In Brief Neuropsychological Assessment, Amnestic Mild Cognitive Impairment (MCI) Is associated with Cerebrospinal Fluid Biomarkers for Cognitive Decline in Contrast to the Prevailing NIA-AA MCI Criterion

Abstract

Background: In the care of persons with cognitive problems, it is important to use a valid mild cognitive impairment (MCI) criterion that discriminates well between normal and pathological aging. Objective: To find the brief neuropsychological screening criterion that best correlates with cerebrospinal fluid (CSF) biomarkers for cognitive decline and dementia in persons seeking help for cognitive problems. Methods: 452 consecutively recruited patients (age 40–80 years) from memory-clinics in the Norwegian national multicentre longitudinal study Dementia Disease Initiation were included. CSF data as well as full data from brief neuropsychological screening were available for all patients. Results: Amnestic MCI, including at least one memory test below T-score 40, outperformed the conventional US National Institute on Aging-Alzheimer’s Association (NIA-AA) MCI criterion. Only amnestic MCI was significantly associated with biomarker pattern of NIA-AA stage 2 (low CSF A β 42 concentrations and elevated tau) in multivariate regression analysis. Conclusions: The finding that amnestic MCI based on brief neuropsychological assessment is significantly associated with CSF biomarkers for cognitive decline and Alzheimer’s disease is in accordance with longitudinal studies that find memory impairment; both in itself and especially in combination with other cognitive deficit to constitute a risk factor for subsequent cognitive decline and dementia. The prevalence of pathological biomarkers for Alzheimer’s disease is common in the elderly and the clinical significance of present findings depend on longitudinal validation.

Cerebrospinal fluid markers for synaptic function and Alzheimer type changes in late life depression

“…Demographically adjusted T-scores of CERAD word list (recall) 34 , VOSP 33 , TMT B and COWAT 35 were used for cognitive staging, defined as impaired if lower than 1.5 standard deviation below the normal population. Details on the neuropsychological battery have been provided elsewhere 36 .…”

Predictive and diagnostic utility of brief neuropsychological assessment in detecting Alzheimer’s pathology and progression to dementia.

“…All participants were categorized using five different MCI definitions in succession. Because one aim of the current study was a longitudinal evaluation of findings from Hessen et al (2019), we This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…Memory impairment is a key feature of MCI due to AD, and meta-analytic evidence shows that impaired performance on neuropsychological memory measures in MCI predicts AD progression (Belleville et al, 2017). In a recent cross-sectional study, Hessen and colleagues (2019) compared brief neuropsychological screening criteria for MCI and their association with cerebrospinal fluid AD biomarkers. It was found that a criterion targeting amnestic MCI was more strongly associated with the NIA-AA Stage 2 (lowered CSF Aβ42 concentrations and elevated CSF tau concentrations; Sperling et al, 2011), than criteria allowing for impairment in any cognitive domain.…”

Speech pause distribution as an early marker for Alzheimer’s disease

“…More specifically, impairment in episodic memory encoding reflected in unsuccessful cued recall and susceptibility to intrusion effects has been associated with higher probability of underlying [22,23,24] even at the prodromal phase of MCI [25]. More recent studies have demonstrated that this particular cognitive profile in MCI is compatible with positive AD biomarkers [26,27,28,29,30], as well as abnormal neural connectivity [31,32,33] and cerebral perfusion patterns [34] during memory encoding tasks. Moreover, declines in memory encoding have been predicted in amyloid-positive cognitively-normal individuals [35,36,37] alongside downstream tau increases [38,39,40,41], as well as in patients with subjective cognitive complaint with positive AD biomarkers [42].…”