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Mild Cognitive Impairment: A Neuropsychological Perspective

Published online by Cambridge University Press:  07 November 2014


Mild cognitive impairment (MCI) is a clinical diagnosis in which deficits in cognitive function are evident but not of sufficient severity to warrant a diagnosis of dementia. For the majority of patients, MCI represents a transitional state between normal aging and mild dementia, usually Alzheimer's disease. Multiple subtypes of MCI are now recognized. In addition to presentations featuring memory impairment, symptoms in other cognitive domains (eg, executive function, language, visuospatial) have been identified. Neuropsychological testing can be extremely useful in making the MCI diagnosis and tracking the evolution of cognitive symptoms over time. A comprehensive test battery includes measures of baseline intellectual ability, attention, executive function, memory, language, visuospatial skills, and mood. Informant-bassed measures of neuropsychiatric symptoms, behaviors, and competency in instrumental activity are also included. Careful assessment can identify subtle deficits that may otherwise elude detection, particularly in individuals of superior baseline intellectual ability. As we move closer to disease-modifying therapy for Alzheimer's disease, early identification becomes critical for identifying patients who have an opportunity to benefit from treatment.

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1.Petersen, RC, Morris, JC. Mild Cognitive impairment as a clinical entity and treatment target. Arch Neurol. 2005;62:11601163.CrossRefGoogle ScholarPubMed
2.Winblad, B, Palmer, K, Kivipelto, M, et al.Mild cognitive impairment—beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. J Intern Med. 2004;256:240246.CrossRefGoogle Scholar
3.Tabert, MH, Manly, JJ, Liu, X, et al. Neuropsychological prediction of conversion to Alzheimer Disease in patients with mild cognitive impairment. Arch Gen Psychiatry. 2006;63:916924.CrossRefGoogle ScholarPubMed
4.Fischer, P, Jungwirth, S, Zehetmayer, S, et al.Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology. 2007;68:288291.CrossRefGoogle ScholarPubMed
5.Blazer, DG, Hayes, JC, Fillenbaum, GG, Gold, DT. Memory complaint as a predictor of cognitive decline: a comparison of African American and White elders. J Aging Health. 1997;9:171184.CrossRefGoogle ScholarPubMed
6.Blessed, G. Tomlinson, BE, Roth, M. The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. Br J Psychiatry. 1968;114:797811.CrossRefGoogle ScholarPubMed
7.Hughes, CP, Berg, L, Danziger, WL, Coben, LA, Martin, RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982;140:566572.CrossRefGoogle Scholar
8.Morris, JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43:24122414.CrossRefGoogle ScholarPubMed
9.Weintraub, S, Baratz, R, Mesulam, MM. Daily living activities in the assessment of dementia. In: Corkin, S, ed. Alzheimer's Disease: A Report of Progress. New York, NY: Raven Press; 1982:189–92.Google Scholar
10.Weintraub, S. The record of independent living. Am J Alzheimers Dis Other Demen. 1986;1:3539.Google Scholar
11.Kaufer, DI, Cummings, JL, Ketchel, P, et al.Validation of the NPI-Q: a brief clinical form of the Neuropsychiatric Inventory. J Neuropsychiatry Clin Neurosci. 2000;12:233239.CrossRefGoogle ScholarPubMed
12.Petersen, RC, Smith, GE, Waring, SC, Ivnik, RJ, Tangalos, EG, Kokmen, E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303308.CrossRefGoogle ScholarPubMed
13.Sliwinski, M, Lipton, RB, Buschke, H, Stewart, W. The effects of preclinical dementia on estimates of normal cognitive functioning in aging. J Gerontol B Psychol Sci Soc Sci. 1996;51:217225.CrossRefGoogle Scholar
14.Rentz, DM, Calvo, VL, Scinto, LFM, Sperling, RA, Budson, AB, Daffner, KR. Detecting early cognitive decline in high- functioning elders. J Geriatr Psychiatry. 2000;33:2748.Google Scholar
15.Rentz, DM, Huh, TJ, Faust, RR, et al.Use of IQ-adjusted norms to predict progressive cognitive decline in highly intelligent older individuals. Neuropsychology. 2004;18:3849.CrossRefGoogle ScholarPubMed
16.Schretlen, DJ, Munro, CA, Anthony, JC, Pearlson, GD. Examining the range of normal intraindividual variability in neuropsychological test performance. J Int Neuropsychol Soc. 2003;9:864870.CrossRefGoogle ScholarPubMed
17.Storandt, M, Grant, EA, Miller, JP, Morris, JC. Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI. Neurology. 2006;67:467473.CrossRefGoogle ScholarPubMed
