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Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss
Bozoki, A; Giordani, B; Heidebrink, JL; Berent, S; Foster, NL;
Univ Michigan, Med Ctr, Dept Neurol, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 Dept Neurol, Ann Arbor, MI 48109 USA Univ Michigan, Med Ctr, Dept Psychiat, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 pt Psychiat, Ann Arbor, MI 48109 USA Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Ann Arbor, MI USA Vet Affairs Med Ctr Ann Arbor MI USA Res Educ & Clin, Ann Arbor, MI USA
Titolo Testata:
fascicolo: 3, volume: 58, anno: 2001,
pagine: 411 - 416
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Life Sciences
Indirizzi per estratti:
Indirizzo: Bozoki, A Univ Michigan, Med Ctr, Dept Neurol, TC1913A,1500 E Med Ctr Dr, Ann Arbor,MI 48109 USA Univ Michigan TC1913A,1500 E Med Ctr Dr Ann Arbor MIUSA 48109 A
A. Bozoki et al., "Mild cognitive impairments predict dementia in nondemented elderly patients with memory loss", ARCH NEUROL, 58(3), 2001, pp. 411-416


Background: Some elderly individuals exhibit significant memory deficits but do not have dementia because their general intellect is preserved and they have no impairments in everyday activities. These symptoms are often a precursor to Alzheimer disease (AD), but sometimes dementia does not occur, even after many years of observation. There is currently no reliable way todistinguish between these 2 possible outcomes in an individual patient. Wehypothesized that clear impairments in at least 1 cognitive domain in addition to memory would help identify those who will progress to AD. Objective: To determine whether nondemented patients with impairments in memory and other domains are more likely than those with memory impairment alone to develop AD. Design and Methods: In a retrospective study, we evaluated 48 nondemented,nondepressed patients with clinical and psychometric evidence of memory impairment who were followed up for 2 or more years. Age-adjusted normative criteria were used to identify whether additional impairments were present in language, attention, motor visuospatial function, and verbal fluency at this initial evaluation. The presence or absence of dementia after 2 years and at the most recent neurological evaluation was compared in subjects withnormal scores in all 4 of these cognitive areas apart from memory (M-) andthose with impairment in 1 or more of these areas (M+). Outcomes were adjusted for age, intelligence at initial evaluation, and years of education. Results: Of the 48 nondemented patients with memory loss, 17 met M- criteria, leaving 31 in the M+ group. Deficits in block design were the most frequent abnormality other than memory loss. At the 2-year follow-up, 1 M-subject (6%) had progressed to AD, whereas 15 (48%) of the M+ group had progressed to AD (P=.003). At the most recent follow-up (mean +/- SD, 4.0 +/- 2.0 years), 4 (24%) of the M- patients progressed to AD compared with 24 (77%) of the M+ patients (P<.001). Conclusions: Among nondemented elderly patients, memory loss alone rarely progresses to dementia in the subsequent 2 years. However, the risk of dementia is significantly increased among patients with clear cognitive impairments beyond memory loss. Further study is needed to determine whether patients with impairments limited to memory loss have a distinctive clinical course or pathophysiology.

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Documento generato il 07/08/20 alle ore 20:47:54