Course and etiology of dysexecutive MCI in a community sample |
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| Institution: | 1. Veterans Affairs San Diego Healthcare System, San Diego, CA, USA;2. Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA;3. Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA;4. San Diego State University/University of California, San Diego Joint Doctoral Program, San Diego, CA, USA;5. Department of Radiology, University of California, San Diego, La Jolla, CA, USA;6. Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA;7. Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University, Richmond, VA, USA;8. Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA;9. National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, MA, USA;10. Psychiatry and Biomedical Genetics, Boston University School of Medicine, Boston, MA, USA;11. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA;12. Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA;13. Department of Psychology, University of California Riverside, Riverside, CA, USA;14. Department of Epidemiology and Biostatistics, St. Louis University, St. Louis, MO, USA;15. School of Education and Social Policy, Merrimack College, North Andover, MA, USA |
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| Abstract: | BackgroundAmnestic mild cognitive impairment (aMCI) is associated with an elevated risk of progressing to Alzheimer's disease. Much less is known about the course of dysexecutive mild cognitive impairment (dMCI). The goals of this study were to determine how the profile of cognitive deficits differs over time between patients with dMCI and aMCI, and control subjects; if the type of dementia differs between dMCI and aMCI in patients who progress to dementia; and if dMCI is more associated with stroke and white matter hyperintensity on magnetic resonance imaging (MRI) than aMCI.MethodsThe authors undertook a prospective evaluation of an inception cohort of 1167 ethnically diverse elders recruited from an urban community-based sample monitored with clinical and neuropsychological testing for an average of 4.5 years (standard deviation, 0.8 year). A subset of the subjects underwent MRI. We compared four groups of MCI patients: single-domain amnestic and dysexecutive MCI, and multiple-domain MCI with and without executive dysfunction.ResultsCompared with aMCI, dMCI was less likely to involve other areas of cognition over time and progress to dementia. None of the 33 single-domain dMCI patients progressed to dementia. The presence of executive dysfunction in multiple-domain MCI did not increase risk of progression to dementia. Patients with multiple-domain MCI with executive dysfunction who progressed to dementia were less likely to have an Alzheimer's–type dementia than MCI patients without executive dysfunction. Patients with dMCI were more likely to experience stroke, but not white matter hyperintensity, detected via MRI than patients with aMCI.ConclusionsdMCI appears to follow a different course, and is less associated with Alzheimer's disease and more associated with stroke than aMCI. |
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