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Related Experiment Videos

Using different memory cutoffs to assess mild cognitive impairment.

David A Loewenstein1, Amarilis Acevedo, Raymond Ownby

  • 1Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA. dloewenstein@worldnet.att.net

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry
|October 28, 2006
PubMed
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Identifying mild cognitive impairment (MCI) lacks standardized memory tests and cutoffs. This study found specific memory measures useful for distinguishing MCI from normal cognition, but cutoff stringency depends on the number of tests used.

Area of Science:

  • Neuroscience
  • Gerontology
  • Psychology

Background:

  • Mild cognitive impairment (MCI) diagnosis relies on memory performance below normative values.
  • There is no scientific consensus on optimal memory measures or cutoffs for diagnosing MCI.

Purpose of the Study:

  • To evaluate the utility of various memory measures in distinguishing MCI from normal cognition.
  • To investigate the impact of different cutoffs and the number of tests on MCI diagnostic accuracy.

Main Methods:

  • Administered eight memory indices to 80 healthy older adults to establish normative data.
  • Compared performance of 23 patients with MCI (meeting Alzheimer disease criteria) to the normative data.
  • Utilized conditional logistic regression for age-matched analysis.

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Main Results:

  • 70-78% of MCI patients were identified as impaired on specific memory tests (immediate recall, delayed visual reproduction, object memory, semantic interference) at 1.5 standard deviations below expected levels.
  • Combining raw scores of these tests did not significantly alter MCI diagnostic odds.
  • Specificity decreased below acceptable levels when more than three measures were used with a 1.5 SD cutoff.

Conclusions:

  • Several widely used neuropsychological tests effectively differentiate MCI due to Alzheimer disease from normal cognition in community-dwelling elders.
  • The choice of impairment cutoffs is critical and influenced by the number of memory measures included in the assessment.
  • Findings inform diagnostic practices for MCI in research and clinical settings regarding test selection and cutoff determination.