Little is known about the service needs for persons caring for individuals with Mild Cognitive Impairment (MCI). In this study, the level of support service need for caregivers of individuals diagnosed with Alzheimer's Disease (AD; N=55) and MCI (N=25) was compared to normal controls (NC; N=44). Study partners (i.e., caregivers) completed questionnaires about their service needs and participants' neurobehavioral symptoms, functional abilities, and frailty. Total, social, and mental health service needs were significantly different among the three groups (p<.0001), with MCI and AD caregivers reporting more need for services as compared to the NC group. There was no significant difference between MCI and AD groups for total and social service need. In the MCI group, caregiver's service need was related to neurobehavioral symptoms and frailty, whereas service need among the AD caregivers was related to functional disability and frailty. Caregivers of individuals with MCI are already experiencing a need for increased services comparable to that of individuals caring for AD patients, though the pattern of patient-related factors is different between the two patient groups. These findings suggest possible areas of intervention that could be considered at the earliest stages of memory loss.
Key words/phrasesmild cognitive impairment; Alzheimer's disease; service need; support services; caregiver The term Mild Cognitive Impairment (MCI) has been used to describe the transitional phase between normal functioning and Alzheimer's disease (AD) 1 . According to Petersen and colleagues'1 original criterion, amnestic MCI is diagnosed when there is a subjective memory complaint as well as evidence of objective memory impairment in the context of intact activities of daily living and general intellectual abilities. Peterson2 later broadened the criterion to include two primary subtypes of MCI: amnestic and nonamnestic MCI. The broader definition of MCI acknowledges the possibility of other cognitive complaints or deficits in other areas besides memory. Many studies indicate that MCI progresses to AD at a relatively high rate, from 13-48% over 12-60 months 3 -5 . The cognitive and functional changes associated with the progression to AD as well as the potential for a longer disease course among individuals with MCI likely pose a unique set of challenges for caregivers or family members who provide assistance to or care for these patients. There is extensive literature on care burden by family Although no research exists on what formal support services family members of patients with MCI use, there is some evidence to suggest that spouses of patients with MCI are experiencing increased caregiver burden [13][14] . Garand and her colleagues 14 reported that MCI spouses/ caregivers endorsed an increase in caregiving responsibilities such as greater frequency of errands, more coordination of transportation, and greater management of business affairs and medications. Lifestyle constraints and increase in household responsibilit...
Objective
Verbal memory difficulties are common among individuals with late-life depression (LLD), though there is limited knowledge about disruptions to underlying cerebral circuitry. The purpose of this study is to examine aberrations to cerebral networks implicated in encoding novel verbal semantic material among older adults with LLD.
Methods
Twenty-four older adults with early-onset LLD and 23 non-depressed comparisons (NDC) participated in the study. Participants completed a word list-learning task while undergoing fMRI.
Results
In the context of equivalent recall and recognition of words following scanning and similar hippocampal volumes, patients with LLD exhibited less activation in structures known to be relevant for new learning and memory, including hippocampus, parahippocampal gyrus, insula, and cingulate, relative to non-ill comparisons. An important region in which the LLD group displayed greater activation than the NDC group was in inferior frontal gyrus (IFG), an area involved in cognitive control and controlled semantic/phonological retrieval and analysis; this region may be critical for LLD patients to consolidate encoded words into memory.
Conclusions
Functional irregularities found in LLD patients may reflect different modes of processing to-be-remembered information and/or early changes predictive of incipient cognitive decline. Future studies might consider mechanisms that could contribute to these functional differences, including HPA-axis functioning and vascular integrity, and utilize longitudinal designs in order to understand whether functional changes are predictive of incipient cognitive decline.
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