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P2–181: A prospective study of cognitive performance in amnestic MCI using comprehensive computerized assessment
Author(s) -
Simon Ely S.,
Goldstein Felicia C.,
Dwolatzky Tzvi,
Levey Allan I.,
Lah James J.,
Doniger Glen M.
Publication year - 2006
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2006.05.1019
Subject(s) - dementia , prospective cohort study , medicine , interim , cognition , visual memory , gerontology , physical therapy , psychiatry , disease , archaeology , history
Background: Only 10 to 15% of individuals diagnosed with amnestic MCI convert to dementia each year, and the clinician is insufficiently equipped to predict who is at risk. The present report is an interim analysis of a study for prospective identification of elderly at high risk for dementia. Objective: To compare the cognitive profile of MCI patients declining after 1-year with those not declining in an ongoing two-site multi-ethnic cohort study. Methods: Participants were 44 MCIs (Petersen’s criteria for amnestic MCI; age: 72.4 10.1; education: 13.8 4.1) and 21 controls (age: 72.7 11.2; education: 15.2 3.1) in a prospective study who completed the Mindstreams Global Assessment Battery (NeuroTrax Corp., NY) at baseline and 1-year. MCIs were defined as “decliners” or “non-decliners” depending upon 1-year ‘MCI Score’ classification. Between-groups analysis was by Mann-Whitney U test. Dependent measures were ageand education-normalized Memory, Executive Function, Visual Spatial, and Attention summary scores, a Global Cognitive Score summarizing battery performance, and Lawton iADL category scores. MCI decliners performed worse than controls at 1-year in executive function (p 0.02), visual spatial (p 0.04), and global performance (p 0.009). In contrast, change in nondecliners was not different from controls for any measure (p’s 0.11). MCI decliners exhibited greater change than MCI non-decliners in executive function (p 0.001), attention (p 0.04) and battery performance (p 0.007); decliners also performed worse in ability to use the telephone (p 0.03). MCI decliners performed more poorly at baseline in executive function (p 0.005) and attention (p 0.04); decliners were also more functionally dependent in telephone use (p 0.003), shopping (p 0.02), and food preparation (p 0.02). Conclusions: Computerized cognitive assessment can assist clinicians in identifying MCI patients likely to convert to dementia. These preliminary findings suggest that executive function at baseline is an important predictor of subsequent cognitive decline in amnestic MCI.