Cognitive complaint in mild cognitive impairment and Alzheimer's disease

Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada.
Journal of the International Neuropsychological Society (Impact Factor: 2.96). 04/2008; 14(2):222-32. DOI: 10.1017/S1355617708080260
Source: PubMed


Whereas the presence of a subjective memory complaint is a central criteria for mild cognitive impairment (MCI), little work has been done to empirically measure its nature and severity. The Self-Evaluation Questionnaire (QAM) assessed memory complaints relative to 10 domains of concrete activities of daily life in 68 persons with MCI, 26 persons with Alzheimer's disease (AD), and 81 healthy older adults. In addition, a neuropsychological battery was administered to assess whether subjective complaints were linked to actual cognitive performance. The findings indicate that individuals with MCI report more memory complaints than controls for a range of specific materials/circumstances. MCI and AD individuals did not differ in their level of memory complaints. Correlational analyses indicated that a higher level of memory complaints relative to conversations and to movies and books were associated with a higher level of objective cognitive deficits in persons with MCI but not in AD. Furthermore, complaints increased in parallel with global cognitive deficits in MCI. These results suggest that persons with MCI report more memory complaints than healthy older controls, but only in specific domains and circumstances, and that anosognosia is more characteristic of the demented than of the MCI phase of Alzheimer's disease.

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    • "The literature pertaining to the positive effects of napping for cognition has to-date been conducted in young healthy samples; however, these findings are of immense interest for clinical research seeking to enhance memory in older adults, specifically in those over the age of 50 years with a history of depression and/or concerns about cognition who are known to be 'at risk' of developing dementia (Clement et al., 2008; Glodzik-Sobanska et al., 2007; Naismith et al., 2012; Norton et al., 2014). In these populations, easily implemented, costeffective interventions are urgently needed. "
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    ABSTRACT: Sleep disturbance is prevalent in older adults, particularly so in those at a greater risk of dementia. However, so far the clinical, medical and neuropsychological correlates of daytime sleep have not been examined. The aims of this study were to investigate the characteristics and effects of napping using actigraphy in older people, particularly in those 'at risk' of dementia. The study used actigraphy and sleep diaries to measure napping habits in 133 older adults 'at risk' of dementia (mean age = 65.5 years, SD = 8.4 years), who also underwent comprehensive medical, psychiatric and neuropsychological assessment. When defined by actigraphy, napping was present in 83.5% (111/133) of participants; however, duration and timing varied significantly among subjects. Nappers had significantly greater medical burden and body mass index, and higher rates of mild cognitive impairment. Longer and more frequent naps were associated with poorer cognitive functioning, as well as higher levels of depressive symptoms, while the timing of naps was associated with poorer nocturnal sleep quality (i.e. sleep latency and wake after sleep onset). This study highlights that in older adults 'at risk' of dementia, napping is associated with underlying neurobiological changes such as depression and cognition. Napping characteristics should be more routinely monitored in older individuals to elucidate their relationship with psychological and cognitive outcomes. © 2015 European Sleep Research Society.
    Journal of Sleep Research 06/2015; 24(5):n/a-n/a. DOI:10.1111/jsr.12313 · 3.35 Impact Factor
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    • "In preclinical individuals, where the rates of AD biomarker accumulation are gradual (Villemagne et al., 2013), affective factors are relatively unconstrained determiners of cognitive discomfort. As pathology progresses to a clinically detectable level, neurobiological causation becomes more potent, constraining affective factors to a more peripheral contributory role (see, Buckley et al., 2013; Clément, Belleville, & Gauthier, 2008; Cook & Marsiske, 2006; Crowe et al., 2006; Foley, 2007). The only complaint theme to relate to depression in MCI was increased endorsement of dependency. "
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    ABSTRACT: Objective: To explore the subjective experience of memory change in groups at risk of dementia (those with mild cognitive impairment MCI or high β-amyloid (Aβ+) burden) to determine the existence of potential phenomenological typologies. Method: We recruited 123 healthy controls (HC) and individuals with MCI from the Australian Imaging, Biomarker and Lifestyle (AIBL) study. Sixty-7 (HC = 47,MCI = 20) had Aβ scans available for analysis. Semistructured interviews were administered, transcribed, and meaningful phrases extracted from transcripts. Twelve themes were defined and compared across diagnostic status and Aβ status. Results: MCI endorsed more complaints of burdensome coping strategies, increasing frequency, sense of predomination, poor contextualization, progression, dependency, impact on affect, and dismissive attitudes. HCAβ+ acknowledged a progressive memory decline compared to HCAβ-, while MCIAβ+ expressed more burdensome coping strategies, dismissive attitudes, and dependency comparative to either healthy group. Depression was more likely to be related to complaint themes in HCs, while complaint themes were associated with poorer list-learning performance in individuals with MCI. Conclusion: Complaint themes in those with MCI align with the MCI symptom complex, particularly when accompanied with high Aβ load. Healthy Aβ+ individuals acknowledged progressive memory change, suggesting they are aware of memory changes not yet detectable via neuropsychological measures. Depressive symptomatology associated with HC complaints, suggesting certain themes are affect-driven, while complaints in MCI are associated with organically driven functional impairment. Qualitative analysis of SMCs can inform the earliest clinical manifestations of Alzheimer's disease. Our findings can inform diagnostic approaches to the clinical evaluation of memory complaints in the nondemented elderly.
    Neuropsychology 02/2015; 29(4). DOI:10.1037/neu0000156 · 3.27 Impact Factor
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    • "Some authors name this decreased consciousness of alterations due to AD of anosognosia (Clément, Belleville, & Gauthier, 2008; Kalbe et al., 2005; Meguro, 2006; Orfei et al., 2010; Spalletta, Girardi, Caltagirone, & Orfei, 2012) and MCI (Galeone, Pappalardo, Chieffi, Iavarone, & Carlomagno, 2011). While Galeone et al. (2011) reported initially that anosognosia is a major symptom of AD and MCI, other authors (Clément et al., 2008; Kalbe et al., 2005; Meguro, 2006; Orfei et al., 2010; Spalletta et al., 2012) observed that anosognosia is common in older patients with AD, even in mild stages of the disease (but not in individuals with MCI). This may be associated with apathy and denial of illness. "
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    ABSTRACT: Cognitive impairment and fear of falling are risk factors for falls in older adults. Recurrent falls are more prevalent in older adults with cognitive impairment. We examined the number of previous falls, self-reported fear of falling, and the Falls Efficacy Scale-International (FES-I) in 104 older adults [26 with mild Alzheimer's disease (AD), 42 with mild cognitive impairment (MCI) and 36 cognitively healthy]. Older adults with AD and MCI had a higher number of falls (1.1 ± 1.2 and 1.5 ± 1.5, respectively) compared to the control group (0.3 ± 0.5, P < .001). Older adults with MCI more often reported fear of falling (74%) than patients with AD (31%) (P ≤ .002) and scored higher on the FES-I (29.7 and 23.8, respectively, P ≤ .01). The prevalence of falls in older adults with MCI and AD is higher than in subjects cognitively healthy. Older adults with MCI and AD differ in terms of reported fear of falling and falls self-efficacy.
    Aging Neuropsychology and Cognition 07/2014; 22(3):1-10. DOI:10.1080/13825585.2014.933770 · 1.07 Impact Factor
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Serge Gauthier