Introduction Little empirical work has been done to examine differences between mild cognitive impairment (MCI) diagnosed in research settings with longitudinal data (incident MCI) and MCI diagnosed in clinical settings (prevalent MCI). Because Alzheimer's disease progresses over a clinicopathological continuum, we examined the cognitive differences between these two different sources of MCI patients. Methods We compared 52 consecutively identified patients with prevalent amnestic MCI with 53 incident amnestic MCI participants from the Arizona APOE study. Neuropsychological data from common tests were compared encompassing four cognitive domains and one global indicator. Results Prevalent MCI cases performed significantly worse than incident MCI cases on global as well as domain-specific measures. Discussion By the time patients seek evaluation for memory loss, they have more severe single domain, amnestic MCI than research subjects with incident MCI. Studies of MCI should distinguish incident and prevalent not just single- and multiple-domain MCI.

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We investigated the cross-sectional association between anticholinergics and cognitive function in persons aged ≥ 50 years. Participants underwent neurological examination, neuropsychological testing and were classified into two groups: Those taking (AC+, N = 51) versus not taking anticholinergics (AC−, N = 204). AC+ were comparable to AC− participants by age, sex and education. There was a trend for worse performance in all memory and most executive function tests for AC+, but only the difference in the Paced Auditory Serial Attention Task 2 was significant. There was no dose-effect relationship between anticholinergic use and cognitive test scores. Results were not impacted by APOE ε4 status. In conclusion, we observed a significant difference between AC+ and AC− groups in only one measure of executive function. Thus anticholinergic medications do not appear to impact cognition in this relatively younger sample of late mid-life individuals. A longitudinal study is needed to confirm these findings.

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