18.WAIS-III/WMS-III: Updated Technical Manual. San Antonio, Tex: The Psychological Corporation; 2002.Google Scholar
19.Wechsler Test of Adult Reading Manual. San Antonio, Tex: The Psychological Corporation; 2001.Google Scholar
20.Grober, E, Sliwinski, M. Development and validation of a model for estimating premorbid verbal intelligence in the elderly. J Clin Exp Neuropsychol. 1991;13:933949.CrossRefGoogle ScholarPubMed
21.Folstein, MF, Folstein, SE, McHugh, PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189198.CrossRefGoogle ScholarPubMed
22.Mattis, S. Mental status examination for organic mental syndrome in the elderly patient. In: Bellak, L, Karasu, TB, eds. Geriatric Psychiatry. New York, NY: Grune and Stratton; 1976:77101.Google Scholar
23.Mattis, S. Dementia Rating Scale: Professional Manual. Odessa, Fla: Psychological Assessment Resources; 1988.Google Scholar
24.Doody, RS, Massman, P, Dunn, JK. A method for estimating progression rates in Alzheimer's disease. Arch Neurol. 2001;58:449454.CrossRefGoogle Scholar
25.Reitan, RM. The relation of the Trail-Making Test to organic brain damage. J Consult Psychol. 1955;19:393394.CrossRefGoogle ScholarPubMed
26.Stroop, JR. Studies of interference in serial verbal reaction. J Exp Psychol. 1935;18:643662.CrossRefGoogle Scholar
27.Grant, DA, Berg, EA. A behavioral analysis of degree of impairment and ease of shifting to new responses in a Weigl-type card sorting problem. J Exp Psychol. 1948;39:404411.CrossRefGoogle Scholar
28.Rey, A. L'examen Clinique en Psychologie. Paris, France: Presses Universitaires de France; 1958.Google Scholar
29.Delis, DC, Kramer, JH, Kaplan, E, Ober, BA. California Verbal Learning Test. San Antonio, Tex: The Psychological Corporation; 1987.Google Scholar
30.Morris, JC, Mohs, RC, Rogers, H, Fillenbaum, G, Heyman, A. Consortium to establish a registry for Alzheimer's disease (CERAD) clinical and neuropsychological assessment of Alzheimer's disease. Psychopharmacol Bull. 1988;24:641652.Google ScholarPubMed
31.Kaplan, EF, Goodglass, H, Weintraub, S. The Boston Naming Test. 2nd ed. Philadelphia, Penn: Lippincott, Williams & Wilkins; 2001.Google Scholar
32.Stern, RA, White, T. Neuropsychological Assessment Battery: Administration, Scoring, and Interpretation Manual. Lutz, Fla: Psychological Assessment Resources; 2003.Google Scholar
33.Ruff, RM, Light, RH, Parker, SB. Benton Controlled Oral Word Association Test: reliability and updated norms. Arch Clin Neuropsychol. 1996;11:329338.CrossRefGoogle ScholarPubMed
34.DeRenzi, E, Vignolo, L. The Token Test: a sensitive test to detect receptive disturbances in aphasics. Brain. 1962;85:665678.CrossRefGoogle Scholar
35.Goodglass, H, Kaplan, E, Baresi, B. Boston Diagnostic Aphasia Examination. 3rd ed. Philadelphia, Penn: Lippincott, Williams & Wilkins; 2001.Google Scholar
36.Mesulam, MM, ed. Principles of Behavioral and Cognitive Neurology. 2nd ed. New York, NY: Oxford University Press; 2000.Google Scholar
37.Benton, AL, Sivan, AB, Hamsher Kerry, deS, Varney, NR, Spreen, O. Contributions to Neuropsychological Assessment. A Clinical Manual. Second Edition. Orlando, Fla: Psychological Assessment Resources; 1994.Google Scholar
38.Hooper, HE. The Hooper Visual Organization Test: Manual. Beverly Hills, Calif: Western Psychological Services; 1958.Google Scholar
39.Freedman, M, Leech, L, Kaplan, EF, et al.Clock Drawing: A Neuropsychological Analysis. New York, NY: Oxford University Press; 1994.Google Scholar
40.Strub, RL, Black, FW. The Mental Status Examination in Neurology. 4th ed. Philadelphia, Penn: FA. Davis; 2000.Google Scholar
41.Rey, A. L'examen Psychologique dans les cas D'encephapothie Traumatique. Archives de Psychologie. 1941;28:286340.Google Scholar
42.Beck, AT, Steer, RA, Brown, GK. Beck Depression Inventory. 2nd ed. San Antonio, Tex: The Psychological Corporation; 1996.Google Scholar
43.Brink, TL, Yesavage, JA, Lum, O, Heersema, P, Adey, MB, Rose, TL. Screening tests for geriatric depression. Clin Gerontol. 1982;1:3743.CrossRefGoogle Scholar
44.Beck, AT, Steer, RA. Beck Anxiety Inventory Manual. San Antonio, Tex: The Psychological Corporation; 1990.Google Scholar
45.Blacker, D, Lee, H, Muzikansky, A, et al.Neuropsychological measures in normal individuals that predict subsequent cognitive decline. Arch Neurol. 2007;64:862871.CrossRefGoogle ScholarPubMed
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