Quantification of five neuropsychological approaches to defining mild cognitive impairment

By A. Jak, M. Bondi, L. Delano-Wood, C. Wierenga, J. Corey-Bloom, David P. Salmon, Dean C. Delis. The American journal of geriatric psychiatry, 2009

727 citations recorded by the source corpus.

Objectives Operational definitions of cognitive impairment have varied widely in diagnosing mild cognitive impairment (MCI). Identifying clinical subtypes of MCI has further challenged diagnostic approaches, since varying the components of the objective cognitive assessment can significantly impact diagnosis. Therefore, we investigated the applicability of diagnostic criteria for clinical subtypes of MCI in a naturalistic research sample of community elders and quantified the variability in diagnostic outcomes that results from modifying the neuropsychological definition of objective cognitive impairment. Design Cross-sectional and longitudinal study Setting San Diego, CA, Veterans Administration Hospital Participants 90 nondemented, neurologically normal, community-dwelling older adults were initially assessed and 73 were seen for follow-up approximately 17 months later. Measurements Participants were classified via consensus diagnosis as either normally aging or having MCI via each of five diagnostic strategies, which varied the cutoff for objective impairment as well as the number of neuropsychological tests considered in the diagnostic process. Results A range of differences in the percentages identified as MCI versus cognitively normal were demonstrated, depending on the classification criteria employed. A substantial minority of individuals demonstrated diagnostic instability over time as well as across diagnostic approaches. The single domain non-amnestic subtype diagnosis was particularly unstable (e.g., prone to reclassification as normal at follow up). Conclusion Our findings provide empirical support for a neuropsychologically derived operational definition of clinical subtypes of MCI and point to the importance of using comprehensive neuropsychological assessments. Diagnoses, particularly involving non-amnestic MCI, were variable over time. The applicability and utility of this particular MCI subtype warrants further investigation.

Subfields: Critical Care and Intensive Care Medicine, Geriatrics and Gerontology, Psychiatry and Mental health

View Paper: https://www.semanticscholar.org/paper/4965ea2775a3c9a5da917b11da270e49073c8c53

Citations in the corpus