older adults with MCI. Method MCI participants were drawn from the Alzheimer’s Disease Neuroimaging Initiative and dichotomized into two groups based on the presence of self-reported memory complaint (no complaint n=191, 77±7 years; complaint n=206, 73±8 years). Cognitive outcomes included episodic memory, executive functioning, information processing speed, and language. Imaging outcomes included regional lobar volumes (frontal, parietal, temporal, cingulate) and specific medial temporal lobe structures (hippocampal volume, entorhinal cortex thickness, parahippocampal gyrus thickness). Results Linear regressions, adjusting for age, gender, race, education, Mini-Mental State Examination score, mood, and apolipoprotein E-4 status, found that cognitive complaint related to immediate (β=−1.07, pmemory performances assessed on a serial list learning task (β=−1.06, p=0.001) but no other cognitive measures or neuroimaging markers. Conclusions Self-reported memory concern was unrelated to structural neuroimaging markers of atrophy and measures of information processing speed, executive functioning, or language. In contrast, subjective memory complaint related to objective verbal episodic learning performance. Future research is warranted to better understand the relation between cognitive complaint and surrogate markers of abnormal brain aging, including Alzheimer’s disease, across the cognitive aging spectrum. PMID:25281602

  14. Subjective memory complaint only relates to verbal episodic memory performance in mild cognitive impairment.

    Science.gov (United States)

    Gifford, Katherine A; Liu, Dandan; Damon, Stephen M; Chapman, William G; Romano Iii, Raymond R; Samuels, Lauren R; Lu, Zengqi; Jefferson, Angela L

    2015-01-01

    A cognitive concern from the patient, informant, or clinician is required for the diagnosis of mild cognitive impairment (MCI); however, the cognitive and neuroanatomical correlates of complaint are poorly understood. We assessed how self-complaint relates to cognitive and neuroimaging measures in older adults with MCI. MCI participants were drawn from the Alzheimer's Disease Neuroimaging Initiative and dichotomized into two groups based on the presence of self-reported memory complaint (no complaint n = 191, 77 ± 7 years; complaint n = 206, 73 ± 8 years). Cognitive outcomes included episodic memory, executive functioning, information processing speed, and language. Imaging outcomes included regional lobar volumes (frontal, parietal, temporal, cingulate) and specific medial temporal lobe structures (hippocampal volume, entorhinal cortex thickness, parahippocampal gyrus thickness). Linear regressions, adjusting for age, gender, race, education, Mini-Mental State Examination score, mood, and apolipoprotein E4 status, found that cognitive complaint related to immediate (β = -1.07, p memory performances assessed on a serial list learning task (β = -1.06, p = 0.001) but no other cognitive measures or neuroimaging markers. Self-reported memory concern was unrelated to structural neuroimaging markers of atrophy and measures of information processing speed, executive functioning, or language. In contrast, subjective memory complaint related to objective verbal episodic learning performance. Future research is warranted to better understand the relation between cognitive complaint and surrogate markers of abnormal brain aging, including Alzheimer's disease, across the cognitive aging spectrum.

  15. Recognition Memory in Amnestic-Mild Cognitive Impairment: Insights from Event-Related Potentials

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    David A Wolk

    2013-12-01

    Full Text Available Episodic memory loss is the hallmark cognitive dysfunction associated with Alzheimer’s Disease (AD. Amnestic Mild Cognitive Impairment (a-MCI frequently represents a transitional stage between normal aging and early AD. A better understanding of the qualitative features of memory loss in a-MCI may have important implications for predicting those most likely to harbor AD-related pathology and for disease monitoring. Dual process models of memory argue that recognition memory is subserved by the dissociable processes of recollection and familiarity. Work studying recognition memory in a-MCI from this perspective has been controversial, particularly with regard to the integrity of familiarity. Event-related potentials (ERPs offer an alternative means for assessing these functions without the associated assumptions of behavioral estimation methods. ERPs were recorded while a-MCI patients and cognitively normal (CN age-matched adults performed a recognition memory task. When retrieval success was measured (hits versus correct rejections in which performance was matched by group, a-MCI patients displayed similar neural correlates to that of the CN group, including modulation of the FN400 and the late parietal complex (LPC which are thought to index familiarity and recollection, respectively. Alternatively, when the integrity of these components were measured based on retrieval attempts (studied versus unstudied items, a-MCI patients displayed a reduced FN400 and LPC. Furthermore, modulation of the FN400 correlated with a behavioral estimate of familiarity and the LPC with a behavioral estimates of recollection obtained in a separate experiment in the same individuals, consistent with the proposed mappings of these indices. These results support a global decline of recognition memory in a-MCI, which suggests that the memory loss of prodromal AD may be qualitatively distinct from normal aging.

  16. Subjective cognitive impairment: Towards early identification of Alzheimer disease.

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    Garcia-Ptacek, S; Eriksdotter, M; Jelic, V; Porta-Etessam, J; Kåreholt, I; Manzano Palomo, S

    2016-10-01

    Neurodegeneration in Alzheimer disease (AD) begins decades before dementia and patients with mild cognitive impairment (MCI) already demonstrate significant lesion loads. Lack of information about the early pathophysiology in AD complicates the search for therapeutic strategies.Subjective cognitive impairment is the description given to subjects who have memory-related complaints without pathological results on neuropsychological tests. There is no consensus regarding this heterogeneous syndrome, but at least some of these patients may represent the earliest stage in AD. We reviewed available literature in order to summarise current knowledge on subjective cognitive impairment. Although they may not present detectable signs of disease, SCI patients as a group score lower on neuropsychological tests than the general population does, and they also have a higher incidence of future cognitive decline. Depression and psychiatric co-morbidity play a role but cannot account for all cognitive complaints. Magnetic resonance imaging studies in these patients reveal a pattern of hippocampal atrophy similar to that of amnestic mild cognitive impairment and functional MRI shows increased activation during cognitive tasks which might indicate compensation for loss of function. Prevalence of an AD-like pattern of beta-amyloid (Aβ42) and tau proteins in cerebrospinal fluid is higher in SCI patients than in the general population. Memory complaints are relevant symptoms and may predict AD. Interpatient variability and methodological differences between clinical studies make it difficult to assign a definition to this syndrome. In the future, having a standard definition and longitudinal studies with sufficient follow-up times and an emphasis on quantifiable variables may clarify aspects of early AD. Copyright © 2012 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. [Neuropsychological study of false memory in patients with amnesia mild cognitive impairment].

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    Xie, Dan-dan; Cheng, Huai-dong; Yin, Chang-lin; Lü, Xin-yi; Wang, Kai

    2011-01-18

    To explore the profile of false memory in aMCI (amnesia mild cognitive impairment) and to elucidate the neuropsychological mechanism of false memory. False memory provoked by pictures and feeling-of-knowing (FOK) test in episodic memory (EM) were conducted in 25 aMCI patients at our hospital from October 2009 to May 2010. And 25 age and education level-matched healthy patients were recruited into the healthy control (HC) group. As compared with HC group, the rate of false memory was higher in the aMCI group. The rate of false memory in recall stage was 26% ± 7% and that of questionnaire stage 28% ± 12%. And the difference between two group was significant (t = 14.437, 7.597, P false recognition in the aMCI group (41% ± 10%) was higher than the HC group. And the difference was significant (t = 4.207, P false memory in recall and questionnaire stages were positively correlated with FOK-EM in aMCI group (r = 0.563, 0.705, P false memory provoked by pictures. The deficit of memory monitoring in aMCI may be the foundation of false memory.

  18. Neural correlates of saccadic inhibition in healthy elderly and patients with amnestic mild cognitive impairment

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    Alichniewicz, K. K.; Brunner, F.; Klünemann, H. H.; Greenlee, M. W.

    2013-01-01

    Performance on tasks that require saccadic inhibition declines with age and altered inhibitory functioning has also been reported in patients with Alzheimer's disease. Although mild cognitive impairment (MCI) is assumed to be a high-risk factor for conversion to AD, little is known about changes in saccadic inhibition and its neural correlates in this condition. Our study determined whether the neural activation associated with saccadic inhibition is altered in persons with amnestic mild cognitive impairment (aMCI). Functional magnetic resonance imaging (fMRI) revealed decreased activation in parietal lobe in healthy elderly persons compared to young persons and decreased activation in frontal eye fields in aMCI patients compared to healthy elderly persons during the execution of anti-saccades. These results illustrate that the decline in inhibitory functions is associated with impaired frontal activation in aMCI. This alteration in function might reflect early manifestations of AD and provide new insights in the neural activation changes that occur in pathological ageing. PMID:23898312

  19. Effect of Exercise and Cognitive Training on Falls and Fall-Related Factors in Older Adults With Mild Cognitive Impairment: A Systematic Review.

