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Updated: May 9, 2025
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Comprehensive Clinical and Behavioral Characteristics of Mild Cognitive Impairment According to Amyloid Positivity: A
Seung Ae Kim1,2, Yeshin Kim3, Duk L Na4,5
1Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Background And Purpose:
Mild cognitive impairment (MCI) is a transitional stage to dementia, Alzheimer's disease being a major cause. Although amyloid beta-positive (Aβ+) MCI has been well-characterized, Aβ-negative (Aβ-) MCI has not. This study compared the comprehensive clinical and behavioral characteristics of Aβ+ and Aβ- MCI in a large multi-center cohort to better understand the heterogeneity of MCI, and to identify contributing factors to cognitive impairment.
Methods:
A total of 686 MCI participants were included. Aβ positivity was determined using Aβ positron emission tomography imaging with a direct conversion Centiloid cutoff value of 25.5. Standardized assessment and questionnaires were used to collect a wide range of clinical information, including vascular risk factors, cognition, daily living function, neuropsychiatric symptoms, and lifestyle behavior. Groups were compared using independent t-tests and χ2 tests.
Results:
Aβ+ participants (n=406) were older, predominantly female, and more likely to be ApoE4 carriers. In contrast, Aβ- participants (n=280) showed higher vascular risk factors, including diabetes, elevated body mass index, and higher C-reactive protein levels. Aβ+ participants exhibited worse global cognition and functional decline, with a higher prevalence of delusions and appetite disturbances. Meanwhile, Aβ- participants reported greater social engagement, but poorer sleep quality.
Conclusions:
This study highlights the distinct clinical and lifestyle profiles of Aβ+ and Aβ- MCI, illuminating the heterogeneity of MCI and its underlying factors in the Korean population.
Insights
Amyloid beta-positive (Aβ+) mild cognitive impairment (MCI) differs from Aβ-negative (Aβ-) MCI. Aβ+ MCI shows worse cognition, while Aβ- MCI presents with more vascular risks and sleep issues.
Area of Science:
- Neurology
- Gerontology
- Biomarkers
Background:
- Mild cognitive impairment (MCI) is a precursor to dementia, with Alzheimer's disease often linked to amyloid beta (Aβ) plaques.
- Amyloid beta-positive (Aβ+) MCI is well-studied, but the characteristics of amyloid beta-negative (Aβ-) MCI remain less understood.
- Understanding MCI heterogeneity is crucial for accurate diagnosis and targeted interventions.
Purpose of the Study:
- To compare the clinical and behavioral profiles of Aβ+ MCI and Aβ- MCI.
- To identify factors contributing to cognitive impairment in different MCI subtypes.
- To elucidate the heterogeneity of MCI in a large, multi-center cohort.
Main Methods:
- Included 686 participants with MCI.
- Determined Aβ positivity using positron emission tomography (PET) imaging with a Centiloid cutoff of 25.5.
- Collected comprehensive data on vascular risk factors, cognition, daily function, neuropsychiatric symptoms, and lifestyle behaviors.
Main Results:
- Aβ+ MCI participants (n=406) were older, more often female, and ApoE4 carriers, with poorer cognition and function.
- Aβ- MCI participants (n=280) had higher vascular risk factors (diabetes, obesity, inflammation) and reported better social engagement but worse sleep quality.
- Distinct clinical and behavioral profiles were observed between Aβ+ and Aβ- MCI groups.
Conclusions:
- This study reveals significant differences between Aβ+ and Aβ- MCI.
- The findings underscore the heterogeneity of MCI and its underlying causes.
- These insights are vital for understanding cognitive decline and developing personalized treatments.
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