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Neuropsychological characteristics of mild cognitive impairment subgroups
  1. O L Lopez1,
  2. J T Becker1,
  3. W J Jagust3,
  4. A Fitzpatrick4,
  5. M C Carlson6,
  6. S T DeKosky1,
  7. J Breitner5,
  8. C G Lyketsos7,
  9. B Jones8,
  10. C Kawas9,
  11. L H Kuller2
  1. 1Departments of Neurology and Psychiatry, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA
  2. 2Department of Epidemiology, University of Pittsburgh Graduate School of Public Health
  3. 3Department of Neurology, University of California at Berkeley, Berkeley, California, USA
  4. 4Department of Epidemiology, University of Washington, Seattle, Washington, USA
  5. 5Geriatric Research, Education, and Clinical Center, Veterans Administration Puget Sound Health Care System, Seattle
  6. 6Department of Mental Hygiene, School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Maryland, USA
  7. 7Department of Psychiatry, Johns Hopkins University
  8. 8Department of Psychiatry, Wake-Forest University, Winston-Salem, North Carolina, USA
  9. 9Department of Neurology, University of California at Irvine, Irvine, California, USA
  1. Correspondence to:
 Dr Oscar L Lopez
 3501 Forbes Avenue, Suite 830, Oxford Building, Pittsburgh, PA 15213; lopezol{at}upmc.edu

Abstract

Objective: To describe the neuropsychological characteristics of mild cognitive impairment (MCI) subgroups identified in the Cardiovascular Health Study (CHS) cognition study.

Methods: MCI was classified as MCI-amnestic type (MCI-AT): patients with documented memory deficits but otherwise normal cognitive function; and MCI-multiple cognitive deficits type (MCI-MCDT): impairment of at least one cognitive domain (not including memory), or one abnormal test in at least two other domains, but who had not crossed the dementia threshold. The MCI subjects did not have systemic, neurological, or psychiatric disorders likely to affect cognition.

Results: MCI-AT (n = 10) had worse verbal and non-verbal memory performance than MCI-MCDT (n = 28) or normal controls (n = 374). By contrast, MCI-MCDT had worse language, psychomotor speed, fine motor control, and visuoconstructional function than MCI-AT or normal controls. MCI-MCDT subjects had memory deficits, though they were less pronounced than in MCI-AT. Of the MCI-MCDT cases, 22 (78.5%) had memory deficits, and 6 (21.5%) did not. MCI-MCDT with memory disorders had more language deficits than MCI-MCDT without memory disorders. By contrast, MCI-MCDT without memory deficits had more fine motor control deficits than MCI-MCDT with memory deficits.

Conclusions: The most frequent form of MCI was the MCI-MCDT with memory deficits. However, the identification of memory impaired MCI groups did not reflect the true prevalence of MCI in a population, as 16% of all MCI cases and 21.5% of the MCI-MCDT cases did not have memory impairment. Study of idiopathic amnestic and non-amnestic forms of MCI is essential for an understanding of the aetiology of MCI.

  • AACD, age associated cognitive decline
  • AAMI, age associated memory impairment
  • ARCD, age related cognitive decline
  • CES-D, Center for Epidemiological Studies Depression Scale
  • CHS, Cardiovascular Health Study
  • IADL, instrumental activities of daily living
  • MCI-MCDT, multiple cognitive deficits type of mild cognitive impairment
  • MCI, mild cognitive impairment
  • MCI-AT, amnestic type of mild cognitive impairment
  • UPDRS, Unified Parkinson’s Disease Rating Scale
  • 3MSE, modified Mini-Mental State Examination
  • Alzheimer’s disease
  • aging
  • dementia
  • mild cognitive impairment
  • neuropsychology

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Footnotes

  • Published Online First 15 August 2005

  • Competing interests: none declared

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