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    Lipardo, Donald S; Aseron, Anne Marie C; Kwan, Marcella M; Tsang, William W

    2017-10-01

    To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive impairment (MCI). Seven databases (PubMed, CINAHL, Cochrane Library, Web of Science, ProQuest, ProQuest Dissertations and Theses, Digital Dissertation Consortium) and reference lists of pertinent articles were searched. Randomized controlled trials (RCTs) on the effect of exercise, cognitive training, or a combination of both on falls and factors associated with falls such as balance, lower limb muscle strength, gait, and cognitive function among community-dwelling older adults with MCI were included. Data were extracted using the modified Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument. Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included. Exercise improved gait speed and global cognitive function in MCI; both are known factors associated with falls. Cognitive training alone had no significant effect on cognitive function, while combined exercise and cognitive training improved balance in MCI. Neither fall rate nor the number of fallers was reported in any of the studies included. This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI. Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Influence of cognitive impairment on fall risk among elderly nursing home residents.

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    Seijo-Martinez, M; Cancela, J M; Ayán, C; Varela, S; Vila, H

    2016-12-01

    Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents. A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20-24) "MCI", moderate (14-19) "MOCI", and severe (≤14) "SCI". Scores above 24 points indicated the absence cognitive impairment (NCI). Information regarding fall history and fall risk during the previous year was collected using standardized questionnaires and tests. Sixty falls (34%) were registered among NCI participants and 417 (43%) among people with cognitive impairment (MCI: 35%; MOCI: 40%; SCI: 50%). A different fall risk model was observed for MCI, MOCI, SCI, and NCI patients. The results imply that the higher the level of cognitive impairment, the greater the number of falls (F1,481 = 113.852; Sig = 0.015), although the level of significance was not maintained when MOCI and SCI participants were compared. Depression, neuropsychiatric disturbances, autonomy constraints in daily life activity performance, and low functional mobility were factors closely associated with fall risk. This study provides evidence indicating that fall risk factors do not hold a direct correlation with the level of cognitive impairment among elderly nursing home care residents.

  1. Symptoms of depression in patients with mild cognitive impairment in Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Ana Lara Soares Blum Malak

    Full Text Available ABSTRACT Objective: To investigate the most frequent depressive symptoms and their association with cognition in Parkinson's disease (PD patients with mild cognitive impairment (MCI. Methods: 48 patients with PD and 44 controls (CG, aged between 50 and 80 years and with at least 4 years of formal education, all with MCI and none diagnosed with depression, were assessed. Patients and controls were matched for age, education, and Mini-Mental State Examination (MMSE score. Participants underwent clinical evaluation with a neurologist followed by neuropsychological assessment employing the instruments: MMSE, Clock Drawing Test, Verbal Fluency Test (semantic and phonemic, Figures Memory Test (FMT, Stroop Test, Trail Making Test, Digit Span (WAIS III, Rey Auditory Verbal Learning Test (RAVLT, Hooper Visual Organization Test, and Beck Depression Inventory (BDI. Results: The most frequent depressive symptoms in the PD group were: difficulty working, fatigue and sleep disorders (the latter also being present in CG. BDI score correlated negatively with learning and recognition memory in both groups. Episodic memory, evaluated by the FMT and RAVLT tests, was the cognitive function showing greatest impairment. Conclusion: Some of the depressive symptoms observed in PD patients with MCI seem to be attributable to complications of PD, while others are common to both PD and MCI, making differential diagnoses complex but crucial.

  2. Learning to predict is spared in mild cognitive impairment due to Alzheimer's disease.

    Science.gov (United States)

    Baker, Rosalind; Bentham, Peter; Kourtzi, Zoe

    2015-10-01

    Learning the statistics of the environment is critical for predicting upcoming events. However, little is known about how we translate previous knowledge about scene regularities to sensory predictions. Here, we ask whether patients with mild cognitive impairment due to Alzheimer's disease (MCI-AD) that are known to have spared implicit but impaired explicit recognition memory are able to learn temporal regularities and predict upcoming events. We tested the ability of MCI-AD patients and age-matched controls to predict the orientation of a test stimulus following exposure to sequences of leftwards or rightwards oriented gratings. Our results demonstrate that exposure to temporal sequences without feedback facilitates the ability to predict an upcoming stimulus in both MCI-AD patients and controls. Further, we show that executive cognitive control may account for individual variability in predictive learning. That is, we observed significant positive correlations of performance in attentional and working memory tasks with post-training performance in the prediction task. Taken together, these results suggest a mediating role of circuits involved in cognitive control (i.e. frontal circuits) that may support the ability for predictive learning in MCI-AD.

  3. Changes in Parahippocampal White Matter Integrity in Amnestic Mild Cognitive Impairment: A Diffusion Tensor Imaging Study

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    E. J. Rogalski

    2009-01-01

    Full Text Available In the present study, changes in the parahippocampal white matter (PWM, in the region that includes the perforant path, were investigated, in vivo, in 14 individuals with amnestic mild cognitive impairment (aMCI compared to 14 elderly controls with no cognitive impairment (NCI. For this purpose, (1 volumetry; (2 diffusion tensor imaging (DTI derived measures of mean diffusivity (MD and fractional anisotropy (FA; and (3 tractography were used. In addition, regression models were utilized to examine the association of PWM measurements with memory decline. The results from this study confirm previous findings in our laboratory and others, showing that compared to controls, individuals with aMCI have PWM volume loss. In addition to volume reduction, participants with aMCI demonstrated a significant increase in MD, but no difference in FA, both in the PWM region and in fibers modeled to pass through the PWM region. Further, the DTI metric of MD was associated with declarative memory performance, suggesting it may be a sensitive marker for memory dysfunction. These results indicate that there is general tissue loss and degradation (decreased volume; increased MD in individuals with aMCI compared to older people with normal cognitive function. However, the microstructural organization of remaining fibers, as determined by measures of anisotropic diffusion, is not significantly different from that of controls.

  4. Age-Related Sensory Impairments and Risk of Cognitive Impairment

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    Fischer, Mary E; Cruickshanks, Karen J.; Schubert, Carla R; Pinto, Alex A; Carlsson, Cynthia M; Klein, Barbara EK; Klein, Ronald; Tweed, Ted S.

    2016-01-01

    Background/Objectives To evaluate the associations of sensory impairments with the 10-year risk of cognitive impairment. Previous work has primarily focused on the relationship between a single sensory system and cognition. Design The Epidemiology of Hearing Loss Study (EHLS) is a longitudinal, population-based study of aging in the Beaver Dam, WI community. Baseline examinations were conducted in 1993 and follow-up exams have been conducted every 5 years. Setting General community Participants EHLS members without cognitive impairment at EHLS-2 (1998–2000). There were 1,884 participants (mean age = 66.7 years) with complete EHLS-2 sensory data and follow-up information. Measurements Cognitive impairment was a Mini-Mental State Examination score of impairment was a pure-tone average of hearing thresholds (0.5, 1, 2 and 4 kHz) of > 25 decibel Hearing Level in either ear. Visual impairment was Pelli-Robson contrast sensitivity of impairment was a San Diego Odor Identification Test score of impairment were independently associated with cognitive impairment risk [Hearing: Hazard Ratio (HR) = 1.90, 95% Confidence Interval (C.I.) = 1.11, 3.26; Vision: HR = 2.05, 95% C.I. = 1.24, 3.38; Olfaction: HR = 3.92, 95% C.I. = 2.45, 6.26]. However, 85% with hearing impairment, 81% with visual impairment, and 76% with olfactory impairment did not develop cognitive impairment during follow-up. Conclusion The relationship between sensory impairment and cognitive impairment was not unique to one sensory system suggesting sensorineural health may be a marker of brain aging. The development of a combined sensorineurocognitive measure may be useful in uncovering mechanisms of healthy brain aging. PMID:27611845

  5. The Use of the Modified Telephone Interview for Cognitive Status (TICS-M) in the Detection of Amnestic Mild Cognitive Impairment

    OpenAIRE

    Cook, Sarah E.; Marsiske, Michael; McCoy, Karin J. M.

