Baseline predictors of clinical progression among patients with dysexecutive mild cognitive impairment

Dement Geriatr Cogn Disord. 2010;30(4):344-51. doi: 10.1159/000318836. Epub 2010 Oct 12.

Abstract

Background/aims: There are few studies that evaluate the clinical outcomes of individuals with non-amnestic mild cognitive impairment (MCI). The purpose of this study was to evaluate baseline predictors of clinical progression after 2 years for patients with dysexecutive MCI (dMCI), a single-domain non-amnestic MCI subgroup.

Methods: We evaluated clinical progression in a sample of 31 older adults with dMCI. Clinical progression was defined as a worsening on the Clinical Dementia Rating sum of boxes at the 2-year visit, whereas patients were classified as stable if the score did not worsen over 2 years. We compared baseline brain MRI, neuropsychological tests, and health risk factors.

Results: Twelve individuals with dMCI progressed clinically, and 19 individuals remained stable over 2 years. Compared to the stable dMCI patients, the dMCI patients who progressed showed brain atrophy in the bilateral insula and left lateral temporal lobe on MRI. dMCI patients who progressed were also older, had lower baseline performance on category fluency and a spatial location task, and reported fewer dysexecutive symptoms. Health risk factors, except hypertension, did not differ between groups.

Conclusion: The results suggest that dMCI patients who progress relatively quickly over 2 years may have unique clinical and brain MRI features.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Amnesia
  • Analysis of Variance
  • Atrophy
  • Brain / pathology*
  • Brain / physiopathology
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / psychology
  • Disease Progression
  • Executive Function
  • Humans
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests*
  • Organ Size
  • Predictive Value of Tests
  • Prospective Studies
  • Severity of Illness Index