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Sex differences in the prevalence and incidence of mild cognitive impairment: A meta-analysis. Ageing Res Rev 2017; 35:176-199. [PMID: 27771474 DOI: 10.1016/j.arr.2016.09.005] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 08/31/2016] [Accepted: 09/26/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE More women have Alzheimer's disease (AD) than men. Understanding sex differences in mild cognitive impairment (MCI) may further knowledge of AD etiology and prevention. We conducted a meta-analysis to examine sex differences in the prevalence and incidence of MCI, which included amnestic and non-amnestic subtypes. METHOD Systematic searches were performed in July 2015 using MEDLINE/PubMed, Scopus, and PsycINFO for population-or community-based studies with MCI data for men and women. Random-effects model were used. RESULTS Fifty-six studies were included. There were no statistically significant sex differences in prevalence or incidence of amnestic MCI. There was a significantly higher prevalence (p=0.038), but not incidence, of non-amnestic MCI among women. There were no sex differences in studies that combined both subtypes of MCI. CONCLUSION The only statistically significant finding emerging from this study was that women have a higher prevalence of non-amnestic MCI. To better understand sex differences in the preclinical stages of dementia, studies must better characterize the etiology of the cognitive impairment.
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Goerlich KS, Votinov M, Dicks E, Ellendt S, Csukly G, Habel U. Neuroanatomical and Neuropsychological Markers of Amnestic MCI: A Three-Year Longitudinal Study in Individuals Unaware of Cognitive Decline. Front Aging Neurosci 2017; 9:34. [PMID: 28275349 PMCID: PMC5320546 DOI: 10.3389/fnagi.2017.00034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 02/08/2017] [Indexed: 11/15/2022] Open
Abstract
Structural brain changes underlying mild cognitive impairment (MCI) have been well-researched, but most previous studies required subjective cognitive complaints (SCC) as a diagnostic criterion, diagnosed MCI based on a single screening test or lacked analyses in relation to neuropsychological impairment. This longitudinal voxel-based morphometry study aimed to overcome these limitations: The relationship between regional gray matter (GM) atrophy and behavioral performance was investigated over the course of 3 years in individuals unaware of cognitive decline, identified as amnestic MCI based on an extensive neuropsychological test battery. Region of interest analyses revealed GM atrophy in the left amygdala, hippocampus, and parahippocampus in MCI individuals compared to normally aging participants, which was specifically related to verbal memory impairment and evident already at the first measurement point. These findings demonstrate that GM atrophy is detectable in individuals with amnestic MCI despite unawareness of beginning cognitive decline. Thus, individuals with GM atrophy in regions associated with verbal memory impairment do not necessarily need to experience SCC before meeting neuropsychological criteria for MCI. These results have important implications for future research and diagnostic procedures of MCI.
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Affiliation(s)
- Katharina S Goerlich
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University Aachen, Germany
| | - Mikhail Votinov
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen UniversityAachen, Germany; Jülich Aachen Research Alliance (JARA) - Translational Brain MedicineAachen, Germany; Institute of Neuroscience and Medicine (INM-10), Research Centre JülichJülich, Germany
| | - Ellen Dicks
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen UniversityAachen, Germany; Alzheimer Center and Department of Neurology, Neuroscience Campus Amsterdam, VU University Medical CenterAmsterdam, Netherlands
| | - Sinika Ellendt
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University Aachen, Germany
| | - Gábor Csukly
- Department of Psychiatry and Psychotherapy, Semmelweis University Budapest, Hungary
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen UniversityAachen, Germany; Jülich Aachen Research Alliance (JARA) - Translational Brain MedicineAachen, Germany
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Chechko N, Drexler EI, Voss B, Kellermann T, Finkelmeyer A, Schneider F, Habel U. Neural Correlates of Unsuccessful Memory Performance in MCI. Front Aging Neurosci 2014; 6:201. [PMID: 25165448 PMCID: PMC4131189 DOI: 10.3389/fnagi.2014.00201] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Accepted: 07/21/2014] [Indexed: 11/26/2022] Open
Abstract
People with mild cognitive impairment (MCI) are at an elevated risk of developing Alzheimer’s disease or other forms of dementia. Although the neural correlates of successful memory performance in MCI have been widely investigated, the neural mechanisms involved in unsuccessful memory performance remain unknown. The current study examines the differences between patients suffering from stable amnestic MCI with multiple deficit syndromes and healthy elderly controls in relation to the neural correlates of both successful and unsuccessful encoding and recognition. Forty-six subjects (27 controls, 19 MCI) from the HelMA (Helmholtz Alliance for Mental Health in an Aging Society) completed a comprehensive neuropsychological test battery and participated in an fMRI experiment for associative face-name memory. In patients, the areas of frontal, parietal, and temporal cortices were less involved during unsuccessful encoding and recognition. A temporary dysfunction of the top-down control of frontal or parietal (or both) areas is likely to result in a non-selective propagation of task-related information to memory.
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Affiliation(s)
- N Chechko
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
| | - E I Drexler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
| | - B Voss
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
| | - T Kellermann
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
| | - A Finkelmeyer
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany ; Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality , Newcastle upon Tyne , UK
| | - F Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
| | - U Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical School, RWTH Aachen University , Aachen , Germany ; Jülich Aachen Research Alliance (JARA) - Translational Brain Medicine , Jülich and Aachen , Germany
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de Gobbi Porto FH, Spíndola L, de Oliveira MO, Figuerêdo do Vale PH, Orsini M, Nitrini R, Dozzi Brucki SM. A score based on screening tests to differentiate mild cognitive impairment from subjective memory complaints. Neurol Int 2013; 5:e16. [PMID: 24147213 PMCID: PMC3794451 DOI: 10.4081/ni.2013.e16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 04/03/2013] [Accepted: 05/06/2013] [Indexed: 12/12/2022] Open
Abstract
It is not easy to differentiate patients with mild cognitive impairment (MCI) from subjective memory complainers (SMC). Assessments with screening cognitive tools are essential, particularly in primary care where most patients are seen. The objective of this study was to evaluate the diagnostic accuracy of screening cognitive tests and to propose a score derived from screening tests. Elderly subjects with memory complaints were evaluated using the Mini Mental State Examination (MMSE) and the Brief Cognitive Battery (BCB). We added two delayed recalls in the MMSE (a delayed recall and a late-delayed recall, LDR), and also a phonemic fluency test of letter P fluency (LPF). A score was created based on these tests. The diagnoses were made on the basis of clinical consensus and neuropsychological testing. Receiver operating characteristic curve analyses were used to determine area under the curve (AUC), the sensitivity and specificity for each test separately and for the final proposed score. MMSE, LDR, LPF and delayed recall of BCB scores reach statistically significant differences between groups (P=0.000, 0.03, 0.001 and 0.01, respectively). Sensitivity, specificity and AUC were MMSE: 64%, 79% and 0.75 (cut off <29); LDR: 56%, 62% and 0.62 (cut off <3); LPF: 71%, 71% and 0.71 (cut off <14); delayed recall of BCB: 56%, 82% and 0.68 (cut off <9). The proposed score reached a sensitivity of 88% and 76% and specificity of 62% and 75% for cut off over 1 and over 2, respectively. AUC were 0.81. In conclusion, a score created from screening tests is capable of discriminating MCI from SMC with moderate to good accurancy.
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Affiliation(s)
- Fábio Henrique de Gobbi Porto
- Behavioral and Cognitive Neurology Unit, Department of Neurology, Cognitive Disorders Reference Center, das Clínicas Hospital, University of São Paulo
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