    2009-01-01

    Many screening tools for detecting cognitive decline require in-person assessment, which is often not cost effective or feasible for those with physical limitations. The Modified Telephone Interview for Cognitive Status (TICS-M) has been used for screening dementia, but little is known about its usefulness in detecting amnestic Mild Cognitive Impairment (aMCI). Community-dwelling participants (mean age= 74.9, mean education= 16.1 years) were administered the TICS-M during initial screening an...

  6. IN SEARCH OF A FAST SCREENING METHOD FOR DETECTING THE MALINGERING OF COGNITIVE IMPAIRMENT

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    Amada Ampudia

    2012-07-01

    Full Text Available Forensic settings demand expedient and conclusive forensic psychological assessment. The aim of this study was to design a simple and fast, but reliable psychometric instrument for detecting the malingering of cognitive impairment. In a quasi-experimental design, 156 individuals were divided into three groups: a normal group with no cognitive impairment; a Mild Cognitive Impairment (MCI group; and a group of informed malingerers with no MCI who feigned cognitive impairment. Receiver Operating Curve (ROC analysis of the Test of Memory Malingering (TOMM, and of several subtests of the Wechsler Memory Scale (WMS-III revealed that the WMS-III was as reliable and accurate as the TOMM in discriminating malingerers from the honest. The results revealed that the diagnostic accuracy, sensitivity and specificity of the WMS-III Auditory Recognition Delayed of Verbal Paired Associates subtest was similar to the TOMM in discriminating malingering from genuine memory impairment. In conclusion, the WMS-III Recognition of Verbal Paired Associates subtest and the TOMM provide a fast, valid and reliable screening method for detecting the malingering of cognitive impairment.

  7. Statistically Derived Subtypes and Associations with Cerebrospinal Fluid and Genetic Biomarkers in Mild Cognitive Impairment: A Latent Profile Analysis.

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    Eppig, Joel S; Edmonds, Emily C; Campbell, Laura; Sanderson-Cimino, Mark; Delano-Wood, Lisa; Bondi, Mark W

    2017-08-01

    Research demonstrates heterogeneous neuropsychological profiles among individuals with mild cognitive impairment (MCI). However, few studies have included visuoconstructional ability or used latent mixture modeling to statistically identify MCI subtypes. Therefore, we examined whether unique neuropsychological MCI profiles could be ascertained using latent profile analysis (LPA), and subsequently investigated cerebrospinal fluid (CSF) biomarkers, genotype, and longitudinal clinical outcomes between the empirically derived classes. A total of 806 participants diagnosed by means of the Alzheimer's Disease Neuroimaging Initiative (ADNI) MCI criteria received a comprehensive neuropsychological battery assessing visuoconstructional ability, language, attention/executive function, and episodic memory. Test scores were adjusted for demographic characteristics using standardized regression coefficients based on "robust" normal control performance (n=260). Calculated Z-scores were subsequently used in the LPA, and CSF-derived biomarkers, genotype, and longitudinal clinical outcome were evaluated between the LPA-derived MCI classes. Statistical fit indices suggested a 3-class model was the optimal LPA solution. The three-class LPA consisted of a mixed impairment MCI class (n=106), an amnestic MCI class (n=455), and an LPA-derived normal class (n=245). Additionally, the amnestic and mixed classes were more likely to be apolipoprotein e4+ and have worse Alzheimer's disease CSF biomarkers than LPA-derived normal subjects. Our study supports significant heterogeneity in MCI neuropsychological profiles using LPA and extends prior work (Edmonds et al., 2015) by demonstrating a lower rate of progression in the approximately one-third of ADNI MCI individuals who may represent "false-positive" diagnoses. Our results underscore the importance of using sensitive, actuarial methods for diagnosing MCI, as current diagnostic methods may be over-inclusive. (JINS, 2017, 23, 564-576).

  8. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

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    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G. [Paracelsus Medical University, Christian-Doppler-Clinic, Department of Neurology, and Center of Cognitive Research Salzburg, Salzburg (Austria); Zauner, H. [Rehabilitation Center of the Pensionsversicherungsanstalt, Grossgmain (Austria)

    2009-05-15

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  9. Łagodne zaburzenia poznawcze – aktualny problem geriatryczny = Mild cognitive impairment – current geriatric issue

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    Oliwia Beck

    2016-04-01

      Streszczenie Artykuł przedstawia aktualny stan wiedzy dotyczący łagodnych zaburzeń poznawczych (Mild Cognitive Impairment, MCI. Termin ten, początkowo uważany za stan przejściowy pomiędzy prawidłowym funkcjonowaniem poznawczym a objawami choroby Alzheimera (Alzheimer’s disease, AD, obecnie oznacza heterogenną grupę widocznych i obiektywnych deficytów kognitywnych u pacjentów bez rozpoznanego otępienia. Deficyty te, choć zauważalne zarówno dla osób nimi dotkniętych, jak i ich otoczenia, są na tyle nieznaczne, że nie wpływają na podstawowe czynności życia codziennego i zdolność do samodzielnej egzystencji. Rozpowszechnienie MCI szacuje się na 15 – 30% wśród osób powyżej 60 roku życia; rośnie ono wraz z wiekiem. Łagodnym zaburzeniom poznawczym – zwłaszcza ich postaci amnestycznej - przypisuje się podwyższone ryzyko rozwinięcia się otępienia, wynoszące 10 – 15% rocznie (przy 1 – 2% dla populacji ogólnej. Z tego powodu identyfikacja osób z MCI jest obecnie najważniejszą strategią opóźniania postępu otępień i zapobiegania im.   Słowa kluczowe: łagodne zaburzenia poznawcze, funkcjonowanie poznawcze, wiek podeszły, otępienie       Summary The article describes current state of knowledge on Mild Cognitive Impairment (MCI. The term, initially considered a transitional state between normal cognitive aging and mild Alzheimer’s disease (AD, currently covers heterogenous group of noticeable and objective cognitive deficits in patients without the diagnosis of dementia. These deficits, although apparent for both afflicted persons and their environment, do not interfere substantially with basic activities of daily living nor result in inability to live independently. The prevalence of MCI is estimated between 15 and 30% in individuals over 60 years old. Subjects with MCI constitute a high risk group because they develop dementia at a rate of 10% to 15% per year compared with 1% to 2% per year in the general

  10. The Dose-Dependent Effects of Vascular Risk Factors on Dynamic Compensatory Neural Processes in Mild Cognitive Impairment

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    Haifeng Chen

    2018-05-01

    Full Text Available Background/Objectives: Mild cognitive impairment (MCI has been associated with risk for Alzheimer's Disease (AD. Previous investigations have suggested that vascular risk factors (VRFs were associated with cognitive decline and AD pathogenesis, and the intervention of VRFs may be a possible way to prevent dementia. However, in MCI, little is known about the potential impacts of VRFs on neural networks and their neural substrates, which may be a neuroimaging biomarker of the disease progression.Methods: 128 elderly Han Chinese participants (67 MCI subjects and 61 matched normal elderly with or without VRFs (hypertension, diabetes mellitus, hypercholesterolemia, smoking and alcohol drinking underwent the resting-state functional magnetic resonance imaging (fMRI and neuropsychological tests. We obtained the default mode network (DMN to identify alterations in MCI with the varying number of the VRF and analyzed the significant correlation with behavioral performance.Results: The effects of VRF on the DMN were primarily in bilateral dorsolateral prefrontal cortex (DLPFC (i.e., middle frontal gyrus. Normal elderly showed the gradually increased functional activity of DLPFC, while a fluctuant activation of DLPFC was displayed in MCI with the growing number of the VRF. Interestingly, the left DLPFC further displayed significantly dynamic correlation with executive function as the variation of VRF loading. Initial level of compensation was observed in normal aging and none-vascular risk factor (NVRF MCI, while these compensatory neural processes were suppressed in One-VRF MCI and were subsequently re-aroused in Over-One-VRF MCI.Conclusions: These findings suggested that the dose-dependent effects of VRF on DLPFC were highlighted in MCI, and the dynamic compensatory neural processes that fluctuated along with variations of VRF loading could be key role in the progression of MCI.

