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Table of Contents
Vol. 28, No. 2, 2009
Issue release date: September 2009
Section title: Original Research Article
Free Access
Dement Geriatr Cogn Disord 2009;28:168–178
(DOI:10.1159/000235732)

Persistence of Neuropsychological Testing Deficits in Mild Cognitive Impairment

Teng E.a · Tingus K.D.a · Lu P.H.a · Cummings J.L.a, b
Departments of aNeurology and bPsychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif., USA
email Corresponding Author

Abstract

Background: The significant variability across studies of mild cognitive impairment (MCI) in rates of progression to Alzheimer’s disease (AD) and reversion to normal cognition may be due to differences in specific neuropsychological tests and thresholds used to define MCI. Methods: We assessed 115 subjects with amnestic (AMN) or non-amnestic (NON) MCI on a standardized neuropsychological battery at baseline and after a mean follow-up of 16.4 months to determine the prevalence and persistence of deficits identified with specific tests. Results: The prevalence of impaired performance varied widely across tests. Deficits were more persistent in the AMN group than in the NON group. Baseline deficits in Visual Reproduction II and the California Verbal Learning Test were the best predictors of persistent memory impairment. Subjects who at baseline were impaired on multiple memory tests or had poorer overall memory performance were more likely to exhibit persistent memory deficits. Conclusions: The use of different neuropsychological tests and thresholds to diagnose MCI identified subsets of subjects with different rates of persistence of cognitive impairment. Standardization of the operational definition of cognitive impairment in MCI may result in more consistent predictions of progression to AD.

© 2009 S. Karger AG, Basel


  

Key Words

  • Alzheimer disease
  • Memory
  • Cognition
  • Dementia
  • Psychometrics

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Author Contacts

Edmond Teng, MD, PhD
Neurobehavior Unit, West Los Angeles VA Healthcare Center
Building 500 (116AF), 11301 Wilshire Boulevard
Los Angeles, CA 90073 (USA)
Tel. +1 310 478 3711, ext. 49633, Fax +1 310 268 4181, E-Mail eteng@ucla.edu

  

Article Information

Accepted: July 8, 2009
Published online: August 26, 2009
Number of Print Pages : 11
Number of Figures : 3, Number of Tables : 3, Number of References : 77

  

Publication Details

Dementia and Geriatric Cognitive Disorders

Vol. 28, No. 2, Year 2009 (Cover Date: September 2009)

Journal Editor: Chan-Palay V. (New York, N.Y.)
ISSN: 1420-8008 (Print), eISSN: 1421-9824 (Online)

