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An investigation of PreMCI: Subtypes and longitudinal outcomes
Author(s) -
Loewenstein David A.,
Greig Maria T.,
Schinka John A.,
Barker Warren,
Shen Qian,
Potter Elizabeth,
Raj Ashok,
Brooks Larry,
Varon Daniel,
Schoenberg Michael,
Banko Jessica,
Potter Huntington,
Duara Ranjan
Publication year - 2012
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.2011.03.002
Subject(s) - dementia , neuropsychology , psychology , memory impairment , cognition , atrophy , verbal fluency test , clinical psychology , medicine , psychiatry , disease
Background/Aims To investigate the clinical features and rates of progression of conditions that are not considered to be normal, but do not fulfill criteria for mild cognitive impairment (MCI). Methods We longitudinally evaluated 269 elderly subjects who did not meet formal criteria for MCI at baseline but had: (1) a clinical history suggesting MCI without neuropsychological deficits (PreMCI‐Clinical); or (2) neuropsychological deficits on one or more memory measures in conjunction with a negative clinical examination (amnestic PreMCI‐NP) or were normal on both neuropsychological and clinical examination. Results The rate of progression to MCI or dementia over an average of 2‐ to 3 years was 3.7% for no cognitive impairment subjects, whereas it was significantly greater for all PreMCI subtypes (22.0% for PreMCI‐Clinical, 38.9% for amnestic PreMCI‐NP subjects with two or more memory impairments). Among PreMCI subjects as a whole, lower baseline scores on object memory and category fluency tests were the best predictors of progression to MCI or dementia. Cardiovascular risk factors, Parkinsonian symptoms, and hippocampal atrophy were not associated with progression. Conclusion Distinct PreMCI subtypes defined on the basis of clinical and neuropsychological evaluations were found to have distinct characteristics, but both subtypes demonstrated elevated risk for progression to MCI or dementia. Despite the lack of evidence of clinical impairment, subjects with neuropsychological deficits in two memory domains were particularly at increased risk for progression of their deficits.