  11. Mild cognitive impairment and prospective memory: translating the evidence into neuropsychological practice.

    Science.gov (United States)

    Kinsella, Glynda J; Pike, Kerryn E; Cavuoto, Marina G; Lee, Stephen D

    2018-04-30

    There has been a recent rapid development of research characterizing prospective memory performance in mild cognitive impairment (MCI) in older age. However, this body of literature remains largely separated from routine clinical practice in neuropsychology. Furthermore, there is emerging evidence of effective interventions to improve prospective memory performance. Therefore, our objective in this article was to offer a clinical neuropsychological perspective on the existing research in order to facilitate the translation of the evidence-base into clinical practice. By conducting a critical review of the existing research related to prospective memory and MCI, we highlight how this data can be introduced into clinical practice, either within diagnostic assessment or clinical management. Prospective memory is impaired in older adults with MCI, with a pattern of performance that helps with differential diagnosis from healthy aging. Clinical neuropsychologists are encouraged to add prospective memory assessment to their toolbox for diagnostic evaluation of clients with MCI. Preliminary findings of prospective memory interventions in MCI are promising, but more work is required to determine how different approaches translate to increasing independence in everyday life.

  12. Novel Virtual User Models of Mild Cognitive Impairment for Simulating Dementia

    Science.gov (United States)

    Segkouli, Sofia; Tzovaras, Dimitrios; Tsakiris, Thanos; Tsolaki, Magda; Karagiannidis, Charalampos

    2015-01-01

    Virtual user modeling research has attempted to address critical issues of human-computer interaction (HCI) such as usability and utility through a large number of analytic, usability-oriented approaches as cognitive models in order to provide users with experiences fitting to their specific needs. However, there is demand for more specific modules embodied in cognitive architecture that will detect abnormal cognitive decline across new synthetic task environments. Also, accessibility evaluation of graphical user interfaces (GUIs) requires considerable effort for enhancing ICT products accessibility for older adults. The main aim of this study is to develop and test virtual user models (VUM) simulating mild cognitive impairment (MCI) through novel specific modules, embodied at cognitive models and defined by estimations of cognitive parameters. Well-established MCI detection tests assessed users' cognition, elaborated their ability to perform multitasks, and monitored the performance of infotainment related tasks to provide more accurate simulation results on existing conceptual frameworks and enhanced predictive validity in interfaces' design supported by increased tasks' complexity to capture a more detailed profile of users' capabilities and limitations. The final outcome is a more robust cognitive prediction model, accurately fitted to human data to be used for more reliable interfaces' evaluation through simulation on the basis of virtual models of MCI users. PMID:26339282

  13. Novel Virtual User Models of Mild Cognitive Impairment for Simulating Dementia

    Directory of Open Access Journals (Sweden)

    Sofia Segkouli

    2015-01-01

    Full Text Available Virtual user modeling research has attempted to address critical issues of human-computer interaction (HCI such as usability and utility through a large number of analytic, usability-oriented approaches as cognitive models in order to provide users with experiences fitting to their specific needs. However, there is demand for more specific modules embodied in cognitive architecture that will detect abnormal cognitive decline across new synthetic task environments. Also, accessibility evaluation of graphical user interfaces (GUIs requires considerable effort for enhancing ICT products accessibility for older adults. The main aim of this study is to develop and test virtual user models (VUM simulating mild cognitive impairment (MCI through novel specific modules, embodied at cognitive models and defined by estimations of cognitive parameters. Well-established MCI detection tests assessed users’ cognition, elaborated their ability to perform multitasks, and monitored the performance of infotainment related tasks to provide more accurate simulation results on existing conceptual frameworks and enhanced predictive validity in interfaces’ design supported by increased tasks’ complexity to capture a more detailed profile of users’ capabilities and limitations. The final outcome is a more robust cognitive prediction model, accurately fitted to human data to be used for more reliable interfaces’ evaluation through simulation on the basis of virtual models of MCI users.

  14. Volumetric correlates of memory and executive function in normal elderly, mild cognitive impairment and Alzheimer’s disease

    Science.gov (United States)

    Duarte, Audrey; Hayasaka, Satoru; Du, Antao; Schuff, Norbert; Jahng, Geon-Ho; Kramer, Joel; Miller, Bruce; Weiner, Michael

    2007-01-01

    In Alzheimer’s disease (AD), atrophy negatively impacts cognition while in healthy adults, inverse relationships between brain volume and cognition may occur. We investigated correlations between gray matter volume and cognition in elderly controls, AD and mild cognitive impairment (MCI) patients with memory and executive deficits. AD demonstrated substantial loss in temporal, parietal and frontal regions while MCI exhibited moderate volume loss in temporal and frontal regions. In controls, memory and executive function were negatively correlated with frontal regions, while in AD, memory was positively correlated with temporal and frontal gyri, and executive function with frontal regions. The combination of the two patterns may explain the lack of correlations in MCI. Developmental versus pathological contributions to these relationships are discussed. PMID:16904823

  15. Theta and Alpha Alterations in Amnestic Mild Cognitive Impairment in Semantic Go/NoGo Tasks

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    Lydia T. Nguyen

    2017-05-01

    Full Text Available Growing evidence suggests that cognitive control processes are impaired in amnestic mild cognitive impairment (aMCI; however the nature of these alterations needs further examination. The current study examined differences in electroencephalographic theta and alpha power related to cognitive control processes involving response execution and response inhibition in 22 individuals with aMCI and 22 age-, sex-, and education-matched cognitively normal controls. Two Go/NoGo tasks involving semantic categorization were used. In the basic categorization task, Go/NoGo responses were made based on exemplars of a single car (Go and a single dog (NoGo. In the superordinate categorization task, responses were made based on multiple exemplars of objects (Go and animals (NoGo. Behavioral data showed that the aMCI group had more false alarms during the NoGo trials compared to controls. The EEG data revealed between group differences related to response type in theta (4–7 Hz and low-frequency alpha (8–10 Hz power. In particular, the aMCI group differed from controls in theta power during the NoGo trials at frontal and parietal electrodes, and in low-frequency alpha power during Go trials at parietal electrodes. These results suggest that alterations in theta power converge with behavioral deterioration in response inhibition, whereas alterations in low-frequency alpha power appear to precede behavioral changes in response execution. Both behavioral and electrophysiological correlates combined provide a more comprehensive characterization of cognitive control deficits in aMCI.

  16. MRI Measures of Hippocampus in Mild Cognitive Impairment and Alzheimer Patients

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    Çağatay Öncel

    2011-12-01

    Full Text Available OBJECTIVE: In this study we aimed to compare the hippocampal volumes of patients diagnosed as Alzheimer’s Disease (AD, Minimal Cognitive Impairment (MCI and the healthy objects. We also tried to demonstrate whether there was a possible correlation between the cognitive tests and the hippocampal volumes. METHODS: Minimental State Examination, Adas-Cog and Global Deterioration Scale were administrated to the patients having Alzheimer’s Disease (n=20. We also performed Minimental State Examination, and Adas-Cog to MCI patients (n=20 and Minimental State Examination to the healthy control group (n=18. Both right and left hippocampal volumes were measured by a three dimensioned Surf Driver programm with the support of cranial magnetic resonance imaging (MRI. RESULTS: Both right and left hippocampal volumes of the Alzheimer’s Disease group were significantly smaller than the MCI and the control groups. Bilaterally hippocampal volumes of MCI group were also smaller than the control group. (Hippocampal volumes; AD 0.05. CONCLUSION: : Surf Driver method succesfully demonstrated the relative hippocampal atrophy in the AD and the MCI groups when compared with the healthy controls

  17. MRI Measures of Hippocampus in Mild Cognitive Impairment and Alzheimer Patients

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    Çağatay Öncel

    2011-12-01

    Full Text Available OBJECTIVE: In this study we aimed to compare the hippocampal volumes of patients diagnosed as Alzheimer’s Disease (AD, Minimal Cognitive Impairment (MCI and the healthy objects. We also tried to demonstrate whether there was a possible correlation between the cognitive tests and the hippocampal volumes. METHODS: Minimental State Examination, Adas-Cog and Global Deterioration Scale were administrated to the patients having Alzheimer’s Disease (n=20. We also performed Minimental State Examination, and Adas-Cog to MCI patients (n=20 and Minimental State Examination to the healthy control group (n=18. Both right and left hippocampal volumes were measured by a three dimensioned Surf Driver programm with the support of cranial magnetic resonance imaging (MRI. RESULTS: Both right and left hippocampal volumes of the Alzheimer’s Disease group were significantly smaller than the MCI and the control groups. Bilaterally hippocampal volumes of MCI group were also smaller than the control group. (Hippocampal volumes; AD 0.05. CONCLUSION: : Surf Driver method succesfully demonstrated the relative hippocampal atrophy in the AD and the MCI groups when compared with the healthy controls.

