Neuropsychological detection and characterization of preclinical Alzheimer's disease

Jacobs, Diane M.; Sano, Mary; Dooneief, George; Marder, Karen; Bell, Karen L.; Stern, Yaakov

doi:10.1212/wnl.45.5.957

Cited by 376 publications

(300 citation statements)

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“…A subgroup of these individuals meeting criteria for amnestic Mild Cognitive Impairment (aMCI) develop AD at elevated rates and have become the targets of secondary prevention trials (Petersen et al, 2005). The definition of MCI has been broadened to include clinical subgroups that have other cognitive deficits including impaired attention or executive dysfunction, (Albert et al, 2001;Masur et al, 1994;Saxton et al, 2004;Tierney et al, 2005), language (Jacobs et al, 1995), or visual spatial impairment (Small et al, 1997). Conversion rates to dementia vary because of differences in cohorts, MCI criteria, and the methods used to implement them.…”

Section: Introductionmentioning

confidence: 99%

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

Grober

Hall

Lipton

et al. 2008

J. Inter. Neuropsych. Soc.

353

314

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In the Baltimore Longitudinal Study of Aging (BLSA), we examined the temporal unfolding of declining performance on tests of episodic memory (Free Recall on the Free and Cued Selective Reminding Test), executive function (Category Fluency, Letter Fluency, and Trails), and Verbal Intelligence (Nelson, 1982; American Version of the Nelson Adult Reading Test [AMNART] ) before the diagnosis of dementia in 92 subjects with incident Alzheimer's disease (AD) followed for up to 15 years before diagnosis. To examine the preclinical onset of cognitive decline, we aligned subjects at the time of initial AD diagnosis and examined the cognitive course preceding diagnosis. We found that declines in performance on tests of episodic memory accelerated 7 years before diagnosis. Declining performance on tests of executive function accelerated 2-3 years before diagnosis, and verbal intelligence declined in close proximity to diagnosis. This cognitive profile is compatible with pathologic data suggesting that structures which mediate memory are affected earlier than frontal structures during the preclinical onset of AD. It also supports the view that VIQ as estimated by the AMNART does not decline during the preclinical onset of AD. (JINS, 2008, 14, 266-278.)

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Section: Introductionmentioning

confidence: 99%

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

Grober

Hall

Lipton

et al. 2008

J. Inter. Neuropsych. Soc.

353

314

View full text Add to dashboard Cite

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“…MCI patients who are impaired in multiple domains usually have a memory impairment, but it is of less magnitude than that observed in patients classified as amnestic MCI (Lopez et al, 2006). The multiple-domain form of MCI is the most prevalent form of MCI (Lopez et al, 2006) and is a better indicator of mild AD than memory impairment alone (Masur et al, 1994;Jacobs et al, 1995;Kluger et al, 1999;Petersen et al, 2001;Winblad et al, 2004). The neuropsychological profile of a multiple-domain MCI person appears similar to the profile of late-life depressed persons observed in the meta-analysis (Elderkin- Thompson et al, 2004a).…”

Section: Depression and MCImentioning

confidence: 99%

Mood, cognition and in vivo protein imaging: the emerging nexus in clinical neuroscience

Kumar

Ajilore

Kepe

et al. 2007

Int J Geriat Psychiatry

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“…Função intelectual e visuo-motora-espacial complexa -Pacientes com demência leve apresentam escores inferiores aos de sujeitos normais em testes de formação de conceitos, raciocínio verbal (subteste de semelhanças do WAIS, resolução de problemas), praxias manuais complexas, habilidades visuo-espaciais e práxico-construtivas 5,7 .…”

Section: Aspectos Neuropsicológicos Relevantesunclassified

Envelhecimento cerebral: o problema dos limites entre o normal e o patológico

Damasceno

1999

Arq. Neuro-Psiquiatr.

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RESUMO -O autor relata três casos de pseudodemência e discute o problema dos limites entre o normal e o patológico no sujeito idoso. O envelhecimento cerebral acompanha-se de alterações mentais e neuropatológicas superponíveis às da demência de Alzheimer (DA), levando a problemas de diagnóstico diferencial. Ainda não existe um marcador biológico seguro de DA e os testes psicométricos podem dar resultados falso-positivos ou falso-negativos. No idoso normal, o declínio da memória operacional e memória secundária é maior que o das memórias primária e terciária, de modo similar ao encontrado nas fases iniciais da DA. Os testes de evocação retardada de lista de palavras, memória lógica, pensamento categórico, destreza visuo-motora-espacial e o Teste de Nomeação de Boston têm sido apontados como os mais discriminativos entre demência incipiente e normalidade. Na neuroimagem, os achados de atrofia ou hipoperfusão em regiões entorrinais-hipocampais ou temporo-parietais são sugestivos de DA, mas podem estar ausentes nas fases iniciais desta doença. O autor conclui sugerindo passos decisivos para o diagnóstico diferencial: avaliação neuropsicológica e comportamental abrangente (com levantamento do nível pré-mórbido de funcionamento cognitivo e sócio-ocupacional do paciente), bem como exames laboratoriais e de neuroimagem; e, se preciso, reavaliação após 4 a 6 meses, para verificar a consistência dos achados. PALAVRAS-CHAVE: envelhecimento cerebral, demência, testes neuropsicológicos. Brain ageing: problems of differential diagnosis between normal and pathologicABSTRACT -The author reports three cases of pseudodementia and discuss the difficulties in establishing limits between normality and illness in the elderly. The mental and neuropathological changes that accompany the normal ageing of the brain are similar to those of early Alzheimer's dementia (AD). These similarities often lead to difficulties in the differential diagnosis, hence the search for consensus criteria. The decline of working and secondary memory is greater than that of primary and tertiary memory, as is found in AD. On the other hand, tests of delayed recall of 10 to 15 unrelated words, logical memory, categorical thinking, visuo-motor-spatial skills, and Boston Naming Test have been pointed out as the most discriminative. Neuroimaging findings of atrophy or hipoperfusion in the entorhinal-hippocampal or temporo-parietal regions are suggestive of DA, but they can be lacking in the early stages of this disease. In the conclusion, the author suggests the diagnostic process should be based on a comprehensive neuropsychological and behavioral evaluation (including a survey of the subject's premorbid level of cognitive and socio-occupational functioning), supplemented by neuroimaging and laboratory tests. If inconclusive, the whole evaluation can be repeated after 4 to 6 months, to check the consistency of the findings.

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Neuropsychological detection and characterization of preclinical Alzheimer's disease

Cited by 376 publications

References 1 publication

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

Mood, cognition and in vivo protein imaging: the emerging nexus in clinical neuroscience

Envelhecimento cerebral: o problema dos limites entre o normal e o patológico

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