Progression to Dementia in Clinical Subtypes of Mild Cognitive Impairment

Alexopoulos, Panagiotis; Grimmer, Timo; Perneczky, Robert; Domes, Gregor; Kurz, Alexander

doi:10.1159/000093101

Cited by 144 publications

(115 citation statements)

References 69 publications

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“…During this time, which may extend over years, functional limitations are slight and distinct, and progressive loss of function is not seen. Evidence suggests that multi-domain MCI progresses to dementia more rapidly than amnestic or single-domain MCI (Alexopoulos et al, 2006;Meyer et al, 2002), which is also consistent with the hypothesis that cortical involvement carries a poor prognosis for everyday function. Arguing against the "more cortical involvement at baseline" hypothesis is the fact that we did not find that degree of cortical volume loss at baseline was predictive of faster functional decline.…”

Section: Discussionsupporting

confidence: 78%

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cahn-Weiner

Farias

Julián

et al. 2007

J. Inter. Neuropsych. Soc.

187

167

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Impaired ability to conduct daily activities is a diagnostic criterion for dementia and a determinant of healthcare services utilization and caregiver burden. What predicts decline in instrumental activities of daily living (IADLs) is not well understood. This study examined measures of episodic memory, executive function, and MRI brain volumes in relation to baseline IADLs and as predictors of rate of IADL change. Participants were 124 elderly persons with cognitive function between normal and moderate dementia both with and without significant small vessel cerebrovascular disease. Random effects modeling showed that baseline memory and executive function (EXEC) were associated with baseline IADL scores, but only EXEC was independently associated with rate of change in IADLs. Whereas hippocampal and cortical gray matter volumes were significantly associated with baseline IADL scores, only hippocampal volume was associated with IADL change. In a model including cognitive and neuroimaging predictors, only EXEC independently predicted rate of decline in IADL scores. These findings indicate that greater executive dysfunction at initial assessment is associated with more rapid decline in IADLs. Perhaps executive function is particularly important with respect to maintaining IADLs. Alternatively, executive dysfunction may be a sentinel event indicating widespread cortical involvement and poor prognosis.

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Section: Discussionsupporting

confidence: 78%

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cahn-Weiner

Farias

Julián

et al. 2007

J. Inter. Neuropsych. Soc.

187

167

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“…Similarly, recent studies show, that when the clinical syndrome of MCI evolves on a neurodegenerative basis, the multiple-domain type of MCI has a less favorable prognosis than the amnestic type and may represent a more advanced prodromal stage of dementia. 35,36 Our results of profound memory impairment in association with executive functions deficit in "amnestic MCI" suggest that more extensive examination of executive functions may help the early identification of incipient AD.…”

Section: Deletedmentioning

confidence: 85%

Executive Functions Deficit in Mild Cognitive Impairment

Traykov¹,

Raoux

Latour

et al. 2007

Cognitive and Behavioral Neurology

165

115

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Objective: To investigate whether patients diagnosed as amnestic mild cognitive impairment (MCI) have also impairment in attention/executive functions and, therefore to clarify whether all subcomponents of executive control are equally affected in MCI.Background: MCI refers to the transitional state between normal ageing and dementia.Amnestic MCI is characterized by impaired episodic memory, although subtle impairment of executive functions has been noted on neuropsychological tests.Methods: We investigated 20 MCI patients and 20 normal controls using episodic memory, attention/executive functions, language and praxis tests. Results: MCI patients had a significantly lower scores on all measures of the Free and CuedSelective Reminding Test (p<0.05 to 0.01) than controls. Furthermore MCI had a greater number of perseverations (p<0.01) on Modified Card Sorting Test and the lowest performance on the Stroop test (p<0.02).Conclusion: Our findings showed impairment in episodic memory performance in MCI as compared to that of controls. In addition, MCI patients had problems with response inhibition, switching and cognitive flexibility which encompass various aspects of executive functions. This suggests that MCI may be identified by using a more detailed procedure for the assessment of cognitive decline than the evaluation of memory alone. IntroductionThe recent developments in drug treatments for Alzheimer's disease (AD) have highlighted the importance of early diagnosis and the need to characterize the cognitive profile of the earliest stages of the disease.Recent research has identified a transitional state between the cognitive changes of normal aging and AD, known as mild cognitive impairment (MCI). Other studies of MCI report cognitive deficits similar to those described by Petersen and colleagues. 5,6 However, in recent years, the literature has reported that, while memory is the hallmark of patients with amnestic MCI, they are impaired on a variety of tasks that have commonly been considered a measure of executive functions. reported recently that tasks requiring executive control are significantly affected in the preclinical phase of AD and are reliable predictors of the disease before diagnosis. The results of these studies emphasised the importance of attention and executive function in MCI patients. However, it must be pointed out that variability across studies in both tasks used to examine aspects of executive function, and in the MCI definition, makes it difficult to determine which aspects of executive control are affected in MCI. Consequently, we selected executive tasks more "universally" accepted like those mentioned in the abovecited studies. The objective was to avoid to further clouding the issues by introducing additional measures.The aims of our study were to investigate whether patients diagnosed as amnestic MCI have also impairment in attention/executive functions and, therefore to clarify whether all subcomponents of executive control are equally affected in MCI. Materials and methods ...