  18. Prediction of progression in patients with mild cognitive impairment using IMP-SPECT

    International Nuclear Information System (INIS)

    Okamura, Nobuyuki; Shinkawa, Mitsutoshi; Arai, Hiroyuki; Matsui, Toshifumi; Nakajo, Kazushi; Maruyama, Masahiro; Hu, Xia Sheng; Sasaki, Hidetada

    2000-01-01

    To examine the difference in functional brain imaging between mild cognitive impairment (MCI) and normal aging, we measured rCBF on functional brain imaging using 123 I-IMP single photon emission computed tomography (IMP-SPECT) in 19 MCI patients who progressed to develop AD on follow-up and 23 probable Alzheimer's disease (AD) patients as well as 15 age-matched normal subjects. Baseline MMSE score was 25.3 (SD 1.2) in the MCI group and 17.5 (SD 3.3) in the AD group. The regions of interest (ROI) in the posterior cingulate gyrus, frontal, temporal and parietal cortices were drawn on the image of IMP-SPECT with reference to an individual MRI image. The rCBF ratio was calculated using ROI value in the cerebellum as a reference. Voxel-based analysis was also preformed using statistical parametric mapping (SPM). The rCBF ratio in the posterior cingulate gyrus was significantly reduced in the MCI group (mean 0.956, SD 0.080) and the AD group (mean 0.833, SD 0.118) compared to that in the normal group (mean 1.083, SD 0.084). In the frontal, temporal and parietal cortices, the rCBF ratio was significantly reduced only in the AD group compared to the normal group. At a fixed specificity of 80%, the diagnostic sensitivity in the discrimination between MCI patients and normal subjects was 80.5% when using rCBF ratio in posterior cingulate gyrus. In the SPM analysis, significant reduction of the rCBF in MCI group was observed only in the posterior cingulate gyrus, compared with normal subject group. Our results suggest that MCI patients presenting with a posterior cingulate hypoperfusion are at higher risk for transition from MCI to clinically recognizable AD. (author)

  19. MILD COGNITIVE IMPAIRMENT: STRUCTURAL, METABOLICAL AND NEUROPHYSIOLOGICAL EVIDENCE OF A NOVEL EEG BIOMARKER

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    Davide Vito Moretti

    2015-07-01

    Full Text Available Background: recent studies demonstrate that the alpha 3/alpha 2 power ratio correlates with cortical atrophy, regional hypoperfusion and memory impairment in subjects with mild cognitive impairment (MCI.Methods: evidences were reviewed in subjects with MCI who underwent EEG recording, Magnetic Resonance Imaging (MRI scans and memory evaluation. Alpha3/alpha2 power ratio (alpha2 8.9–10.9 Hz range; alpha3 10.9–12.9 Hz range, cortical thickness, linear EEG coherence and memory impairment have been evaluated in a large group of 74 patients. A subset of 27 subjects within the same group underwent also Single Photon Emission Computed Tomography (SPECT evaluation. Results: in MCI subjects with higher EEG upper/low alpha power ratio a greater temporo-parietal and hippocampal atrophy was found as well as a decrease in regional blood perfusion and memory impairment. In this group, an increase of theta oscillations is associated with a greater interhemispheric coupling between temporal areas. Conclusion: the increase of alpha3/alpha2 power ratio is a promising novel biomarker in identifying MCI subjects at risk for Alzheimer’s disease

  20. Cardiovascular disease risk factors and cognitive impairment.

    Science.gov (United States)

    Nash, David T; Fillit, Howard

    2006-04-15

    The role of cardiovascular disease risk factors in the occurrence and progression of cognitive impairment has been the subject of a significant number of publications but has not achieved widespread recognition among many physicians and educated laymen. It is apparent that the active treatment of certain of these cardiovascular disease risk factors is accompanied by a reduced risk for cognitive impairment. Patients with hypertension who are treated experience fewer cardiovascular disease events as well as less cognitive impairment than similar untreated patients. Patients who exercise may present with less cognitive impairment, and obesity may increase the risk for cognitive impairment. Lipid abnormalities and genetic markers are associated with an increased risk for cardiovascular disease and cognitive impairment. Autopsy studies have demonstrated a correlation between elevated levels of cholesterol and amyloid deposition in the brain. Research has demonstrated a relation between atherosclerotic obstruction lesions in the circle of Willis and dementia. Diabetes mellitus is associated with an increased risk for cardiovascular disease and cognitive impairment. A number of nonpharmacologic factors have a role in reducing the risk for cognitive impairment. Antioxidants, fatty acids, and micronutrients may have a role, and diets rich in fruits and vegetables and other dietary approaches may improve the outlook for patients considered at risk for cognitive impairment.

  1. Correlation of MRI Visual Scales with Neuropsychological Profile in Mild Cognitive Impairment of Parkinson’s Disease

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    Luiz Felipe Vasconcellos

    2017-01-01

    Full Text Available Few studies have evaluated magnetic resonance imaging (MRI visual scales in Parkinson’s disease-Mild Cognitive Impairment (PD-MCI. We selected 79 PD patients and 92 controls (CO to perform neurologic and neuropsychological evaluation. Brain MRI was performed to evaluate the following scales: Global Cortical Atrophy (GCA, Fazekas, and medial temporal atrophy (MTA. The analysis revealed that both PD groups (amnestic and nonamnestic showed worse performance on several tests when compared to CO. Memory, executive function, and attention impairment were more severe in amnestic PD-MCI group. Overall analysis of frequency of MRI visual scales by MCI subtype did not reveal any statistically significant result. Statistically significant inverse correlation was observed between GCA scale and Mini-Mental Status Examination (MMSE, Montreal Cognitive Assessment (MoCA, semantic verbal fluency, Stroop test, figure memory test, trail making test (TMT B, and Rey Auditory Verbal Learning Test (RAVLT. The MTA scale correlated with Stroop test and Fazekas scale with figure memory test, digit span, and Stroop test according to the subgroup evaluated. Visual scales by MRI in MCI should be evaluated by cognitive domain and might be more useful in more severely impaired MCI or dementia patients.

  2. Multimodal MRI for early diabetic mild cognitive impairment: study protocol of a prospective diagnostic trial

    International Nuclear Information System (INIS)

    Yu, Ying; Sun, Qian; Yan, Lin-Feng; Hu, Yu-Chuan; Nan, Hai-Yan; Yang, Yang; Liu, Zhi-Cheng; Wang, Wen; Cui, Guang-Bin

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a risk factor for dementia. Mild cognitive impairment (MCI), an intermediary state between normal cognition and dementia, often occurs during the prodromal diabetic stage, making early diagnosis and intervention of MCI very important. Latest neuroimaging techniques revealed some underlying microstructure alterations for diabetic MCI, from certain aspects. But there still lacks an integrated multimodal MRI system to detect early neuroimaging changes in diabetic MCI patients. Thus, we intended to conduct a diagnostic trial using multimodal MRI techniques to detect early diabetic MCI that is determined by the Montreal Cognitive Assessment (MoCA). In this study, healthy controls, prodromal diabetes and diabetes subjects (53 subjects/group) aged 40-60 years will be recruited from the physical examination center of Tangdu Hospital. The neuroimaging and psychometric measurements will be repeated at a 0.5 year-interval for 2.5 years’ follow-up. The primary outcome measures are 1) Microstructural and functional alterations revealed with multimodal MRI scans including structure magnetic resonance imaging (sMRI), resting state functional magnetic resonance imaging (rs-fMRI), diffusion kurtosis imaging (DKI), and three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL); 2) Cognition evaluation with MoCA. The second outcome measures are obesity, metabolic characteristics, lifestyle and quality of life. The study will provide evidence for the potential use of multimodal MRI techniques with psychometric evaluation in diagnosing MCI at prodromal diabetic stage so as to help decision making in early intervention and improve the prognosis of T2DM. This study has been registered to ClinicalTrials.gov (NCT02420470) on April 2, 2015 and published on July 29, 2015

  3. Lack of semantic priming effects in famous person recognition in Mild Cognitive Impairment.

    Science.gov (United States)

    Brambati, Simona M; Peters, Frédéric; Belleville, Sylvie; Joubert, Sven

    2012-04-01

    Growing evidence indicates that individuals with Mild Cognitive Impairment (MCI) manifest semantic deficits that are often more severe for items that are characterized by a unique semantic and lexical association, such as famous people and famous buildings, than common concepts, such as objects. However, it is still controversial whether the semantic deficits observed in MCI are determined by a degradation of semantic information or by a deficit in intentional access to semantic knowledge. Here we used a semantic priming task in order to assess the integrity of the semantic system without requiring explicit access to this system. This paradigm may provide new insights in clarifying the nature of the semantic deficits in MCI. We assessed the semantic and repetition priming effect in 13 individuals with MCI and 13 age-matched controls who engaged in a familiarity judgment task of famous names. In the semantic priming condition, the prime was the name of a member of the same occupation category as the target (Tom Cruise-Brad Pitt), while in the repetition priming condition the prime was the same name as the target (Charlie Chaplin-Charlie Chaplin). The results showed a defective priming effect in MCI in the semantic but not in the repetition priming condition. Specifically, when compared to controls, MCI patients did not show a facilitation effect in responding to the same occupation prime-target pairs, but they showed an equivalent facilitation effect when the target was the same name as the prime. The present results provide support to the hypothesis that the semantic impairments observed in MCI cannot be uniquely ascribed to a deficit in intentional access to semantic information. Instead, these findings point to the semantic nature of these deficits and, in particular, to a degraded representation of semantic information concerning famous people. Copyright © 2011 Elsevier Srl. All rights reserved.

  4. Influence of APOE and RNF219 on Behavioral and Cognitive Features of Female Patients Affected by Mild Cognitive Impairment or Alzheimer’s Disease

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    Alessandra Mosca

    2018-04-01

    Full Text Available The risk for Alzheimer’s disease (AD is associated with the presence of the 4 allele of Apolipoprotein E (APOE gene and, recently, with a novel genetic variant of the RNF219 gene. This study aimed at evaluating interactions between APOE-4 and RNF219/G variants in the modulation of behavioral and cognitive features of two cohorts of patients suffering from mild cognitive impairment (MCI or AD. We enrolled a total of 173 female MCI or AD patients (83 MCI; 90 AD. Subjects were screened with a comprehensive set of neuropsychological evaluations and genotyped for the APOE and RNF219 polymorphic variants. Analysis of covariance was performed to assess the main and interaction effects of APOE and RNF219 genotypes on the cognitive and behavioral scores. The analysis revealed that the simultaneous presence of APOE-4 and RNF219/G variants results in significant effects on specific neuropsychiatric scores in MCI and AD patients. In MCI patients, RNF219 and APOE variants worked together to impact the levels of anxiety negatively. Similarly, in AD patients, the RNF219 variants were found to be associated with increased anxiety levels. Our data indicate a novel synergistic activity APOE and RNF219 in the modulation of behavioral traits of female MCI and AD patients.

  5. Classifying cognitive profiles using machine learning with privileged information in Mild Cognitive Impairment

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    Hanin Hamdan Alahmadi

    2016-11-01

    Full Text Available Early diagnosis of dementia is critical for assessing disease progression and potential treatment. State-or-the-art machine learning techniques have been increasingly employed to take on this diagnostic task. In this study, we employed Generalised Matrix Learning Vector Quantization (GMLVQ classifiers to discriminate patients with Mild Cognitive Impairment (MCI from healthy controls based on their cognitive skills. Further, we adopted a ``Learning with privileged information'' approach to combine cognitive and fMRI data for the classification task. The resulting classifier operates solely on the cognitive data while it incorporates the fMRI data as privileged information (PI during training. This novel classifier is of practical use as the collection of brain imaging data is not always possible with patients and older participants.MCI patients and healthy age-matched controls were trained to extract structure from temporal sequences. We ask whether machine learning classifiers can be used to discriminate patients from controls based on the learning performance and whether differences between these groups relate to individual cognitive profiles. To this end, we tested participants in four cognitive tasks: working memory, cognitive inhibition, divided attention, and selective attention. We also collected fMRI data before and after training on the learning task and extracted fMRI responses and connectivity as features for machine learning classifiers. Our results show that the PI guided GMLVQ classifiers outperform the baseline classifier that only used the cognitive data. In addition, we found that for the baseline classifier, divided attention is the only relevant cognitive feature. When PI was incorporated, divided attention remained the most relevant feature while cognitive inhibition became also relevant for the task. Interestingly, this analysis for the fMRI GMLVQ classifier suggests that (1 when overall fMRI signal for structured stimuli is

  6. SYNERGIC TRIAL (SYNchronizing Exercises, Remedies in Gait and Cognition) a multi-Centre randomized controlled double blind trial to improve gait and cognition in mild cognitive impairment.

    Science.gov (United States)

    Montero-Odasso, Manuel; Almeida, Quincy J; Burhan, Amer M; Camicioli, Richard; Doyon, Julien; Fraser, Sarah; Li, Karen; Liu-Ambrose, Teresa; Middleton, Laura; Muir-Hunter, Susan; McIlroy, William; Morais, José A; Pieruccini-Faria, Frederico; Shoemaker, Kevin; Speechley, Mark; Vasudev, Akshya; Zou, G Y; Berryman, Nicolas; Lussier, Maxime; Vanderhaeghe, Leanne; Bherer, Louis

    2018-04-16

    Physical exercise, cognitive training, and vitamin D are low cost interventions that have the potential to enhance cognitive function and mobility in older adults, especially in pre-dementia states such as Mild Cognitive Impairment (MCI). Aerobic and progressive resistance exercises have benefits to cognitive performance, though evidence is somewhat inconsistent. We postulate that combined aerobic exercise (AE) and progressive resistance training (RT) (combined exercise) will have a better effect on cognition than a balance and toning control (BAT) intervention in older adults with MCI. We also expect that adding cognitive training and vitamin D supplementation to the combined exercise, as a multimodal intervention, will have synergistic efficacy. The SYNERGIC trial (SYNchronizing Exercises, Remedies in GaIt and Cognition) is a multi-site, double-blinded, five-arm, controlled trial that assesses the potential synergic effect of combined AE and RT on cognition and mobility, with and without cognitive training and vitamin D supplementation in older adults with MCI. Two-hundred participants with MCI aged 60 to 85 years old will be randomized to one of five arms, four of which include combined exercise plus combinations of dual-task cognitive training (real vs. sham) and vitamin D supplementation (3 × 10,000 IU/wk. vs. placebo) in a quasi-factorial design, and one arm which receives all control interventions. The primary outcome measure is the ADAS-Cog (13 and plus modalities) measured at baseline and at 6 months of follow-up. Secondary outcomes include neuroimaging, neuro-cognitive performance, gait and mobility performance, and serum biomarkers of inflammation (C reactive protein and interleukin 6), neuroplasticity (brain-derived neurotropic factor), endothelial markers (vascular endothelial growth factor 1), and vitamin D serum levels. The SYNERGIC Trial will establish the efficacy and feasibility of a multimodal intervention to improve cognitive performance

  7. Long-Term Air Pollution and Traffic Noise Exposures and Mild Cognitive Impairment in Older Adults: A Cross-Sectional Analysis of the Heinz Nixdorf Recall Study.

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    Tzivian, Lilian; Dlugaj, Martha; Winkler, Angela; Weinmayr, Gudrun; Hennig, Frauke; Fuks, Kateryna B; Vossoughi, Mohammad; Schikowski, Tamara; Weimar, Christian; Erbel, Raimund; Jöckel, Karl-Heinz; Moebus, Susanne; Hoffmann, Barbara

    2016-09-01

    Mild cognitive impairment (MCI) describes the intermediate state between normal cognitive aging and dementia. Adverse effects of air pollution (AP) on cognitive functions have been proposed, but investigations of simultaneous exposure to noise are scarce. We analyzed the cross-sectional associations of long-term exposure to AP and traffic noise with overall MCI and amnestic (aMCI) and nonamnestic (naMCI) MCI. At the second examination of the population-based Heinz Nixdorf Recall study, cognitive assessment was completed in 4,086 participants who were 50-80 years old. Of these, 592 participants were diagnosed as having MCI (aMCI, n = 309; naMCI, n = 283) according to previously published criteria using five neuropsychological subtests. We assessed long-term residential concentrations for size-fractioned particulate matter (PM) and nitrogen oxides with land use regression, and for traffic noise [weighted 24-hr (LDEN) and night-time (LNIGHT) means]. Logistic regression models adjusted for individual risk factors were calculated to estimate the association of environmental exposures with MCI in single- and two-exposure models. Most air pollutants and traffic noise were associated with overall MCI and aMCI. For example, an interquartile range increase in PM2.5 and a 10 A-weighted decibel [dB(A)] increase in LDEN were associated with overall MCI as follows [odds ratio (95% confidence interval)]: 1.16 (1.05, 1.27) and 1.40 (1.03, 1.91), respectively, and with aMCI as follows: 1.22 (1.08, 1.38) and 1.53 (1.05, 2.24), respectively. In two-exposure models, AP and noise associations were attenuated [e.g., for aMCI, PM2.5 1.13 (0.98, 1.30) and LDEN 1.46 (1.11, 1.92)]. Long-term exposures to air pollution and traffic noise were positively associated with MCI, mainly with the amnestic subtype. Tzivian L, Dlugaj M, Winkler A, Weinmayr G, Hennig F, Fuks KB, Vossoughi M, Schikowski T, Weimar C, Erbel R, Jöckel KH, Moebus S, Hoffmann B, on behalf of the Heinz Nixdorf Recall study

