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P3‐099: Difference of clinical and cognitive functions in MCI according to the presence of depression
Author(s) -
Shim YongSoo,
Yoon Bora,
Yang Dong Won
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.2012.05.2159
Subject(s) - depression (economics) , stroop effect , clinical dementia rating , dementia , neuropsychology , psychology , cognition , medicine , memory span , diabetes mellitus , clinical psychology , disease , psychiatry , working memory , endocrinology , macroeconomics , economics
Background: This study used a prospective design to identify cognitive tests that predict cognitive decline in persons with mild cognitive impairment. The battery included episodicmemory and executive tasks as they reflect different components of the neurobiological defect and because they were shown to be impaired early in the disease. Language and visuo-spatial processing measures were also included.Methods: One hundred and five participants identified as suffering from amnestic mild cognitive impairment (multiple or single domain) were recruited from memory clinics in Montr eal. They were asked to complete an indepth cognitive assessment that measured different executive control components (working memory, divided attention and switching), episodic memory (immediate and delayed text recall; free and cued recall), language (naming; rhyme judgment) and visuo-spatial processing (object decision, line orientation, circle judgment). Results: Participants received yearly clinical follow-up examinations (mean follow-up length: 41.81 months) to identify those who later declined and those who remained cognitively stable. This study used a different set of measures to predict and diagnose decline. Thus decline was determined with measures different from those tested as predictors. 62 percent of the participants were identified as decliners and 38 percent as stable MCIs. ANOVAs and t-tests were first used to compare decliners from stable MCIs on the individual cognitive variables that were used as potential predictors. The two groups differed on a large number of variables including those measuring memory, those measuring executive control and some of those measuring language perception. Logistic regression was then used to determine which variable or set of variables predicted whether participants declined or remained stable. Memory was the strongest predictor of decline. However, combining episodic memory, executive functions and perception measures provided the best model for distinguishing stable-MCI from decliners and the final model classified correctly 86 percent of the participants (sensitivity1⁄4 86.4%; specificity1⁄4 85.7%). Conclusions: This study indicates that theoretically-motivated cognitive measures can be useful to predict future decline in persons meeting criteria for mild cognitive impairment. Furthermore, measuringmultiple cognitive domains—including executive control and perception—might provide the best approach to optimize sensitivity and specificity.