Neuropsychological impairments and their cognitive architecture in mild cognitive impairment (MCI) with Lewy bodies and MCI-Alzheimer's disease

J Ciafone, A Thomas, R Durcan… - Journal of the …, 2022 - cambridge.org
J Ciafone, A Thomas, R Durcan, PC Donaghy, CA Hamilton, S Lawley, G Roberts, S Colloby
Journal of the International Neuropsychological Society, 2022cambridge.org
Objective: The present study aimed to clarify the neuropsychological profile of the emergent
diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine
whether domain-specific impairments such as in memory were related to deficits in domain-
general cognitive processes (executive function or processing speed). Method: Patients (n=
83) and healthy age-and sex-matched controls (n= 34) underwent clinical and imaging
assessments. Probable MCI-LB (n= 44) and MCI-Alzheimer's disease (AD)(n= 39) were …
Objective:The present study aimed to clarify the neuropsychological profile of the emergent diagnostic category of Mild Cognitive Impairment with Lewy bodies (MCI-LB) and determine whether domain-specific impairments such as in memory were related to deficits in domain-general cognitive processes (executive function or processing speed).Method:Patients (n = 83) and healthy age- and sex-matched controls (n = 34) underwent clinical and imaging assessments. Probable MCI-LB (n = 44) and MCI-Alzheimer’s disease (AD) (n = 39) were diagnosed following National Institute on Aging-Alzheimer’s Association (NIA-AA) and dementia with Lewy bodies (DLB) consortium criteria. Neuropsychological measures included cognitive and psychomotor speed, executive function, working memory, and verbal and visuospatial recall.Results:MCI-LB scored significantly lower than MCI-AD on processing speed [Trail Making Test B: p = .03, g = .45; Digit Symbol Substitution Test (DSST): p = .04, g = .47; DSST Error Check: p < .001, g = .68] and executive function [Trail Making Test Ratio (A/B): p = .04, g = .52] tasks. MCI-AD performed worse than MCI-LB on memory tasks, specifically visuospatial (Modified Taylor Complex Figure: p = .01, g = .46) and verbal (Rey Auditory Verbal Learning Test: p = .04, g = .42) delayed recall measures. Stepwise discriminant analysis correctly classified the subtype in 65.1% of MCI patients (72.7% specificity, 56.4% sensitivity). Processing speed accounted for more group-associated variance in visuospatial and verbal memory in both MCI subtypes than executive function, while no significant relationships between measures were observed in controls (all ps > .05)Conclusions:MCI-LB was characterized by executive dysfunction and slowed processing speed but did not show the visuospatial dysfunction expected, while MCI-AD displayed an amnestic profile. However, there was considerable neuropsychological profile overlap and processing speed mediated performance in both MCI subtypes.
Cambridge University Press
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