  8. Effects of Aerobic Training on Cognition and Brain Glucose Metabolism in Subjects with Mild Cognitive Impairment.

    Science.gov (United States)

    Porto, Fábio Henrique de Gobbi; Coutinho, Artur Martins Novaes; Pinto, Ana Lucia de Sá; Gualano, Bruno; Duran, Fabio Luís de Souza; Prando, Silvana; Ono, Carla Rachel; Spíndola, Lívia; de Oliveira, Maira Okada; do Vale, Patrícia Helena Figuerêdo; Nitrini, Ricardo; Buchpiguel, Carlos Alberto; Brucki, Sonia Maria Dozzi

    2015-01-01

    Aerobic training (AT) is a promising intervention for mild cognitive impairment (MCI). To evaluate the effects of AT on cognition and regional brain glucose metabolism (rBGM) in MCI patients. Subjects performed a twice-a-week, moderate intensity, AT program for 24 weeks. Assessment with ADAS-cog, a comprehensive neuropsychological battery, and evaluation of rBGM with positron emission tomography with 18F-fluorodeoxyglucose ([18F]FDG-PET) were performed before and after the intervention. Aerobic capacity was compared using the maximal oxygen consumption VO2max (mL/Kg/min). [18F]FDG-PET data were analyzed on a voxel-by-voxel basis with SPM8 software. Forty subjects were included, with a mean (M) age of 70.3 (5.4) years and an initial Mini-Mental State Exam score of 27.4 (1.7). Comparisons using paired t-tests revealed improvements in the ADAS-cog (M difference: -2.7 (3.7), p <  0.001) and VO2max scores (M difference: 1.8 (2.0) mL/kg/min, p <  0.001). Brain metabolic analysis revealed a bilateral decrease in the rBGM of the dorsal anterior cingulate cortex, pFWE = 0.04. This rBGM decrease was negatively correlated with improvement in a visuospatial function/attentional test (rho =-0.31, p = 0.04). Several other brain areas also showed increases or decreases in rBGM. Of note, there was an increase in the retrosplenial cortex, an important node of the default mode network, that was negatively correlated with the metabolic decrease in the dorsal anterior cingulate cortex (r =-0.51, p = 0.001). AT improved cognition and changed rBGM in areas related to cognition in subjects with MCI.

  9. Assessment of Driving Safety in Older Adults with Mild Cognitive Impairment.

    Science.gov (United States)

    Anstey, Kaarin J; Eramudugolla, Ranmalee; Chopra, Sidhant; Price, Jasmine; Wood, Joanne M

    2017-01-01

    With population aging, drivers with mild cognitive impairment (MCI) are increasing; however, there is little evidence available regarding their safety. We aimed to evaluate risk of unsafe on-road driving performance among older adults with MCI. The study was a cross-sectional observational study, set in Canberra, Australia. Participants were non-demented, current drivers (n = 302) aged 65 to 96 years (M = 75.7, SD = 6.18, 40% female) recruited through the community and primary and tertiary care clinics. Measures included a standardized on-road driving test (ORT), a battery of screening measures designed to evaluate older driver safety (UFOV®, DriveSafe, Multi-D), a neurocognitive test battery, and questionnaires on driving history and behavior. Using Winblad criteria, 57 participants were classified as having MCI and 245 as cognitively normal (CN). While the MCI group had a significantly lower overall safety rating on the ORT (5.61 versus 6.05, p = 0.03), there was a wide range of driving safety scores in the CN and MCI groups. The MCI group performed worse than the CN group on the off-road screening tests. The best fitting model of predictors of ORT performance across the combined sample included age, the Multi-D, and DriveSafe, classifying 90.4% of the sample correctly. Adults with MCI exhibit a similar range of driving ability to CN adults, although on average they scored lower on off-road and on-road assessments. Driving specific tests were more strongly associated with safety ratings than traditional neuropsychological tests.

  10. A Rehabilitation Protocol for Empowering Spatial Orientation in MCI. A Pilot Study.

    Science.gov (United States)

    Gadler, Erminia; Grassi, Alessandra; Riva, Giuseppe

    2009-01-01

    Spatial navigation is among the first cognitive functions to be impaired in Alzheimer's disease [1] and deficit in this domain is detectable earlier in patients with Mild Cognitive Impairment [2]. Since efficacy of cognitive training in persons with MCI was successfully assessed [3], we developed a multitasking training protocol using virtual environments for stimulating attention, perception and visuo-spatial cognition in order to empower spatial orientation in MCI. Two healthy elders were exposed to the training over a period of four weeks and both showed improved performances in attention and orientation after the end of the intervention.

  11. Frequency of Depressive Syndromes in Elderly Individuals with No Cognitive Impairment, Mild Cognitive Impairment, and Alzheimer's Disease Dementia in a Memory Clinic Setting.

    Science.gov (United States)

    Lee, Jun Ho; Byun, Min Soo; Yi, Dahyun; Choe, Young Min; Choi, Hyo Jung; Baek, Hyewon; Sohn, Bo Kyung; Kim, Hyun Jung; Lee, Younghwa; Woo, Jong Inn; Lee, Dong Young

    2016-01-01

    The aims of this study were to investigate the frequency of various depressive syndromes in elderly individuals with no cognitive impairment (NC), mild cognitive impairment (MCI), and Alzheimer's disease dementia (AD) in a memory clinic setting, and then to test whether severe and milder forms of depressive syndromes are differentially associated with the cognitive groups. For 216 NC, 478 MCI, and 316 AD subjects, we investigated the frequency of depressive syndromes, defined by three different categories: major and minor depressive disorder (MaDD and MiDD) according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, as well as depression according to the National Institute of Mental Health provisional diagnostic criteria for depression in Alzheimer's disease (NIMH-dAD). The frequency of MaDD did not show any significant difference among NC, MCI, and AD. In contrast, the frequencies of MiDD and NIMH-dAD were higher than those of MaDD and showed significant group differences with a gradual increase from NC to AD. The findings suggest that the degenerative process of Alzheimer's disease contributes to the occurrence of mild depressive conditions, but not to severe depression. © 2016 S. Karger AG, Basel.

  12. Mild cognitive impairment in elderly users of municipal centers of the Region of Murcia (Spain

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    Andrés Escarbajal de Haro

    2016-01-01

    Full Text Available This article of investigation tries to know the issue of mild cognitive impairment (MCI in elderly users of municipal centres to measure the importance of psycho-educational dimension like preventive alternative. For this reason, we have used a qualitative methodology (semistructurated interview after a selection of people applying quantitative scales (e.g. MMSE, EUROTEST and Lawton. We selected a sample of 148 people for the scales, out of which 30 people were considered suitable for the interviews. The results show that despite the fact that elderly people have a MCI , they are able to practice activities for improving their quality of life. Within this investigation, new lines of work based in the free time, lonely, self esteem and self are opened to elderly people with MCI.

  13. Diagnostic Labels, Stigma, and Participation in Research Related to Dementia and Mild Cognitive Impairment

    Science.gov (United States)

    Garand, Linda; Lingler, Jennifer H.; Conner, Kyaien O.; Dew, Mary Amanda

    2010-01-01

    Health care professionals use diagnostic labels to classify individuals for both treatment and research purposes. Despite their clear benefits, diagnostic labels also serve as cues that activate stigma and stereotypes. Stigma associated with the diagnostic labels of dementia and mild cognitive impairment (MCI) can have a significant and negative impact on interpersonal relationships, interactions with the health care community, attitudes about service utilization, and participation in clinical research. The impact of stigma also extends to the family caregivers of individuals bearing such labels. In this article, we use examples from our investigations of individuals with dementia or MCI and their family caregivers to examine the impact of labeling and stigma on clinical research participation. We also discuss how stigma can affect numerous aspects of the nursing research process. Strategies are presented for addressing stigma-related barriers to participation in clinical research on dementia and MCI. PMID:20077972

  14. Ecological assessment of mild cognitive impairment and Alzheimer disease using the Rivermead Behavioural Memory Test.

