Browsing by Subject "Mild cognitive impairment"

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  • Pöllä, Satu (Helsingin yliopisto, 2020)
    Objective: Mild cognitive impairment is state between normal cognition and dementia, but there are several different definitions and criteria for identifying this condition. The purpose of this study is to determine proportion of participants who meet the criteria for different definitions of mild cognitive impairment, namely the Age-Associated Memory Impairment AAMI, Mild Cognitive Impairment MCI and mild Neurocognitive Disorder mNCD in the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER). We also evaluate overlapping of the groups who meet the criteria for different definitions and whether they differ in terms of functional performance. In addition, we investigate whether the change in MCI subtype differs in the two-year follow-up between the different subtypes and the intervention and control group. Methods: Quantities of those who met the AAMI, MCI and mNCD criteria were analyzed in the screening phase of the FINGER-study (n=2595, 98 % of participants), at the baseline (n=1073, 85 % of participants) and at two-year follow-up (n=884, 80 % of participants). Subjects were 60-77 years of ages in the beginning of the intervention. Cognition was assessed by the CERAD battery. Results: 61, 67 and 18 % of the subjects met the AAMI criteria, 37, 50 and 23 met the MCI criteria and 37, 45 and 21 % the mNCD criteria (screening, baseline and 2 years follow-up, respectively). The overlap between MCI and mNCD was 90%, between AAMI and MCI 31%, and AAMI and mNCD 34%. The functional performance of those who only met the AAMI criteria was better compared to those who met the criteria of all classifications. None of the MCI subtypes distinguished as more stable than the others after two years follow-up. Those who had met the amnestic MCI criteria at the baseline had more transition to the multidomain MCI in the control group than in the intervention group. Conclusion: Different definitions of mild cognitive impairment identify populations of different sizes and partially different qualities. The results of the study support the idea of equal instability of MCI subtypes. The results provide an indication of multifactorial lifestyle intervention preventing amnestic MCI from developing into multidomain MCI.
  • Vuoksimaa, Eero; McEvoy, Linda K.; Holland, Dominic; Franz, Carol E.; Kremen, William S. (2020)
    Mild cognitive impairment (MCI) is a heterogeneous condition with variable outcomes. Improving diagnosis to increase the likelihood that MCI reliably reflects prodromal Alzheimer's Disease (AD) would be of great benefit for clinical practice and intervention trials. In 230 cognitively normal (CN) and 394 MCI individuals from the Alzheimer's Disease Neuroimaging Initiative, we studied whether an MCI diagnostic requirement of impairment on at least two episodic memory tests improves 3-year prediction of medial temporal lobe atrophy and progression to AD. Based on external age-adjusted norms for delayed free recall on the Rey Auditory Verbal Learning Test (AVLT), MCI participants were further classified as having normal (AVLT+, above -1 SD, n = 121) or impaired (AVLT -, -1 SD or below, n = 273) AVLT performance. CN, AVLT+, and AVLT- groups differed significantly on baseline brain (hippocampus, entorhinal cortex) and cerebrospinal fluid (amyloid, tau, p-tau) biomarkers, with the AVLT- group being most abnormal. The AVLT- group had significantly more medial temporal atrophy and a substantially higher AD progression rate than the AVLT+ group (51% vs. 16%, p <0.001). The AVLT+ group had similar medial temporal trajectories compared to CN individuals. Results were similar even when restricted to individuals with above average (based on the CN group mean) baseline medial temporal volume/thickness. Requiring impairment on at least two memory tests for MCI diagnosis can markedly improve prediction of medial temporal atrophy and conversion to AD, even in the absence of baseline medial temporal atrophy. This modification constitutes a practical and cost-effective approach for clinical and research settings.
  • Nikolaev, Alexandre; Higby, Eve; Hyun, JungMoon; Lehtonen, Minna; Ashaie, Sameer; Hallikainen, Merja; Hänninen, Tuomo; Soininen, Hilkka (2020)
    While cognitive changes in aging and neurodegenerative disease have been widely studied, language changes in these populations are less well understood. Inflecting novel words in a language with complex inflectional paradigms provides a good opportunity to observe how language processes change in normal and abnormal aging. Studies of language acquisition suggest that children inflect novel words based on their phonological similarity to real words they already know. It is unclear whether speakers continue to use the same strategy when encountering novel words throughout the lifespan or whether adult speakers apply symbolic rules. We administered a simple speech elicitation task involving Finnish-conforming pseudo-words and real Finnish words to healthy older adults, individuals with mild cognitive impairment, and individuals with Alzheimer’s disease (AD) to investigate inflectional choices in these groups and how linguistic variables and disease severity predict inflection patterns. Phonological resemblance of novel words to both a regular and an irregular inflectional type, as well as bigram frequency of the novel words, significantly influenced participants’ inflectional choices for novel words among the healthy elderly group and people with AD. The results support theories of inflection by phonological analogy (single-route models) and contradict theories advocating for formal symbolic rules (dual-route models).