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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Neuropsychological characteristics of mild cognitive impairment subgroups
O L Lopez1, J T Becker, W J Jagust
1Department of Neurology, University of Pittsburgh, School of Medicine, PA 15213, USA. lopezol@upmc.edu
Objective:
To describe the neuropsychological characteristics of mild cognitive impairment (MCI) subgroups identified in the Cardiovascular Health Study (CHS) cognition study.
Methods:
MCI was classified as MCI-amnestic type (MCI-AT): patients with documented memory deficits but otherwise normal cognitive function; and MCI-multiple cognitive deficits type (MCI-MCDT): impairment of at least one cognitive domain (not including memory), or one abnormal test in at least two other domains, but who had not crossed the dementia threshold. The MCI subjects did not have systemic, neurological, or psychiatric disorders likely to affect cognition.
Results:
MCI-AT (n = 10) had worse verbal and non-verbal memory performance than MCI-MCDT (n = 28) or normal controls (n = 374). By contrast, MCI-MCDT had worse language, psychomotor speed, fine motor control, and visuoconstructional function than MCI-AT or normal controls. MCI-MCDT subjects had memory deficits, though they were less pronounced than in MCI-AT. Of the MCI-MCDT cases, 22 (78.5%) had memory deficits, and 6 (21.5%) did not. MCI-MCDT with memory disorders had more language deficits than MCI-MCDT without memory disorders. By contrast, MCI-MCDT without memory deficits had more fine motor control deficits than MCI-MCDT with memory deficits.
Conclusions:
The most frequent form of MCI was the MCI-MCDT with memory deficits. However, the identification of memory impaired MCI groups did not reflect the true prevalence of MCI in a population, as 16% of all MCI cases and 21.5% of the MCI-MCDT cases did not have memory impairment. Study of idiopathic amnestic and non-amnestic forms of MCI is essential for an understanding of the aetiology of MCI.
Insights
Mild cognitive impairment (MCI) presents in distinct subgroups. The amnestic type shows memory deficits, while the multiple cognitive deficits type exhibits broader impairments, including non-memory domains.
Area of Science:
- Neuropsychology
- Cognitive Neurology
- Gerontology
Background:
- Mild cognitive impairment (MCI) is a transitional stage between normal aging and dementia.
- Understanding MCI subtypes is crucial for early diagnosis and intervention.
- The Cardiovascular Health Study (CHS) provided a unique cohort for investigating MCI characteristics.
Purpose of the Study:
- To delineate the neuropsychological profiles of distinct MCI subgroups.
- To characterize the amnestic (MCI-AT) and multiple cognitive deficits (MCI-MCDT) types of MCI.
- To assess the prevalence and cognitive features of MCI subtypes within the CHS cohort.
Main Methods:
- MCI was classified into amnestic (MCI-AT) and multiple cognitive deficits (MCI-MCDT) types based on specific cognitive criteria.
- Neuropsychological assessments evaluated memory, language, psychomotor speed, fine motor control, and visuoconstructional abilities.
- Subjects with systemic, neurological, or psychiatric disorders affecting cognition were excluded.
Main Results:
- MCI-AT (n=10) demonstrated poorer verbal and non-verbal memory compared to MCI-MCDT (n=28) and controls (n=374).
- MCI-MCDT exhibited deficits in language, psychomotor speed, fine motor control, and visuoconstructional function.
- A significant proportion of MCI-MCDT cases (78.5%) had memory deficits, but 21.5% did not, highlighting heterogeneity within this subtype.
Conclusions:
- MCI-MCDT with memory deficits was the most frequent MCI form observed.
- Relying solely on memory impairment for MCI identification may underestimate its prevalence, as non-amnestic presentations exist.
- Investigating both amnestic and non-amnestic MCI forms is vital for understanding MCI etiology.
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