    Science.gov (United States)

    Bolló-Gasol, S; Piñol-Ripoll, G; Cejudo-Bolivar, J C; Llorente-Vizcaino, A; Peraita-Adrados, H

    2014-01-01

    The Rivermead Behavioural Memory Test (RBMT) is a short, ecologically-valid memory test battery that can provide data about a subject's memory function in daily life. We used RBMT to examine daily memory function in patients with mild cognitive impairment (MCI), Alzheimer disease (AD), and in healthy controls. We also evaluated differences between the memory profiles of subjects whose MCI remained stable after 1 year and those with conversion to AD. Sample of 91 subjects older than 60 years: 30 controls, 27 MCI subjects and 34 AD patients. Subjects were assessed using MMSE and RBMT. The 40 men and 51 women in the sample had a mean age of 74.29±6.71 and 5.87±2.93 years of education. For the total profile and screening RBMT scores (Pde Neurología. Published by Elsevier Espana. All rights reserved.

  15. EEG markers of cognitive impairments in patients with coronary artery disease

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    I. V. Tarasova

    2016-01-01

    Full Text Available Objective: to identify the indicators of bioelectrical activity of the cerebral cortex, which are associated with cognitive impairments in patients with coronary artery disease (CAD.Patients and methods. The study included 122 male patients aged 45 to 69 years with CAD. Sixty of them were found to have mild cognitive impairments (MCI, their average Mini-Mental State Examination (MMSE score was 26.2±0.90; the other 62 patients had no cognitive impairment; their MMSE score was 28.5±0.86. All the patients underwent clinical and instrumental examinations and computer-based multichannel electroencephalography (EEG. Eyes-closed and eyes-open resting EEG monopolarly recorded in 62 standard leads of the 10-20 system. A binary logistic regression analysis was used to identify EEG predictors of MCI in patients with CAD.Results. The high power values of theta1-rhythm biopotentials with closed eyes in the frontal and occipital areas of the left hemisphere and those of alpha2-rhythm ones with open eyes in the frontal areas of the right hemisphere, and the high theta/alpha EEG power ratio are associated with an increased risk of MCI in CAD patients. The most important clinical and anamnestic factors associated with a decreased risk of MCI were higher education level, the lack of type 2 diabetes, and milder coronary bed lesions according to the SYNTAX scale. There was an association of the power values of the biopotentials and theta/alpha EEG power ratio and the development of MCI in CAD patients.

  16. Atrophy-specific MRI brain template for Alzheimer's disease and mild cognitive impairment

    DEFF Research Database (Denmark)

    Fonov, Vladimir; Coupe, Pierrick; Eskildsen, Simon Fristed

    Background Rapid brain loss is characteristic for the patients with mild cognitive impairment (MCI) and Alzheimer disease (AD) [1]. Increase of the lateral ventricular volume is strongly correlated with the progression of the disease. High variability in the degree of atrophy for subjects with AD....... Alzheimer's and Dementia, 2010. 6(4, Supplement 1). [3] Fonov, V, et al. NeuroImage, 2011. 54(1).......Background Rapid brain loss is characteristic for the patients with mild cognitive impairment (MCI) and Alzheimer disease (AD) [1]. Increase of the lateral ventricular volume is strongly correlated with the progression of the disease. High variability in the degree of atrophy for subjects with AD...... of the brain and the contrast between different tissue types for the given level of atrophy. Figure 1 shows images through 6 example values of increasing RLVV. Conclusions The proposed method and resulting template will be useful tools for the development of robust automatic image processing methods targeted...

  17. Cognitive impairment in COPD: a systematic review

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    Irene Torres-Sánchez

    2015-04-01

    Full Text Available The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  18. Cognitive impairment in COPD: a systematic review.

    Science.gov (United States)

    Torres-Sánchez, Irene; Rodríguez-Alzueta, Elisabeth; Cabrera-Martos, Irene; López-Torres, Isabel; Moreno-Ramírez, Maria Paz; Valenza, Marie Carmen

    2015-01-01

    The objectives of this study were to characterize and clarify the relationships between the various cognitive domains affected in COPD patients and the disease itself, as well as to determine the prevalence of impairment in the various cognitive domains in such patients. To that end, we performed a systematic review using the following databases: PubMed, Scopus, and ScienceDirect. We included articles that provided information on cognitive impairment in COPD patients. The review of the findings of the articles showed a significant relationship between COPD and cognitive impairment. The most widely studied cognitive domains are memory and attention. Verbal memory and learning constitute the second most commonly impaired cognitive domain in patients with COPD. The prevalence of impairment in visuospatial memory and intermediate visual memory is 26.9% and 19.2%, respectively. We found that cognitive impairment is associated with the profile of COPD severity and its comorbidities. The articles reviewed demonstrated that there is considerable impairment of the cognitive domains memory and attention in patients with COPD. Future studies should address impairments in different cognitive domains according to the disease stage in patients with COPD.

  19. Generalizability of the Disease State Index Prediction Model for Identifying Patients Progressing from Mild Cognitive Impairment to Alzheimer's Disease

    NARCIS (Netherlands)

    Hall, A.; Munoz-Ruiz, M.; Mattila, J.; Koikkalainen, J.; Tsolaki, M.; Mecocci, P.; Kloszewska, I.; Vellas, B.; Lovestone, S.; Visser, P.J.; Lotjonen, J.; Soininen, H.

    2015-01-01

    Background: The Disease State Index (DSI) prediction model measures the similarity of patient data to diagnosed stable and progressive mild cognitive impairment (MCI) cases to identify patients who are progressing to Alzheimer's disease. Objectives: We evaluated how well the DSI generalizes across

  20. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: Positional versus object-location recall

    NARCIS (Netherlands)

    Kessels, R.P.C.; Rijken, S.; Joosten-Weyn Banningh, L.W.A.; Schuylenborgh-van Es, N. van; Olde Rikkert, M.G.M.

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been Studied in patients with Alzheimer dementia (AD), while Studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the

  1. Categorical spatial memory in patients with mild cognitive impairment and Alzheimer dementia: positional versus object-location recall.

    NARCIS (Netherlands)

    Kessels, R.P.C.; Rijken, S.; Joosten-Weyn Banningh, L.W.A.; Schuylenborgh-van Es, N. van; Olde Rikkert, M.G.M.

    2010-01-01

    Memory for object locations, as part of spatial memory function, has rarely been studied in patients with Alzheimer dementia (AD), while studies in patients with Mild Cognitive Impairment (MCI) patients are lacking altogether. The present study examined categorical spatial memory function using the

  2. Working Memory Capacity and Its Relation to Stroop Interference and Facilitation Effects in Individuals with Mild Cognitive Impairment

    Science.gov (United States)

    Sung, Jee Eun; Kim, Jin Hee; Jeong, Jee Hyang; Kang, Heejin

    2012-01-01

    Purpose: The purposes of the study were to investigate (a) the task-specific differences in short-term memory (STM) and working memory capacity (WMC) in individuals with mild cognitive impairment (MCI) and normal elderly adults (NEAs), (b) the Stroop interference and facilitation effects, and (c) the relationship of STM and WMC to the Stroop…

  3. [11C]PIB, [18F]FDG and MR imaging in patients with mild cognitive impairment

    DEFF Research Database (Denmark)

    Brück, A; Virta, J R; Koivunen, J

    2013-01-01

    Cortical glucose metabolism, brain amyloid β accumulation and hippocampal atrophy imaging have all been suggested as potential biomarkers in predicting which patients with mild cognitive impairment (MCI) will convert to Alzheimer's disease (AD). The aim of this study was to compare the prognostic...

  4. Using functional Magnetic Resonance Imaging to differentiate between healthy aging subjects, Mild Cognitive Impairment, and Alzheimer′s patients

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Oghabian

    2010-01-01

    Full Text Available Background: Alzheimer′s disease is the most common form of dementia which is still difficult to be differentiated from other types of brain disorders. Moreover, Mild Cognitive Impairment refers to the presence of cognitive impairments that is not severe enough to meet the criteria of Alzheimer′s, and its diagnosis in early stages is so critical. There is currently no distinct method available for diagnosing Alzheimer′s or Mild Cognitive