Background/Aims: To study how vascular disease and Alzheimer-typical biomarkers relate to cognitive performance in mild cognitive impairment (MCI). Methods: Three groups diagnosed with MCI, one with vascular disease (MCI-vas, n = 61), one with Alzheimer-typical biomarkers (MCI-bio, n = 99) and one with both vascular disease and Alzheimer-typical biomarkers (MCI-vasbio, n = 56), were examined with a comprehensive neuropsychological test battery. Results: The MCI-vas and MCI-bio groups performed quite similarly on the test battery, whereas the MCI-vasbio group tended to perform worse than the other groups. MCI-vasbio patients performed significantly worse on tests within all cognitive domains, with the most clear-cut differences on an executive test. Conclusions: Considering the small differences between MCI-vas and MCI-bio, vascular disease or biomarkers alone do not seem to be associated with a specific cognitive profile. The combination of vascular disease and Alzheimer-typical biomarkers, on the other hand, seems to be associated with more severe cognitive deficits. The difference in an aspect of executive functioning is interpreted as a synergetic effect.

1.
Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E: Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308.
2.
Nordlund A, Rolstad S, Hellstrom P, Sjogren M, Hansen S, Wallin A: The Goteborg MCI study: mild cognitive impairment is a heterogeneous condition. J Neurol Neurosurg Psychiatry 2005;76:1485–1490.
3.
Busse A, Hensel A, Guhne U, Angermeyer MC, Riedel-Heller SG: Mild cognitive impairment: long-term course of four clinical subtypes. Neurology 2006;67:2176–2185.
4.
Guarch J, Marcos T, Salamero M, Blesa R: Neuropsychological markers of dementia in patients with memory complaints. Int J Geriatr Psychiatry 2004;19:352–358.
5.
Nordlund A, Rolstad S, Klang O, Edman A, Hansen S, Wallin A: Two-year outcome of MCI subtypes and aetiologies in the Göteborg MCI study. J Neurol Neurosurg Psychiatry 2010;81:541–546.
6.
Nordlund A, Rolstad S, Gothlin M, Edman A, Hansen S, Wallin A: Cognitive profiles of incipient dementia in the Göteborg MCI study. Dement Geriatr Cogn Disord 2010;30:403–410.
7.
Saito Y, Murayama S: Neuropathology of mild cognitive impairment. Neuropathology 2007;27:578–584.
8.
Nordlund A, Rolstad S, Klang O, Lind K, Hansen S, Wallin A: Cognitive profiles of mild cognitive impairment with and without vascular disease. Neuropsychology 2007;21:706–712.
9.
Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M: Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke 2002;33:1981–1985.
10.
Frisoni GB, Galluzzi S, Bresciani L, Zanetti O, Geroldi C: Mild cognitive impairment with subcortical vascular features: clinical characteristics and outcome. J Neurol 2002;249:1423–1432.
11.
Roman GC, Sachdev P, Royall DR, Bullock RA, Orgogozo JM, Lopez-Pousa S, Arizaga R, Wallin A: Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia. J Neurol Sci 2004;226:81–87.
12.
Luis CA, Barker WW, Loewenstein DA, Crum TA, Rogaeva E, Kawarai T, St. George-Hyslop P, Duara R: Conversion to dementia among two groups with cognitive impairment. A preliminary report. Dement Geriatr Cogn Disord 2004;18:307–313.
13.
Loewenstein DA, Acevedo A, Agron J, Issacson R, Strauman S, Crocco E, Barker WW, Duara R: Cognitive profiles in Alzheimer’s disease and in mild cognitive impairment of different etiologies. Dement Geriatr Cogn Disord 2006;21:309–315.
14.
Ivanoiu A, Sindic CJ: Cerebrospinal fluid tau protein and amyloid beta42 in mild cognitive impairment: prediction of progression to Alzheimer’s disease and correlation with the neuropsychological examination. Neurocase 2005;11:32–39.
15.
Schoonenboom SN, Visser PJ, Mulder C, Lindeboom J, Van Elk EJ, Van Kamp GJ, Scheltens PH: Biomarker profiles and their relation to clinical variables in mild cognitive impairment. Neurocase 2005;11:8–13.
16.
Nordlund A, Rolstad S, Klang O, Lind K, Pedersen M, Blennow K, Edman A, Hansen S, Wallin A: Episodic memory and speed/attention deficits are associated with Alzheimer-typical CSF abnormalities in mci. J Int Neuropsychol Soc 2008;14:582–590.
