scholarly journals Predictors of Mild Cognitive Impairment Stability, Progression, or Reversion in the Lothian Birth Cohort 1936

2021 ◽  
pp. 1-8
Author(s):  
Miles Welstead ◽  
Michelle Luciano ◽  
Graciela Muniz-Terrera ◽  
Stina Saunders ◽  
Donncha S. Mullin ◽  
...  

Background: Mild cognitive impairment (MCI) describes a borderland between healthy cognition and dementia. Progression to and reversion from MCI is relatively common but more research is required to understand the factors affecting this fluidity and improve clinical care interventions. Objective: We explore these transitions in MCI status and their predictive factors over a six-year period in a highly-phenotyped longitudinal study, the Lothian Birth Cohort 1936. Methods: MCI status was derived in the LBC1936 at ages 76 (n = 567) and 82 years (n = 341) using NIA-AA diagnostic guidelines. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status. Results: Of the 292 participants who completed both time points, 41 (14%) participants had MCI at T1 and 56 (19%) at T2. Over the follow-up period, 74%remained cognitively healthy, 12%transitioned to MCI, 7%reverted to healthy cognition, and 7%maintained their baseline MCI status. Findings indicated that membership of these transition groups was affected by age, cardiovascular disease, and number of depressive symptoms. Conclusion: Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. However, further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition.

2014 ◽  
Vol 27 (2) ◽  
pp. 279-288 ◽  
Author(s):  
Sophie Pilleron ◽  
Jean-Pierre Clément ◽  
Bébène Ndamba-Bandzouzi ◽  
Pascal Mbelesso ◽  
Jean-François Dartigues ◽  
...  

ABSTRACTBackground:To date, no studies have examined the relationship between cognitive disorders and personality disorders. Our aim was to investigate the association between dependent personality disorder (DPD) and cognitive disorders in Central Africa.Methods:Between 2011 and 2012, a cross-sectional multicenter population-based study was carried out in rural and urban areas of the Central African Republic (CAR) and the Republic of Congo (ROC). Participants aged ≥65 years were interviewed using the Community Screening Interview for Dementia (CSI-D). Elderly people who performed poorly (CSI-D cognitive tests score or COGSCORE ≤ 24.5/30) were clinically assessed by neurologists and underwent further psychometric testing. The Diagnostic and Statistical Manual of Mental Disorders, 4th Edition and Petersen criteria were required for the diagnosis of dementia and mild cognitive impairment (MCI) respectively. DPD was assessed using the Personality Diagnostic Questionnaire-4+. Socio-demographic, vascular, and psychological factors were also documented. Multivariate multinomial logistic regression models were used to estimate the associations.Results:Of the 2,002 participants screened, 860 and 912 had data for cognitive status and DPD in CAR and ROC respectively. In fully adjusted models, DPD was significantly associated with MCI in ROC (Odds Ratio (OR) = 2.2, 95% CI: 1.0–4.7) and CAR (OR = 2.1, 95% CI: 1.1–4.0) and with dementia only in ROC (OR = 4.8, 95% CI: 2.0–11.7).Conclusions:DPD was associated with cognitive disorders among elderly people in Central Africa. This association should be confirmed in other contexts. This study paves the way for research on the association between personality and cognitive impairment in Africa.


2021 ◽  
Vol 12 ◽  
Author(s):  
Sofia Cuoco ◽  
Immacolata Carotenuto ◽  
Arianna Cappiello ◽  
Sara Scannapieco ◽  
Maria Claudia Russillo ◽  
...  

Introduction: The aim of this study is to investigate the impact of orthostatic hypotension (OH) on cognitive functions in patients with multiple system atrophy (MSA) followed over time.Methods: Thirty-two MSA patients were enrolled and underwent a comprehensive neuropsychological battery; at baseline (T0) 15 out of 32 patients presented OH, assessed by means of orthostatic standing test. All patients underwent a follow-up (T1) evaluation 12 months after baseline. Thirteen out of 32 patients also underwent a second follow-up (T2) evaluation at 24 months. Changes over time on different neuropsychological tasks were compared between patients with and without OH by means of Mann-Whitney's U-test. Moreover, clinical categories of normal cognition, mild cognitive impairment, and dementia were determined, and changes at T1 and T2 in global cognitive status were compared between patients with and without OH.Results: At T0, patients with OH had better performance on words/non-words repetition task (p = 0.02) compared to patients without OH. Compared to patients without OH, patients with OH performed worse on semantic association task (p < 0.01) at T1 and on Stroop test-error effect (p = 0.04) at T2. The percentage of patients with worsened cognitive status at T1 was higher among patients with OH than among patients without OH (93 vs. 59%, p = 0.03). OH (β = −4.67, p = 0.01), education (β = 0.45, p = 0.02), age (β = 0.19, p = 0.03), and Montreal Cognitive Assessment battery (MOCA) score at T0 (β = −0.26, p = 0.04) were significant predictors of global cognitive status worsening at T1.Discussion: We found that global cognitive status worsened at 1-year follow-up in 93% of patients with OH, and OH, along with age, education, and MOCA score, predicted cognitive worsening over time. To clarify the relationship between OH and cognitive dysfunction in MSA, we suggest the use of clinical categories of normal cognition, mild cognitive impairment, and dementia in further longitudinal studies on MSA patients with and without OH.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Miles Welstead ◽  
Michelle Luciano ◽  
Graciela Muniz-Terrera ◽  
Adele M. Taylor ◽  
Tom C. Russ