For additional information: http://www.karger.com/DEM


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References

  1. Petersen RC: Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194.
  2. Bruscoli M, Lovestone S: Is MCI really just early dementia? A systematic review of conversion studies. Int Psychogeriatr 2004;16:129–140.
  3. Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST: Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56:1133–1142.
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  6. Ravaglia G, Forti P, Maioli F, Martelli M, Servadei L, Brunetti N, Pantieri G, Mariani E: Conversion of mild cognitive impairment to dementia: predictive role of mild cognitive impairment subtypes and vascular risk factors. Dement Geriatr Cogn Disord 2006;21:51–58.
  7. Kryscio RJ, Schmitt FA, Salazar JC, Mendiondo MS, Markesbery WR: Risk factors for transitions from normal to mild cognitive impairment and dementia. Neurology 2006;66:828–832.
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  9. Luis CA, Loewenstein DA, Acevedo A, Barker WW, Duara R: Mild cognitive impairment: directions for future research. Neurology 2003;61:438–444.
  10. Visser PJ, Scheltens P, Verhey FR, Schmand B, Launer LJ, Jolles J, Jonker C: Medial temporal lobe atrophy and memory dysfunction as predictors for dementia in subjects with mild cognitive impairment. J Neurol 1999;246:477–485.
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  12. Busse A, Angermeyer MC, Riedel-Heller SG: Progression of mild cognitive impairment to dementia: a challenge to current thinking. Br J Psychiatry 2006;189:399–404.
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  19. Ritchie K, Artero S, Touchon J: Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 2001;56:37–42.
  20. Ganguli M, Dodge HH, Shen C, DeKosky ST: Mild cognitive impairment, amnestic type: an epidemiologic study. Neurology 2004;63:115–121.
  21. Griffith HR, Netson KL, Harrell LE, Zamrini EY, Brockington JC, Marson DC: Amnestic mild cognitive impairment: diagnostic outcomes and clinical prediction over a two-year time period. J Int Neuropsychol Soc 2006;12:166–175.
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  24. Kluger A, Ferris SH, Golomb J, Mittelman MS, Reisberg B: Neuropsychological prediction of decline to dementia in nondemented elderly. J Geriatr Psychiatry Neurol 1999;12:168–179.
  25. Chen P, Ratcliff G, Belle SH, Cauley JA, DeKosky ST, Ganguli M: Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented. Neurology 2000;55:1847–1853.
  26. Albert MS, Moss MB, Tanzi R, Jones K: Preclinical prediction of AD using neuropsychological tests. J Int Neuropsychol Soc 2001;7:631–639.
  27. Ahmed S, Mitchell J, Arnold R, Nestor PJ, Hodges JR: Predicting rapid clinical progression in amnestic mild cognitive impairment. Dement Geriatr Cogn Disord 2008;25:170–177.
  28. Sarazin M, Berr C, De Rotrou J, Fabrigoule C, Pasquier F, Legrain S, Michel B, Puel M, Volteau M, Touchon J, Verny M, Dubois B: Amnestic syndrome of the medial temporal type identifies prodromal AD: a longitudinal study. Neurology 2007;69:1859–1867.
  29. Alladi S, Arnold R, Mitchell J, Nestor PJ, Hodges JR: Mild cognitive impairment: applicability of research criteria in a memory clinic and characterization of cognitive profile. Psychol Med 2006;36:507–515.
  30. Backman L, Small BJ, Fratiglioni L: Stability of the preclinical episodic memory deficit in Alzheimer’s disease. Brain 2001;124:96–102.
  31. Hodges JR, Erzinclioglu S, Patterson K: Evolution of cognitive deficits and conversion to dementia in patients with mild cognitive impairment: a very-long-term follow-up study. Dement Geriatr Cogn Disord 2006;21:380–391.
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  36. Delis DC, Kramer JH, Kaplan E, Ober B: The California Verbal Learning Test, ed 2. San Antonio, The Psychological Corporation, 2000.
  37. Meyers J, Meyers K: Rey Complex Figure and Recognition Trial: Professional Manual. Odessa, Psychological Assessment Resources, Inc., 1995.
  38. Wechsler D: Wechsler Adult Intelligence Scale, ed 3: Administration and Scoring Manual. San Antonio, The Psychological Corporation, 1997.
  39. Tombaugh TN: Trail Making Test A and B: Normative data stratified by age and education. Arch Clin Neuropsychol 2004;19:203–214.
  40. Tombaugh TN, Hubley AM: The 60-item Boston Naming Test: norms for cognitively intact adults aged 25 to 88 years. J Clin Exp Neuropsychol 1997;19:922–932.
  41. Tombaugh TN, Kozak J, Rees L: Normative data stratified by age and education for two measures of verbal fluency: FAS and animal naming. Arch Clin Neuropsychol 1999;14:167–177.
  42. Demick J, Harkins D: Role of cognitive style in the driving skills of young, middle-aged, and older adults. American Association of Retired Persons Andrus Foundation Final Grant Report. Washington, American Association of Retired Persons, 1997.
  43. Folstein MF, Folstein SE, McHugh PR: ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975;12:189–198.
  44. Yesavage JA: Geriatric Depression Scale. Psychopharmacol Bull 1988;24:709–711.
  45. Lezak MD, Howieson DB, Loring DW: Neuropsychological Assessment, ed 4. New York, Oxford University Press, 2004.
  46. de Rotrou J, Wenisch E, Chausson C, Dray F, Faucounau V, Rigaud AS: Accidental MCI in healthy subjects: a prospective longitudinal study. Eur J Neurol 2005;12:879–885.
  47. Loewenstein DA, Acevedo A, Ownby R, Agron J, Barker WW, Isaacson R, Strauman S, Duara R: Using different memory cutoffs to assess mild cognitive impairment. Am J Geriatr Psychiatry 2006;14:911–919.
  48. Palmer BW, Boone KB, Lesser IM, Wohl MA: Base rates of ‘impaired’ neuropsychological test performance among healthy older adults. Arch Clin Neuropsychol 1998;13:503–511.
  49. Ingraham LJ, Aiken CB: An empirical approach to determining criteria for abnormality in test batteries with multiple measures. Neuropsychology 1996;10:120–124.

    External Resources

  50. Jelic V, Kivipelto M, Winblad B: Clinical trials in mild cognitive impairment: lessons for the future. J Neurol Neurosurg Psychiatry 2006;77:429–438.
  51. Fischer P, Jungwirth S, Zehetmayer S, Weissgram S, Hoenigschnabl S, Gelpi E, Krampla W, Tragl KH: Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology 2007;68:288–291.
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