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Are Empirically-Derived Subtypes of Mild Cognitive Impairment Consistent with Conventional Subtypes?

Published online by Cambridge University Press:  03 April 2013

Lindsay R. Clark
Affiliation:
San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California
Lisa Delano-Wood
Affiliation:
Department of Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, UC San Diego, School of Medicine, La Jolla, California
David J. Libon
Affiliation:
Department of Neurology, Drexel University, College of Medicine, Philadelphia, Pennsylvania
Carrie R. McDonald
Affiliation:
Department of Psychiatry, UC San Diego, School of Medicine, La Jolla, California
Daniel A. Nation
Affiliation:
Department of Veterans Affairs San Diego Healthcare System, San Diego, California
Katherine J. Bangen
Affiliation:
Department of Psychiatry, UC San Diego, School of Medicine, La Jolla, California
Amy J. Jak
Affiliation:
Department of Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, UC San Diego, School of Medicine, La Jolla, California
Rhoda Au
Affiliation:
Department of Neurology, Boston University, School of Medicine, Boston, Massachusetts
David P. Salmon
Affiliation:
Department of Neurosciences, UC San Diego, School of Medicine, La Jolla, California
Mark W. Bondi*
Affiliation:
Department of Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, UC San Diego, School of Medicine, La Jolla, California
*
Correspondence and reprint requests to: Mark W. Bondi, VA San Diego Healthcare System (116B), 3350 La Jolla Village Drive, San Diego, CA 92161. E-mail: mbondi@ucsd.edu

Abstract

Given the importance of identifying dementia prodromes for future treatment efforts, we examined two methods of diagnosing mild cognitive impairment (MCI) and determined whether empirically-derived MCI subtypes of these diagnostic methods were consistent with one another as well as with conventional MCI subtypes (i.e., amnestic, non-amnestic, single-domain, multi-domain). Participants were diagnosed with MCI using either conventional Petersen/Winblad criteria (n = 134; >1.5 SDs below normal on one test within a cognitive domain) or comprehensive neuropsychological criteria developed by Jak et al. (2009) (n = 80; >1 SD below normal on two tests within a domain), and the resulting samples were examined via hierarchical cluster and discriminant function analyses. Results showed that neuropsychological profiles varied depending on the criteria used to define MCI. Both criteria revealed an Amnestic subtype, consistent with prodromal Alzheimer's disease (AD), and a Mixed subtype that may capture individuals in advanced stages of MCI. The comprehensive criteria uniquely yielded Dysexecutive and Visuospatial subtypes, whereas the conventional criteria produced a subtype that performed within normal limits, suggesting its susceptibility to false positive diagnostic errors. Whether these empirically-derived MCI subtypes correspond to dissociable neuropathologic substrates and represent reliable prodromes of dementia will require additional follow-up. (JINS, 2013, 19, 1–11)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2013 

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