2018 ◽  
Vol 45 (1-2) ◽  
pp. 66-78 ◽  
Author(s):  
Julius S. Ngwa ◽  
Thomas V. Fungwe ◽  
Oyonumo Ntekim ◽  
Joanne S. Allard ◽  
Sheree M. Johnson ◽  
...  

Background: It is increasingly evident that high blood pressure can promote reduction in global and regional brain volumes. While these effects may preferentially affect the hippocampus, reports are inconsistent. Methods: Using data from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), we examined the relationships of hippocampal volume to pulse pressure (PPR) and systolic (SBP) and diastolic (DBP) blood pressure according to apolipoprotein (APOE) ɛ4 positivity and cognitive status. The ADNI data included 1,308 participants: Alzheimer disease (AD = 237), late mild cognitive impairment (LMCI = 454), early mild cognitive impairment (EMCI = 254), and cognitively normal (CN = 365), with up to 24 months of follow-up. Results: Higher quartiles of PPR were significantly associated with lower hippocampal volumes (Q1 vs. Q4, p = 0.034) in the CN and AD groups, but with increasing hippocampal volume (Q1, p = 0.008; Q2, p = 0.020; Q3, p = 0.017; Q4 = reference) in the MCI groups. In adjusted stratified analyses among non-APOE ɛ4 carriers, the effects in the CN (Q1 vs. Q4, p = 0.006) and EMCI groups (Q1, p = 0.002; Q2, p = 0.013; Q3, p = 0.002; Q4 = reference) remained statistically significant. Also, higher DBP was significantly associated with higher hippocampal volume (p = 0.002) while higher SBP was significantly associated with decreasing hippocampal volume in the EMCI group (p = 0.015). Conclusion: Changes in PPR, SBP, and DBP differentially influenced hippocampal volumes depending on the cognitive and APOE genotypic categories.


2019 ◽  
Vol 34 (6) ◽  
pp. 1056-1056
Author(s):  
M Sharma ◽  
B Varatharajah ◽  
A Wall ◽  
B Callahan

Abstract Objective To examine baseline differences in neuropsychological performance between long-term stable mild cognitive impairment (sMCI) and those who convert from MCI to dementia (cMCI), hypothesizing sMCI will perform better on memory measures. While conversion has been previously examined, none examined sMCI with over 10 years follow-up. Method Data from the National Alzheimer’s Coordinating Center were used. Participants were defined as sMCI (n = 29) if cognitive status was MCI at first visit and at least 9 subsequent visits (10 total) and cMCI (n = 1887) if cognitive status was MCI at first visit and the participant converted to dementia at any subsequent visit. Participants with any history of stroke, traumatic brain injury, alcohol or drug abuse, or other neurological disorder were excluded. Participants completed neuropsychological measures of global cognition, immediate and delayed verbal memory, working memory, mental manipulation, semantic fluency, processing speed, and confrontational naming. Depressive symptoms were assessed using the Geriatric Depression Scale. The Mann-Whitney-U non-parametric test was used to compare both groups at baseline on all measures. Predictors of sMCI were explored using binomial logistic regression. Results Participants did not differ significantly in age, level of education, or depressive symptoms. Comparison between groups at baseline indicate sMCI participants performed significantly better than cMCI on global cognition U = 13673,p < .001, delayed verbal memory U = 14549,p < .001, and semantic fluency U = 15538.5,p < .001. Of these significant measures, none predicted sMCI. Conclusions As hypothesized, sMCI performed better on delayed verbal memory, but also semantic fluency and global cognition, though none predicted sMCI. Future research must examine neuropsychological measures of other cognitive domains and their predictive value.


