Exploring heterogeneity in mild cognitive impairment

作者：Zachary T. Goodman, Maria M. Llabre, Sonya Kaur, Nikhil Banerjee, Katalina McInerney, Xiaoyan Sun, A. Saporta, Bonnie Levin · 发表于：Journal of Alzheimer s Disease · 年份：2024 · DOI：10.1177/13872877241290127 · 被引用次数：6 · 研究领域：Dementia and Cognitive Impairment Research、Frailty in Older Adults、Traumatic Brain Injury Research

Background Mild cognitive impairment (MCI) is a heterogeneous diagnostic entity, without a clear prognosis, often accompanied by psychiatric symptomatology and physical frailty. Objective Understanding the heterogeneity within MCI is a critical step in improving the early detection of cognitive decline and developing effective interventions. Methods Cross-sectional multivariate latent mixture analyses of data from patients evaluated between 2015 and 2019, who were routinely entered into a multidisciplinary database for research purposes. A sample of 538 community-dwelling older adults drawn from a large academic medical center, referred from within the Department of Neurology (63.7% Female, M age = 67.8, SD age = 10.6). Participants completed comprehensive neuropsychological assessments, psychiatric symptom measures, and frailty evaluations. Results Latent profile analyses supported five profiles of cognitive impairment: At-Risk , Pre-MCI , Amnestic MCI , Multiple Domain MCI , and Major Cognitive Impairment . The inclusion of concomitant psychiatric symptoms and frailty criteria revealed two additional profiles: Psychiatric/Frail , without cognitive impairments, and Multiple Cognitive Domains/Psychiatric/Frail . Critically, 55% of those classified as Healthy based on cognitive data alone were reclassified. Significant profile-wise differences emerged across auxiliary variables of brief cognitive screening, sociodemographics, and medical and psychosocial risk. Conclusions Resu...