Deterioro cognitivo leve: características neuropsicológicas de los distintos subtipos

Profiles of Mild Cognitive Impairment (MCI) in the Elderly

“…As we already mentioned, we considered each one of the three yearly assessments separately, using the 40 th percentile as the cut-off point for a solution of 4 groups, which was the one that presented the best fit. Already the results of the LCA for the first neuropsychological assessment were very similar to the four profiles described in the solution adopted by Díaz & Peraita (2008) in which the cut-off point was -1.5 SDs below the mean, as has been common in previous studies using similar criteria (Loewenstein et al, 2009;Migliacci et al, 2009). Therefore, there seem to be four basic profiles; two of them showing good performance in memory tests, and the other two with poor performance.…”

“…In general, when MCI is detected by means of the current neuropsychological tests in addition to established clinical criteria, subjects are classified into three profiles or subprofiles, as a function of the cognitive functions or processes observed to be impaired: 1] the amnestic profile, in which memory is the single impaired cognitive process; 2] the non-amnestic profile, in which memory is not affected at all, but some other cognitive processes [such as language, executive function, or praxis] are; and 3] the multidomain profile, in which both memory and some other cognitive processes are altered (Busse, Hensel, Gühne, Angermeyer, & Riedel-Heller, 2006;Migliacci, Scharovsky, & Gonorazky, 2009). Given this logic, clinical criteria alone are seldom used, and psychometric data always play a fundamental role in diagnosis, since the results obtained on neuropsychological tests can be compared to the normative data for the reference population in those or comparable existing tests.…”

“…Given this logic, clinical criteria alone are seldom used, and psychometric data always play a fundamental role in diagnosis, since the results obtained on neuropsychological tests can be compared to the normative data for the reference population in those or comparable existing tests. The typical criterion for classification used in these cases consists of assigning one of three MCI profiles to the individual who performs 1.5 SDs below the mean [though sometimes only 1.0 SD is required] on one or more of the tests that assess various cognitive processes [i.e., memory, executive function, language, visuo-spatial perception, or (Alladi, Arnold, Mitchell, Nestor, & Hodges, 2006;Brandt et al, 2009;Díaz & Peraita, 2008;Migliacci et al, 2009;Petersen & Negash, 2008;Petersen et al, 2001).…”

“…It is clear that, from either a conceptual or an operational point of view, this classification has its problems. Thus, diagnosis will largely depend on the number and type of tests selected for the neuropsychological assessment, and on the availability of norms for the target population, on the ascertainment method and the criteria used to select participants, on the goals of the assessment, and on other methodological factors (Alladi et al, 2006;Migliacci et al, 2009;Peña-Casanova et al, 2009;Petersen et al, 2001). Additional considerations affecting the assessment have to do with whether cognitive processes are assessed exhaustively or not, whether each cognitive function is evaluated by a single test or by several, whether participants are selected from a clinical or a community setting, and whether they are recruited into a clinical study or within a research setting.…”

Problems in Classifying Mild Cognitive Impairment (MCI): One or Multiple Syndromes?

“…The diagnosis of MCI is not only based on cognitive assessment, often performed through a short screening and with the limitations that this implies [ 42 ] but also takes into account the individual’s medical history, and their physical and functional status, as well as complementary medical tests [ 43 ]. Accordingly, comprehensive cognitive assessments, not only through screening tests but also through well-designed assessment batteries, should detect deficits in various cognitive processes and allow different subtypes of MCI to be established [ 44 , 45 , 46 ].…”