2017 ◽  
Vol 43 (3-4) ◽  
pp. 155-169 ◽  
Author(s):  
Elvira Lara ◽  
Ai Koyanagi ◽  
Joan Domènech-Abella ◽  
Marta Miret ◽  
Jose Luis Ayuso-Mateos ◽  
...  

Background/Aims: In the absence of effective treatments for dementia, major efforts are being directed towards identifying the risk factors of the prodromal phase of the disease. We report the incidence rates of mild cognitive impairment (MCI) in a Spanish population sample and assess the effect of depression at baseline on incident MCI (or MCI subtypes) at a 3-year follow-up. Methods: A total of 1,642 participants (age ≥50 years) were examined as part of a Spanish nationally representative longitudinal study. MCI was defined as the presence of cognitive concerns, objective evidence of impairment in one or more cognitive domains, preservation of independence in functional abilities, and no dementia. Depression was assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Binary and multinomial logistic regression analyses were carried out to assess the associations. Results: The overall MCI incidence rate was 33.19 (95% CI = 26.02, 43.04) per 1,000 person-years. Depression at baseline predicted the onset of MCI at follow-up after controlling for sociodemographics, cognitive functioning, and other physical health conditions (OR = 2.79; 95% CI = 1.70, 4.59). The effect of baseline depression on incident MCI subtypes was as follows: amnestic MCI, OR = 3.81 (95% CI = 1.96, 7.43); nonamnestic MCI, OR = 2.03 (95% CI = 0.98, 4.21). Conclusion: Depression significantly increases the risk for MCI. Targeting depression among those at risk for dementia may help delay or even prevent the onset of dementia.


Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 718
Author(s):  
Salvatore Mazzeo ◽  
Valentina Bessi ◽  
Silvia Bagnoli ◽  
Giulia Giacomucci ◽  
Juri Balestrini ◽  
...  

Background: Periodic circadian protein homolog 2 (PER2) has a role in the intracellular signaling pathways of long-term potentiation and has implications for synaptic plasticity. We aimed to assess the association of PER2 C111G polymorphism with cognitive functions in subjective cognitive decline (SCD). Methods: Forty-five SCD patients were included in this study. All participants underwent extensive neuropsychological investigation, analysis of apolipoprotein E (APOE) and PER2 genotypes, and neuropsychological follow-up every 12 or 24 months for a mean time of 9.87 ± 4.38 years. Results: Nine out of 45 patients (20%) were heterozygous carriers of the PER2 C111G polymorphism (G carriers), while 36 patients (80%) were not carriers of the G allele (G non-carriers). At baseline, G carriers had a higher language composite score compared to G non-carriers. During follow-up, 15 (34.88%) patients progressed to mild cognitive impairment (MCI). In this group, we found a significant interaction between PER2 G allele and follow-up time, as carriers of G allele showed greater worsening of executive function, visual-spatial ability, and language composite scores compared to G non-carriers. Conclusions: PER2 C111G polymorphism is associated with better language performance in SCD patients. Nevertheless, as patients progress to MCI, G allele carriers showed a greater worsening in cognitive performance compared to G non-carriers. The effect of PER2 C111G polymorphism depends on the global cognitive status of patients.


2016 ◽  
Vol 28 (6) ◽  
pp. 921-928 ◽  
Author(s):  
Ellen De Roeck ◽  
Ingrid Ponjaert-Kristoffersen ◽  
Marc Bosmans ◽  
Peter Paul De Deyn ◽  
Sebastiaan Engelborghs ◽  
...  

ABSTRACTBackground:Depressive symptoms are common in amnestic mild cognitive impairment (aMCI). The association between depressive symptoms and conversion to dementia is not yet clear. This longitudinal study was conducted to ascertain whether depressive symptoms in aMCI patients are predictive of conversion to dementia.Methods:35 aMCI patients participated in this study. All participants underwent cognitive testing and were administered the geriatric depression scale (GDS) to determine the presence of depressive symptoms. A score equaling or higher than 11 on the GDS was taken as the cut-off point for presence of significant depressive symptoms. Conversion to dementia was assessed at follow-up visits after 1.5, 4, and 10 years.Results:31.4% of the patients reported depressive symptoms at baseline. None of the cognitive measures revealed a significant difference at baseline between patients with and without depressive symptoms. After 1.5, 4, and 10 years respectively 6, 14, and 23 patients had converted to dementia. Although the GDS scores at baseline did not predict conversion to dementia, the cognitive measures and more specifically a verbal cued recall task (the memory impairment scale-plus) was a good predictor for conversion.Conclusions:Based on this dataset, the presence of depressive symptoms in aMCI patients is not predictive of conversion to dementia.


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