Mild Cognitive Impairment (MCI) is a heterogeneous condition between normal aging and dementia. Upon neuropsychological testing, MCI can be divided into four groups: singledomain amnestic MCI (sd-aMCI), multiple-domain amnestic MCI (md-aMCI), single-and multiple-domain non-amnestic MCI (sd-naMCI, md-naMCI). Some controversy exists about whether the risk of progression to Alzheimer's disease (risk-AD) is increased in all MCI subtypes. We meta-analyzed the risk-AD for four MCI groups using random-effects metaregression with the Hierarchical Robust Variance Estimator and sample size, criterion for objective cognitive impairment, length of follow-up and source of recruitment as covariates. From a pool of 134 available studies, 81 groups from 33 studies (N = 4,907) were metaanalyzed. All the studies were rated as having a high risk of bias. aMCI is overrepresented in studies from memory clinics. Multivariate analyses showed that md-aMCI had a similar risk-AD relative to sd-aMCI, whereas both sd-naMCI and md-naMCI showed a lower risk-AD compared to sd-aMCI. The risk-AD was significantly associated with differences in sample sizes across studies and between groups within studies. md-aMCI had a similar risk-AD relative to sd-aMCI in studies from memory clinics and in studies in the community. Several potential sources of bias such as blindness of AD diagnosis, the MCI diagnosis approach and the reporting of demographics were associated with the risk-AD. This work provides important data for use in both clinical and research scenarios.
Considering normal variability in cognitive test performance when diagnosing MCI may help identify individuals at greatest risk of progression to AD with greater certainty.
This work was aimed at obtaining a profile of neuropsychological impairments in young Spanish participants with anorexia nervosa (AN) to demonstrate that right-hemisphere and frontal capacity impairments are present not only in the acute phase but also after weight recovery in a Spanish sample compared with a healthy control group. Twelve patients with AN in the acute phase (body mass index [BMI] < 17) were compared both to 16 healthy control subjects and 12 weight-recovered AN participants (BMI ! 17) matched by age, IQ, and educational level by utilizing a wide neuropsychological battery. Differences were found between AN groups only for long-term verbal memory, which worsens as BMI increases. Among participants with AN as a group, results showed differences in speed of information processing, working memory, visual memory, and inhibition, unrelated to attentional capabilities. We cannot support the hypothesis of a specific right cerebral dysfunction in patients with AN. A general cognitive dysfunction, primarily in information processing, working memory, visual and verbal memory, as well as frontal impairments such as impulsivity and poor behavioral control, appeared unrelated to BMI. We support previous works affirming that neuropsychological impairments in AN are not a consequence of the illness but a risk factor for it to develop.
Obtaining one or more low scores, or scores indicative of impairment, is common in neuropsychological batteries that include several measures even among cognitively normal individuals. However, the expected number of low scores in batteries with differing number of tests is unknown. Using 10 neuropsychological measures from the National Alzheimer’s Coordinating Center database, 1,023 permutations were calculated from a sample of 5,046 cognitively normal individuals. The number of low scores (i.e., z score ≤−1.5) varied for the same number of measures and among different number of measures and did not increase linearly as the number of measures increased. According to the number of low scores shown by fewer than 10% of the sample, cognitive impairment should be suspected for 1 or more, 2 or more, and 3 or more in batteries with up to 2 measures, 3 to 9 measures, and 10 measures, respectively. These results may increase the identification of mild cognitive impairment.
Along with the burden commonly experienced by informal caregivers (ICs) of people with dementia (PwD), associated with the progressive decline that accompanies dementia, the lockdown due to the public health crisis has had a great negative impact on the emotional wellbeing, physical health, and social relationships of ICs. Support interventions through telemedicine represent an opportunity for ICs to learn the skills required for the care and maintenance of social networks. In this work, a narrative review of the effects of e-health training and social support interventions was carried out. A literature search was conducted using the ProQuest, Ovid, and Scopus databases. Information regarding social support (SS), psychological interventions, and training for the management of medications and behavioral changes was extracted. One hundred and nine studies were included in this review. Forums and training platforms were the main tools for ICs. The most effective platforms to improve SS include the participation of both ICs and health professionals. However, no significant improvements in objective caring skills were identified. Platforms developed specifically for ICs should be based in tools that ICs are familiar with, because many ICs have not yet incorporated Information and Communication Technologies in many activities of their daily lives. Education in the digitalization to ICs of PwD should be one of the priority objectives in telehealth interventions.
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