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Course and etiology of dysexecutive MCI in a community sample
Author(s) -
Huey Edward D.,
Manly Jennifer J.,
Tang MingX.,
Schupf Nicole,
Brickman Adam M.,
Manoochehri Masood,
Mez Jesse,
DeCarli Charles,
Devanand Davangere P.,
Mayeux Richard
Publication year - 2013
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.2012.10.014
Subject(s) - dementia , executive dysfunction , neuropsychology , hyperintensity , psychology , dysexecutive syndrome , stroke (engine) , white matter , cognition , cohort , cognitive decline , medicine , audiology , psychiatry , magnetic resonance imaging , disease , radiology , mechanical engineering , engineering
Background Amnestic mild cognitive impairment (aMCI) is associated with an elevated risk of progressing to Alzheimer's disease. Much less is known about the course of dysexecutive mild cognitive impairment (dMCI). The goals of this study were to determine how the profile of cognitive deficits differs over time between patients with dMCI and aMCI, and control subjects; if the type of dementia differs between dMCI and aMCI in patients who progress to dementia; and if dMCI is more associated with stroke and white matter hyperintensity on magnetic resonance imaging (MRI) than aMCI. Methods The authors undertook a prospective evaluation of an inception cohort of 1167 ethnically diverse elders recruited from an urban community‐based sample monitored with clinical and neuropsychological testing for an average of 4.5 years (standard deviation, 0.8 year). A subset of the subjects underwent MRI. We compared four groups of MCI patients: single‐domain amnestic and dysexecutive MCI, and multiple‐domain MCI with and without executive dysfunction. Results Compared with aMCI, dMCI was less likely to involve other areas of cognition over time and progress to dementia. None of the 33 single‐domain dMCI patients progressed to dementia. The presence of executive dysfunction in multiple‐domain MCI did not increase risk of progression to dementia. Patients with multiple‐domain MCI with executive dysfunction who progressed to dementia were less likely to have an Alzheimer's–type dementia than MCI patients without executive dysfunction. Patients with dMCI were more likely to experience stroke, but not white matter hyperintensity, detected via MRI than patients with aMCI. Conclusions dMCI appears to follow a different course, and is less associated with Alzheimer's disease and more associated with stroke than aMCI.