Affective and Behavioral Symptoms in the age-related cognitive impairment continuum: assessment and predictive validity

Os Síntomas Afectivos e Conductuais (SAC) poderían ser relevantes para a predicción da demencia. Esta tese comprende un total de catro estudos de investigación. O primeiro deles é un metáanalise sobre a capacidade dos SAC medidos a través do Cuestionario Neuropsiquiátrico (NPI/NPI-Q) para predecir progresión de Deterioro Cognitivo Lixeiro (DCL) a demencia. Os resultados indicaron que as puntuacións no NPI e NPI-Q eran maiores nas persoas que evolucionaron a demencia. Outros dous estudos estudaron a prevalencia do Deterioro Comportamental Lixeiro, entidade caracterizada pola presenza dos SAC, en DCL en Deterioro Cognitivo Subxetivo, sendo esta de 14.2% e 5.8% respectivamente. O último estudo empregou a técnica de Machine Learning (ML) e concluiu que os SAC son variables relevantes na conversión a demencia

Do informant-reported subjective cognitive complaints predict progression to mild cognitive impairment and dementia better than self-reported complaints in old adults? A meta-analytical study

Background: Subjective cognitive complaints (SCCs) are considered a risk factor for objective cognitive decline and conversion to dementia. The aim of this study was to determine whether self-reported or informant-reported SCCs best predict progression to mild cognitive impairment (MCI) and/or dementia. Methods: We reviewed prospective longitudinal studies of Cognitively Unimpaired (CU) older adults with self-reported and informant-reported SCCs at baseline, assessed by questions or questionnaires that considered the transition to MCI and/or dementia. A random-effects meta-analysis was performed to obtain pooled estimates and 95% CIs. Results: Both self-reported and informant-reported SCCs are associated with an elevated risk of transition from CU to MCI and/or dementia. The association appears stronger and more robust for informant-reported data [1.38, with a 95% CI of 1.16 –1.64, p < 0.001] than for self-reported data [1.27 (95% CI 1.06 – 1.534, p = 0.011]. Conclusions Our results suggest that corroborated information from one informant could provide important details for distinguishing between normal aging and clinical statesThis work was supported though FEDER founds by the Spanish National Research Agency (Spanish 'Ministry of Science, Innovation and Universities) (Project Ref. PSI2017-89389-C2-1-R), FEDER founds (‘A way to make Europe’) by the Spanish AEI (Doi: 10.13039/501100011033; Refs. PID2020-114521RB-C21 and PSI2017-89389-C2-1-R) and by the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e estruturación de unidades de investigación competitivas do Sistema Universitario de Galicia; GI-1807-USC: Ref. ED431C 2021/04)S

Assessing Mild Behavioral Impairment with the Mild Behavioral Impairment-Checklist in People with Mild Cognitive Impairment

Background: Neuropsychiatric symptoms (NPS) are non-cognitive, behavioral, or psychiatric symptoms, common in mild cognitive impairment (MCI) and associated with a higher risk of dementia. Mild behavioral impairment (MBI) is a validated diagnostic entity, that describes the emergence of later life NPS in pre-dementia states. The Mild Behavioral Impairment Checklist (MBI-C) is the first measure developed to assess MBI. Objective: To estimate the prevalence of MBI in people with MCI and to study the score distribution, sensitivity, specificity, diagnostic utility of the MBI-C, and its correlations with neuropsychological tests. Methods: One hundred eleven MCI participants were evaluated with the Questionnaire for Subjective Memory Complaints (QSMC), Mini-Mental State Examination, Cambridge Cognitive Assessment-Revised, Neuropsychiatric Inventory- Questionnaire (NPI-Q), Geriatric Depression Scale-15 items (GDS-15), Lawton and Brody Index, and the MBI-C, which was administered by phone to participants’ informants. Descriptive, logistic regression, ROC curve, and bivariate correlations analyses were performed. Results: MBI diagnosis prevalence was 14.2%. The total MBI-C score differentiated people with MBI at a cutoff-point of 6.5, optimizing sensitivity and specificity. MBI-C total score correlated positively with NPI-Q, QSMC, GDS-15, and Lawton and Brody Index. Conclusion: The total MBI-C score, obtained by phone administration, is sensitive for detecting MBI in people with MCI. The MBI-C scores indicated that MCI participants had subtle NPS that were correlated to their subjective memory complaints reported by informants, depressive symptoms, and negatively with Instrumental Activities of Daily Living. Further research should be done to clarify the predictive role of NPS in MCI for incident dementiaThe study was funded by the Spanish Ministry of Economy and Competitiveness (ref. PSI2014-55316- C3-1-R) and the Galician Autonomous Government Grant (ref. ED431C2017/27). The first author is funded by a fellowship from the Spanish Ministry of Economy and Competitiveness (ref. BES-2015- 071253)S