17.
Nagata K, Saito H, Ueno T, Sato M, Nakase T, Maeda T, Satoh Y, Komatsu H, Suzuki M, Kondoh Y: Clinical diagnosis of vascular dementia. J Neurol Sci 2007;257:44–48.
18.
Zekry D, Hauw JJ, Gold G: Mixed dementia: epidemiology, diagnosis, and treatment. J Am Geriatr Soc 2002;50:1431–1438.
19.
Nagga K, Radberg C, Marcusson J: CT brain findings in clinical dementia investigation – underestimation of mixed dementia. Dement Geriatr Cogn Disord 2004;18:59–66.
20.
Prasad K, Wiryasaputra L, Ng A, Kandiah N: White matter disease independently predicts progression from mild cognitive impairment to Alzheimer’s disease in a clinic cohort. Dement Geriatr Cogn Disord 2011;31:431–434.
21.
Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Backman L, Albert M, Almkvist O, Arai H, Basun H, Blennow K, de Leon M, DeCarli C, Erkinjuntti T, Giacobini E, Graff C, Hardy J, Jack C, Jorm A, Ritchie K, van Duijn C, Visser P, Petersen RC: Mild cognitive impairment – Beyond controversies, towards a consensus: report of the international working group on mild cognitive impairment. J Intern Med 2004;256:240–246.
22.
Wallin A, Edman A, Blennow K, Gottfries CG, Karlsson I, Regland B, Sjogren M: Stepwise comparative status analysis (STEP): a tool for identification of regional brain syndromes in dementia. J Geriatr Psychiatry Neurol 1996;9:185–199.
23.
Royall DR, Mahurin RK, Gray KF: Bedside assessment of executive cognitive impairment: the executive interview. J Am Geriatr Soc 1992;40:1221–1226.
24.
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.
25.
Morris JC: Clinical dementia rating: a reliable and valid diagnostic and staging measure for dementia of the Alzheimer type. Int Psychogeriatr 1997;9(suppl 1):173–178.
26.
Scheltens P, Erkinjunti T, Leys D, Wahlund LO, Inzitari D, del Ser T, Pasquier F, Barkhof F, Mantyla R, Bowler J, Wallin A, Ghika J, Fazekas F, Pantoni L: White matter changes on CT and MRI: an overview of visual rating scales. European Task Force on Age-Related White Matter Changes. Eur Neurol 1998;39:80–89.
27.
Blennow K, Wallin A, Agren H, Spenger C, Siegfried J, Vanmechelen E: Tau protein in cerebrospinal fluid: a biochemical marker for axonal degeneration in Alzheimer disease? Mol Chem Neuropathol 1995;26:231–245.
28.
Andreasen N, Hesse C, Davidsson P, Minthon L, Wallin A, Winblad B, Vanderstichele H, Vanmechelen E, Blennow K: Cerebrospinal fluid beta-amyloid(1–42) in Alzheimer disease: differences between early- and late-onset Alzheimer disease and stability during the course of disease. Arch Neurol 1999;56:673–680.
29.
Meyer J, Xu G, Thornby J, Chowdhury M, Quach M: Longitudinal analysis of abnormal domains comprising mild cognitive impairment (MCI) during aging. J Neurol Sci 2002;201:19–25.
30.
Arnaiz E, Almkvist O, Ivnik RJ, Tangalos EG, Wahlund LO, Winblad B, Petersen RC: Mild cognitive impairment: a cross-national comparison. J Neurol Neurosurg Psychiatry 2004;75:1275–1280.
31.
Sachdev PS, Brodaty H, Valenzuela MJ, Lorentz L, Looi JC, Wen W, Zagami AS: The neuropsychological profile of vascular cognitive impairment in stroke and TIA patients. Neurology 2004;62:912–919.
32.
Fernandez PJ, Campoy G, Garcia Santos JM, Antequera MM, Garcia-Sevilla J, Castillo A, Antunez C, Fuentes LJ: Is there a specific pattern of attention deficit in mild cognitive impairment with subcortical vascular features? Evidence from the attention network test. Dement Geriatr Cogn Disord 2011;31:268–275.
33.
Villeneuve S, Belleville S, Massoud F, Bocti C, Gauthier S: Impact of vascular risk factors and diseases on cognition in persons with mild cognitive impairment. Dement Geriatr Cogn Disord 2009;27:375–381.
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