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The heterogeneity of mild cognitive impairment: A neuropsychological analysis

Published online by Cambridge University Press:  03 November 2009

DAVID J. LIBON ,
SHARON X. XIE ,
JOEL EPPIG ,
GRAHAM WICAS ,
MELISSA LAMAR ,
CAROL LIPPA ,
BRIANNE M. BETTCHER ,
CATHERINE C. PRICE ,
TANIA GIOVANNETTI  and
ROD SWENSON
...Show all authors
DAVID J. LIBON*
Affiliation:
Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania
SHARON X. XIE
Affiliation:
Departments of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania
JOEL EPPIG
Affiliation:
Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania Department of Psychology, Temple University, Philadelphia, Pennsylvania
GRAHAM WICAS
Affiliation:
Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania
MELISSA LAMAR
Affiliation:
Institute of Psychiatry, King’s College, London, United Kingdom
CAROL LIPPA
Affiliation:
Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania
BRIANNE M. BETTCHER
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
CATHERINE C. PRICE
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
TANIA GIOVANNETTI
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
ROD SWENSON
Affiliation:
Department of Neuroscience, University of North Dakota Medical School, Fargo, North Dakota
DENENE M. WAMBACH
Affiliation:
Department of Neurology, Drexel University College of Medicine, Philadelphia, Pennsylvania
*
*Correspondence and reprint requests to: David J. Libon, Drexel University College of Medicine, Hahnemann University Hospital, New College Building, Mail Stop 423, 245 North 15th Street, Philadelphia, PA 19102. E-mail: [email protected] NINDS K23NS060660 (CP), Alzheimer’s Association IIRG-06-27542 (CP, TG, DJL). The authors have nothing to disclose.
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Abstract

A group of 94 nondemented patients self-referred to an outpatient memory clinic for memory difficulties were studied to determine the incidence of single versus multi-domain mild cognitive impairment (MCI) using Petersen criteria. Fifty-five community dwelling normal controls (NC) participants without memory complaints also were recruited. Tests assessing executive control, naming/lexical retrieval, and declarative memory were administered. Thirty-four patients exhibited single-domain MCI, 43 patients presented with multi-domain MCI. When the entire MCI sample (n = 77) was subjected to a cluster analysis, 14 patients were classified with amnesic MCI, 21 patients with dysexecutive MCI, and 42 patients were classified into a mixed/multi-domain MCI group involving low scores on tests of letter fluency, “animal” fluency, and delayed recognition discriminability. Analyses comparing the three cluster-derived MCI groups versus a NC group confirmed the presence of memory and dysexecutive impairment for the amnesic and dysexecutive MCI groups. The mixed MCI group produced lower scores on tests of letter fluency compared with the amnesic MCI and NC groups and lower scores on tests of naming and memory compared with the NC group. In summary, multi-domain MCI is quite common. These data suggest that MCI is a highly nuanced and complex clinical entity. (JINS, 2010, 16, 84–93.)

Keywords

Mild cognitive impairmentVascular cognitive impairmentDementiaAlzheimer’s diseaseVascular dementiaExecutive controlDeclarative memory
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 16 , Issue 1 , January 2010 , pp. 84 - 93
Copyright
Copyright © The International Neuropsychological Society 2009

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