Related Experiment Videos
Visual memory tests enhance the identification of amnestic MCI cases at greater risk of Alzheimer's disease
Javier Oltra-Cucarella1,2, Miriam Sánchez-SanSegundo1, Darren M Lipnicki3
1Department of Health Psychology, University of Alicante, Alicante, Spain.
Objectives:
To investigate whether amnestic mild cognitive impairment (aMCI) identified with visual memory tests conveys an increased risk of Alzheimer's disease (risk-AD) and if the risk-AD differs from that associated with aMCI based on verbal memory tests.
Participants:
4,771 participants aged 70.76 (SD = 6.74, 45.4% females) from five community-based studies, each a member of the international COSMIC consortium and from a different country, were classified as having normal cognition (NC) or one of visual, verbal, or combined (visual and verbal) aMCI using international criteria and followed for an average of 2.48 years. Hazard ratios (HR) and individual patient data (IPD) meta-analysis analyzed the risk-AD with age, sex, education, single/multiple domain aMCI, and Mini-Mental State Examination (MMSE) scores as covariates.
Results:
All aMCI groups (n = 760) had a greater risk-AD than NC (n = 4,011; HR range = 3.66 - 9.25). The risk-AD was not different between visual (n = 208, 17 converters) and verbal aMCI (n = 449, 29 converters, HR = 1.70, 95%CI: 0.88, 3.27, p = 0.111). Combined aMCI (n = 103, 12 converters, HR = 2.34, 95%CI: 1.13, 4.84, p = 0.023) had a higher risk-AD than verbal aMCI. Age and MMSE scores were related to the risk-AD. The IPD meta-analyses replicated these results, though with slightly lower HR estimates (HR range = 3.68, 7.43) for aMCI vs. NC.
Conclusions:
Although verbal aMCI was most common, a significant proportion of participants had visual-only or combined visual and verbal aMCI. Compared with verbal aMCI, the risk-AD was the same for visual aMCI and higher for combined aMCI. Our results highlight the importance of including both verbal and visual memory tests in neuropsychological assessments to more reliably identify aMCI.
Insights
Amnestic mild cognitive impairment (aMCI) identified by visual memory tests carries the same Alzheimer's disease risk as verbal aMCI. Combined visual and verbal aMCI shows a higher risk, underscoring the need for comprehensive memory assessments.
Area of Science:
- Neuroscience
- Gerontology
- Cognitive Psychology
Background:
- Amnestic mild cognitive impairment (aMCI) is a transitional stage between normal cognition and Alzheimer's disease.
- Distinguishing between visual and verbal memory deficits in aMCI is crucial for accurate risk prediction.
- Previous research has primarily focused on verbal memory deficits in aMCI.
Purpose of the Study:
- To determine if visual memory impairment in aMCI increases Alzheimer's disease risk.
- To compare the Alzheimer's disease risk associated with visual aMCI versus verbal aMCI.
- To investigate the risk associated with combined visual and verbal aMCI.
Main Methods:
- A meta-analysis of individual patient data from 4,771 participants across five international studies was conducted.
- Participants were classified as having normal cognition (NC) or visual, verbal, or combined aMCI.
- Hazard ratios (HR) were calculated, adjusting for age, sex, education, and Mini-Mental State Examination (MMSE) scores.
Main Results:
- All aMCI groups exhibited a significantly higher risk of Alzheimer's disease compared to NC.
- The risk of Alzheimer's disease did not differ significantly between visual aMCI and verbal aMCI.
- Combined aMCI demonstrated a significantly higher risk of Alzheimer's disease compared to verbal aMCI.
Conclusions:
- While verbal aMCI is more prevalent, visual and combined aMCI are also significant indicators of Alzheimer's disease risk.
- Visual aMCI poses a similar risk for Alzheimer's disease as verbal aMCI.
- Comprehensive neuropsychological assessments incorporating both verbal and visual memory tests are essential for accurate aMCI identification and risk stratification.