Predicting decline in mild cognitive impairment: A prospective cognitive study.

Belleville, Sylvie; Gauthier, Serge; Lepage, Émilie; Kergoat, Marie‐Jeanne; Gilbert, Brigitte

doi:10.1037/neu0000063

Cited by 50 publications

(64 citation statements)

References 38 publications

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“…This is consistent with the observation that MCI is mainly characterized by memory deficits [3,5], and that both episodic memory and working memory are impaired early in the disease process and are predictors of conversion from MCI to AD [11,36] (for a review, see [37]) and from healthy aging to MCI [38].…”

Section: Discussionsupporting

confidence: 89%

“…One other crucial difference between the two studies is that we differentiated nonprogressor from progressor MCI. Some studies have indicated that executive functions and inhibition are more impaired in progressors than in non-progressor MCIs [20,21,43,47] and predictive models that are most sensitive and specific often include executive function measures [11] (for a review, see [37]). Our results support this literature as executive functions were found to differ between non-progressor and progressor MCI and only the latter showed increased impairment.…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the studies assessing the cognitive profile in MCI are predictive studies aiming to identify the factors/neuropsychological tests that are predictive of future progression to dementia [10][11][12] (for a review, see [13]). In turn, natural history studies aim to characterize the changes that occur in different cognitive domains as individuals progress during the early phase of MCI, and to provide the opportunity to study the trajectory of the symptoms, per cognitive domain.…”

Section: Natural Historymentioning

confidence: 99%

“…As a result, it is unclear how memory deficits increase over time, and how and when non-memory deficits (e.g., executive functions, language) emerge in the MCI-to-dementia continuum. It is critical to understand the progression of deficits in these different domains, as some authors have suggested that dementia occurs predominantly as a result of the occurrence of executive deficits [11,20,21].…”

Section: Natural Historymentioning

confidence: 99%

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O2‐07‐03: Patterns of Cognitive Decline Prior to Dementia in Persons With Mild Cognitive Impairment

Cloutier

Chertkow

Lepage

et al. 2014

Alzheimer's & Dementia

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Abstract. Only a limited number of studies have investigated the decline of discrete cognitive domains as individuals progress from mild cognitive impairment (MCI) to dementia. Thus, the goal of this longitudinal study was to evaluate the cognitive changes underway during the years preceding a diagnosis of probable Alzheimer's disease (AD), and to compare these changes to those found in MCI participants who do not progress to dementia. Participants were compared as a function of whether they later converted to AD (n = 47) or not (n = 74). Cognitive change was assessed prior to the conversion year, using that year as a starting point. A combination of polynomial regression analyses and mixed ANOVAs assessed 1) the trajectory of cognitive decline for each domain and 2) the differences between non-progressors and those who had converted to AD. The different cognitive domains demonstrated very different patterns of decline in the group of MCI progressors. A quadratic function, i.e., many years of stable performance followed by a rapid decline just prior to diagnosis, was observed for delayed recall, working memory, and spatial memory. In contrast, a gradual linear decline was observed for immediate recall, executive function, and visuo-spatial abilities. Finally, language in progressors was impaired on all time periods relative to non-progressors, but there was no further change between the first assessments and conversion to AD. Individuals with MCI who progress to AD show abnormal cognition at least two years prior to their dementia diagnosis. The pattern of symptom change observed appears to depend upon the cognitive domain and thus, clinical studies should not assume similar rate of decline across domains. In contrast and, apart from verbal memory, the non-progressors present a performance similar to that of healthy older adults.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Natural Historymentioning

confidence: 99%

Section: Natural Historymentioning

confidence: 99%

See 2 more Smart Citations

O2‐07‐03: Patterns of Cognitive Decline Prior to Dementia in Persons With Mild Cognitive Impairment

Cloutier

Chertkow

Lepage

et al. 2014

Alzheimer's & Dementia

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“…The combination of impairments in several cognitive domains has been shown to be a stronger predictor of conversion to dementia than impairment within a single cognitive domain [24,25,35,36]. HP subfields may become compromised sequentially, where anterior structure atrophy precedes global HP atrophy [12].…”

Section: Introductionmentioning

confidence: 99%

Hippocampal Subfield Atrophy in Multi-Domain but Not Amnestic Mild Cognitive Impairment

Eliassen

Selnes

Almdahl

et al. 2015

Dement Geriatr Cogn Disord

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Background/Aims: To investigate differences in hippocampal (HP) subfields and the adjoining perirhinal and entorhinal cortices (PRC and ERC) between amnestic mild cognitive impairment (aMCI) and multi-domain amnestic MCI (mdMCI) patients, and controls. Methods: Nineteen patients characterized as aMCI were compared with 24 mdMCI patients and 31 controls by means of an automatic HP segmentation procedure. Results: We found significant atrophy of the PRC and ERC in aMCI relative to controls, whereas a more pronounced pattern of atrophy in most subfields, including total HP volume, was found in the mdMCI group. The mdMCI group also had a significant cornu ammonis sector 4 region with dentate gyrus, subiculum and total HP atrophy relative to aMCI. Conclusion: The aMCI group showed atrophy in the PRC and ERC, whereas significantly more affection of the HP subfields was evident in mdMCI. The mdMCI group may thus represent clinical progression relative to aMCI coupled with HP subfield affection.

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Trajectories of decline on instrumental activities of daily living prior to dementia in persons with mild cognitive impairment

Cloutier

Chertkow

Kergoat

et al. 2020

Int J Geriat Psychiatry

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ObjectivesThe main objective was to determine the trajectory of instrumental activities of daily living (iADL) decline in persons with mild cognitive impairment (MCI) who progressed towards dementia relative to persons with MCI who remained stable.Methods/DesignAt study entry, 121 participants met criteria for MCI. Based on the follow‐up, 47 participants later converted to dementia and were identified as progressors. Sixteen participants, identified as decliners, presented a significant cognitive decline but did not reach the criteria for dementia within the study timeframe. Stable MCI remained cognitively stable during the 5‐year follow‐up; n = 58. Participants completed a yearly assessment using clinical tests/questionnaires, neuropsychological measures, and functional autonomy assessment until they met criteria for dementia. The average number of months for the follow‐up was 34.ResultsMany years of stable performance followed by an accelerated decline just prior to diagnosis, was observed for complex activities for progressors. No change was found for stable MCI and a gradual linear decline characterized decliners. The housekeeping‐related activities component showed a linear decline in progressors and did not change in stable and decliner MCI. We found a predictive model that includes significant predictors of dementia conversion with a high diagnostic accuracy the following year (area under the curve = 0.94 [95% confidence level; lower bound: 0.87, upper bound: 1]).ConclusionsIt is critical to assess iADL that reflect complex activities in the evaluation of MCI individuals as their impairment, combined with change on cognitive markers, indicates a higher risk of dementia progression 1 or 2 years later.

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Predicting decline in mild cognitive impairment: A prospective cognitive study.

Cited by 50 publications

References 38 publications

O2‐07‐03: Patterns of Cognitive Decline Prior to Dementia in Persons With Mild Cognitive Impairment

O2‐07‐03: Patterns of Cognitive Decline Prior to Dementia in Persons With Mild Cognitive Impairment

Hippocampal Subfield Atrophy in Multi-Domain but Not Amnestic Mild Cognitive Impairment

Trajectories of decline on instrumental activities of daily living prior to dementia in persons with mild cognitive impairment

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