Which symptoms can distinguish between subjective cognitive impairment (SCI) and mild cognitive impairment (MCI)?

Medial Temporal Lobe Atrophy in Older Adults With Subjective Cognitive Impairments Affects Gait Parameters in the Spatial Navigation Task

Both navigation abilities and gait can be affected by the atrophy in the medial temporal cortex. This study aimed to determine whether navigation abilities could differentiate seniors with and without medial temporal lobe atrophy who complained about their cognitive status. The participants, classified to either the medial temporal atrophy group (n = 23) or the control group (n = 22) underwent neuropsychological assessment and performed a spatial navigation task while their gait parameters were recorded. The study showed no significant differences between the two groups in memory, fluency, and semantic knowledge or typical measures of navigating abilities. However, gait parameters, particularly the propulsion index during certain phases of the navigation task, distinguished between seniors with and without medial temporal lobe lesions. These findings suggest that the gait parameters in the navigation task may be a valuable tool for identifying seniors with cognitive complaints and subtle medial temporal atrophy.

Effect of Pushen capsule for treating vascular mild cognitive impairment: a pilot observational study

Objective

Traditional Chinese medicine (TCM) may be beneficial for vascular dementia (VaD). We evaluated the efficacy of Pushen capsule, a compound containing several TCM components, for treating vascular mild cognitive impairment (VaMCI).

Methods

Seventy outpatients with VaMCI were randomized to Pushen capsule or control treatment with Ginkgo biloba. Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Subjective Memory Loss Rating Scale scores; and lipid, lipoprotein, and haemorheological parameters were collected at baseline, week 4, and week 12 of treatment.

Results

MMSE score at week 12 was significantly higher in the treatment group compared with baseline (t = −2.352) but was not significantly different from week 12 in the control group. The MoCA score at week 12 was higher than that at baseline for both the treatment and control groups (t = −2.619 and −2.582, respectively), as was the “delayed recall” item score. Subjective memory loss score and the cognitive function “forgetting acquaintance's name” were significantly higher in the treatment group at week 12 than at baseline (t = −2.621 and χ² = 4.419, respectively). Lipid, lipoprotein, and haemorheological parameters were significantly different after treatment in both groups.

Conclusion

The benefits of Pushen capsule on cognitive function in VaMCI were comparable with that of Ginkgo biloba.

Usefulness of the University of California San Diego Performance-Based Skills Assessment for the evaluation of cognitive function and activities of daily living function in patients with cognitive impairment

OBJECTIVES

To assess the usefulness of the University of California San Diego Performance-Based Skills Assessment (UPSA) as a new diagnostic method and tool for the assessment of cognitive function and activities of daily living function in patients with cognitive impairment.

METHOD

In total, 35 patients with cognitive impairment and 35 healthy controls were recruited for this study. The Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Global Deterioration Scale (GDS) were used for the evaluation of cognitive function, while the Barthel Activities of Daily Living Index (BADL), Instrumental Activities of Daily Living Index (IADL), and UPSA were used for the evaluation of activities of daily living function.

RESULTS

UPSA scores were significantly lower in patients with cognitive impairment than in controls. The UPSA total score was significantly correlated with MMSE, CDR, GDS, and IADL scores. With regard to the detection of cognitive impairment, UPSA exhibited a greater determination power (R² = 0.593) compared with BADL (R² = 0.149) and IADL (R² = 0.423) and higher sensitivity and specificity compared with IADL.

CONCLUSION

Our results suggest that UPSA is a useful tool for the evaluation of cognitive function and activities of daily living function in patients with cognitive impairment.

Self and informant memory concerns align in healthy memory complainers and in early stages of mild cognitive impairment but separate with increasing cognitive impairment

BACKGROUND

Information provided by an informant about a patient with cognitive change is an essential component of clinical history taking. How an informant's report relates to the patient's phenomenological experience of memory loss is yet to be understood. The aim was to examine patterns of relationships between self and informant reports from a phenomenological perspective.

METHODS

Forty-three healthy non-memory complainers (HC-NMC), 37 healthy subjective memory complainers (HC-SMC) and 43 individuals with mild cognitive impairment (MCI) were administered a semi-structured interview, which measured their concerns of frequency of memory lapses and impact on mood. Informants responded to questionnaires.

RESULTS

Self-reported concerns of increasing frequency and impacted mood related to informant concerns in HC-SMCs. MCI with lower informant concern showed a similar pattern to HC-SMCs on complaints of increasing frequency. In those with higher informant concern, self-reports markedly separated from informant concern. The MCI group with greater informant concern performed comparatively poor on verbal and non-verbal memory measures.

CONCLUSIONS

Our results suggest that the association between self-reported and informant memory concerns is moderated by MCI severity. Self and informant reports of increasing memory lapse frequency aligned in HC-SMC and MCIs with low informant concern, suggesting a similar dyadic experience of memory change. In MCIs with greater informant concern, the pattern changed exposing a changing insight with advancing memory impairment. These individuals are potentially reflecting a 'forgetting that they forget' phenomenon in elements of their concern.

Functional and physical abilities in the early continuum of cognitive decline

BACKGROUND/AIMS

The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks.

METHODS

A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA).

RESULTS

Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items.

CONCLUSION

These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses.