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P3‐007: Instability of a diagnosis of mild cognitive impairment based on a brief screening assessment of English‐ and Spanish‐speaking individuals in a general care clinic
Author(s) -
Cartmell Su P.,
Xie Sharon X.,
Martinez Patricia,
Nunez Jessica,
Janis Peter,
Baek Young,
Karlawish Jason H.T.,
Arnold Steven E.,
Clark Christopher M.
Publication year - 2008
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.2008.05.1570
Subject(s) - dementia , medicine , cognitive impairment , cognition , specialty , memory clinic , screening test , cognitive assessment system , cognitive test , physical therapy , pediatrics , clinical psychology , psychiatry , disease
as gray matter volume in the right frontal eye field (FEF) region. We investigated the fMRI correlates of AS performance in normal elderly (NE) individuals. Methods: AS performance measured using an infrared eye tracker was evaluated in 20 NE (CDR 0), 7 individuals with mild cognitive impairment (MCI; CDR 0.5) and 10 individuals with mild AD (CDR 1.0). Subsequently, 11 NE (mean age 65) and 9 younger (mean age 25) controls performed blocks of AS trials alternating with a prosaccade control condition during fMRI on a GE 3T MR scanner. AS-related BOLD signal was correlated with AS performance measured outside the scanner using SPM5. Results: There was an effect of diagnostic group on AS performance (ANOVA, F 27.8, p 0.001), with each group’s performance significantly different from the others’ (p 0.05, Tukey post hoc). NE performed 85.2 3.8%, MCI performed 48.3 8.8% and mild AD performed 23.4 5.8% of AS trials correctly. Notably, there were 4 NE who displayed impaired AS performance ( 81% correct). AS performance predicted MMSE score, after controlling for diagnosis, age and gender (linear regression, r 0.70, p 0.001). After controlling for age, the percentage of correct AS responses was correlated with fMRI BOLD signal (p 0.01, FWE corrected) in the right FEF region, with more BOLD signal observed outside the cortical oculomotor regions in NE with impaired AS performance. Conclusions: The AS task is sensitive to ADrelated cognitive dysfunction. Our preliminary fMRI data suggest that AS impairments in NE reflect altered function of the same brain regions involved in attention control that are sensitive to AS-related atrophy in neurodegenerative dementia. Further studies are warranted to determine whether AS impairment in NE indicates an increased risk of future cognitive impairment.