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“…Importantly, individuals who experience more pronounced difficulties with memory may ultimately progress to mild cognitive impairment and/or dementia. 27 Indeed, various cardiovascular risk factors have been associated with risk for mild cognitive impairment and dementia. 2,28 It is unclear whether the apparent crossover effect for younger and older participants on select measures (eg, CVLT learning slope) reflects a biological phenomenon, statistical artifact, or complex survival issues (see Reference 3), but similar findings have been noted in the blood pressurecognition literature.…”

Section: Discussionmentioning

confidence: 99%

Pulse Pressure and Pulse Wave Velocity Are Related to Cognitive Decline in the Baltimore Longitudinal Study of Aging

et al. 2008

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Abstract-Pulse pressure and pulse wave velocity, markers of arterial stiffness, have been associated with stroke, dementia, and lowered levels of cognitive function. Here we examine longitudinal relations of pulse pressure and pulse wave velocity to multiple domains of cognitive function among nondemented, stroke-free persons. Up to 1749 participants from the Baltimore Longitudinal Study of Aging completed tests of verbal and nonverbal memory, attention, perceptuo-motor speed, confrontation naming, executive functions, and cognitive screening measures, as well as concurrent sphygmomanometric assessment of blood pressure (for derivation of pulse pressure) on 1 to 8 occasions over 14 years. A subset of Յ582 participants also underwent a single baseline assessment of pulse wave velocity and cognitive assessment on 1 to 6 occasions over 11 years. Results of mixed-effects regression models revealed a prospective decline on tests of verbal learning, nonverbal memory, working memory, and a cognitive screening measure among those with increasing levels of pulse pressure (PϽ0.05). Persons with higher baseline pulse wave velocity also exhibited prospective decline on tests of verbal learning and delayed recall, nonverbal memory, and a cognitive screening measure (PϽ0.05). Markers of arterial stiffness are associated prospectively with cognitive decline before dementia. ypertension is a well-established risk factor for stroke and dementia 1,2 and is associated with diminished cognitive performance and cognitive decline before these conditions. 3-5 However, findings have been mixed regarding the respective contributions of systolic versus diastolic blood pressure and the domains of cognitive function affected. 3 Among older adults (Ͼ50 years of age), systolic hypertension is the dominant form of hypertension. Systolic hypertension is attributed in large part to increased arterial stiffness. 6 We therefore sought to examine the contributions of arterial stiffness to cognitive function.Two common markers of arterial stiffness are increased pulse pressure (PP) and pulse wave velocity (PWV). Although these measures are moderately correlated, PWV is considered a direct measure of arterial stiffness, whereas PP is viewed as a surrogate marker. 7 PP and PWV are independent predictors of cardiovascular diseases including stroke 8 -11 and are considered markers of preclinical cardiovascular disease. 12 Both high and low PP predict incident Alzheimer's disease. 13 Furthermore, greater PP has been associated with lower levels of cognitive performance among nondemented persons. 14 In cross-sectional studies, PWV has been found to be higher in patients with vascular dementia, Alzheimer's disease, or mild cognitive impairment than in cognitively intact individuals. 15 Higher PWV has also been related to lower levels of, or decline in, performance mainly on screening measures of cognitive function, such as the Mini Mental State Examination (MMSE). 16 -18 However, a recent longitudinal investigation did not identify prospective relations...

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Progression to Dementia in Clinical Subtypes of Mild Cognitive Impairment

Cited by 144 publications

References 69 publications

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cognitive and neuroimaging predictors of instrumental activities of daily living

Executive Functions Deficit in Mild Cognitive Impairment

Pulse Pressure and Pulse Wave Velocity Are Related to Cognitive Decline in the Baltimore Longitudinal Study of Aging

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