Does empirically derived classification of individuals with subjective cognitive complaints predict dementia?

Background: Early identification of mild cognitive impairment (MCI) in people reporting subjective cognitive complaints (SCC) and the study of progression of cognitive decline are important issues in dementia research. This paper examines whether empirically derived procedures predict progression from MCI to dementia. (2) Methods: At baseline, 192 participants with SCC were diagnosed according to clinical criteria as cognitively unimpaired (70), single-domain amnestic MCI (65), multiple-domain amnestic MCI (33) and multiple-domain non-amnestic MCI (24). A two-stage hierarchical cluster analysis was performed for empirical classification. Categorical regression analysis was then used to assess the predictive value of the clusters obtained. Participants were re-assessed after 36 months. (3) Results: Participants were grouped into four empirically derived clusters: Cluster 1, similar to multiple-domain amnestic MCI; Cluster 2, characterized by subjective cognitive decline (SCD) but with low scores in language and working memory; Cluster 3, with specific deterioration in episodic memory, similar to single-domain amnestic MCI; and Cluster 4, with SCD but with scores above the mean in all domains. The majority of participants who progressed to dementia were included in Cluster 1. (4) Conclusions: Cluster analysis differentiated between MCI and SCD in a sample of people with SCC and empirical criteria were more closely associated with progression to dementia than standard criteria.This work was financially supported by the Spanish Directorate General of Scientific and Technical Research (Project PSI2014- 55316-C3-1-R) and by the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e Estruturación de unidades de investigación competitivas do Sistema universitario de Galicia; GRC (GI-1807-USC); Ref: ED431-2017/27) through FEDER fundsS

Longitudinal Patterns of the Tip-of-the-Tongue Phenomenon in People With Subjective Cognitive Complaints and Mild Cognitive Impairment

Background: The Tip-of-the-Tongue (ToTs) state is considered a universal phenomenon and is a frequent cognitive complaint in old age. Previous cross-sectional studies have found that ToT measures successfully discriminate between cognitively unimpaired adults and adults with Mild Cognitive Impairment (MCI). The aim of this study was to identify longitudinal patterns of ToTs in individuals with subjective complaints and with MCI regarding progress of their cognitive status. Method: The study included 193 participants with subjective cognitive complaints (SCC) and 56 participants with MCI who completed a baseline and two follow-up assessments, with an interval of about 18 months between each assessment. Participants were classified into three groups by considering cognitive stability or deterioration from the baseline diagnosis: SCC-stable, MCI-stable and MCI-worsened. Participants performed a ToT task involving recognition and naming of famous people depicted in 50 photographs. Generalized Linear Mixed Models (GLMM) were used to model longitudinal changes in familiarity, feeling of knowing, semantic access, phonological access and verbal fluency. Results: Phonological access differentiated MCI patients, stable and worsened, from adults with SCCs at all evaluation times. Phonological access declined over time in the three groups, without significant interactions between groups and time. Discussion: This study provides the first longitudinal evidence of differences in ToT measures for adults with MCI. The findings indicate that phonological access measures successfully differentiated between the diagnostic groups. However, slopes remain irrespective of the diagnostic group and progression toward more advance stages of cognitive impairmentThis work was supported through FEDER founds by the Spanish Directorate General of Scientific and Technical Research (Project Ref. PSI2014-55316-C3-1-R), the National Research Agency (Spanish Ministry of Science, Innovation and Universities) (Project Ref. PSI2017-89389-C2-1-R) and by the Galician Government (Consellería de Cultura, Educación e Ordenación Universitaria; axudas para a consolidación e estruturación de unidades de investigación competitivas do Sistema Universitario de Galicia; GI-1807-USC: Ref. ED431-2017/27)S