Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T13:17:52.070Z Has data issue: false hasContentIssue false
  • English
  • Français

Identification of Mild Cognitive Impairment in ACTIVE: Algorithmic Classification and Stability

Published online by Cambridge University Press:  25 October 2012

Sarah E. Cook ,
Michael Marsiske ,
Kelsey R. Thomas ,
Frederick W. Unverzagt ,
Virginia G. Wadley ,
Jessica B.S. Langbaum  and
Michael Crowe
Sarah E. Cook
Affiliation:
Department of Psychiatry, Duke University, Durham, North Carolina Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
Michael Marsiske*
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
Kelsey R. Thomas
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
Frederick W. Unverzagt
Affiliation:
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana
Virginia G. Wadley
Affiliation:
Department of Psychology, University of Alabama-Birmingham, Birmingham, Alabama
Jessica B.S. Langbaum
Affiliation:
Banner Alzheimer's Institute, Banner Health, Phoenix, Arizona
Michael Crowe
Affiliation:
Department of Psychology, University of Alabama-Birmingham, Birmingham, Alabama
*
Correspondence and reprint requests to: Michael Marsiske, Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, 32610-0165. E-mail: marsiske@ufl.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Rates of mild cognitive impairment (MCI) have varied substantially, depending on the criteria used and the samples surveyed. The present investigation used a psychometric algorithm for identifying MCI and its stability to determine if low cognitive functioning was related to poorer longitudinal outcomes. The Advanced Cognitive Training of Independent and Vital Elders (ACTIVE) study is a multi-site longitudinal investigation of long-term effects of cognitive training with older adults. ACTIVE exclusion criteria eliminated participants at highest risk for dementia (i.e., Mini-Mental State Examination < 23). Using composite normative for sample- and training-corrected psychometric data, 8.07% of the sample had amnestic impairment, while 25.09% had a non-amnestic impairment at baseline. Poorer baseline functional scores were observed in those with impairment at the first visit, including a higher rate of attrition, depressive symptoms, and self-reported physical functioning. Participants were then classified based upon the stability of their classification. Those who were stably impaired over the 5-year interval had the worst functional outcomes (e.g., Instrumental Activities of Daily Living performance), and inconsistency in classification over time also appeared to be associated increased risk. These findings suggest that there is prognostic value in assessing and tracking cognition to assist in identifying the critical baseline features associated with poorer outcomes. (JINS, 2012, 18, 1–15)

Keywords

Cognitive impairmentResearch classificationCognitive agingLongitudinal follow-up
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 19 , Issue 1 , January 2013 , pp. 73 - 87
Copyright
Copyright © The International Neuropsychological Society 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association. (1994) Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association Press.Google Scholar
Artero, S., Ancelin, M.-L., Portet, F., Dupuy, A., Berr, C., Dartigues, J.-F., Ritchie, K. (2008). Risk profiles for mild cognitive impairment and progression to dementia are gender specific. Journal of Neurology, Neurosurgery, & Psychiatry, 79(9), 979–984. doi:10.1136/jnnp.2007.136903CrossRefGoogle ScholarPubMed
Ball, K., Berch, D.B., Helmers, K.F., Jobe, J.B., Leveck, M.D., Marsiske, M., Willis, S.L. (2002). Effects of cognitive training interventions with older adults. Journal of the American Medical Association, 288, 2271–2281.CrossRefGoogle ScholarPubMed
Ball, K., Owsley, C. (1993). The Useful Field of View test: A new technique for evaluating age-related declines in visual functioning. Journal of the American Optometric Association, 64, 71–79.Google Scholar
Bickel, H., Mösch, E., Seigerschmidt, E., Siemen, M., Förstl, H. (2006). Prevalence and persistence of mild cognitive impairment among elderly patients in general hospitals. Dementia and Geriatric Cognitive Disorders, 2, 242–250.CrossRefGoogle Scholar
Blazer, D.G., Hays, J.C., Fillenbaum, G.G., Gold, D.T. (1997). Memory complaint as a predictor of cognitive decline. Journal of Aging and Health, 9, 171–184.CrossRefGoogle ScholarPubMed
Brandt, J. (1991). The Hopkins Verbal Learning Test: Development of a new memory test with six equivalent forms. The Clinical Neuropsychologist, 5, 125–142.CrossRefGoogle Scholar
Brooks, B.L., Iverson, G.L., Holdnack, J.A., Feldman, H.H. (2008). Potential for misclassification of mild cognitive impairment: A study of memory scores on the Wechsler Memory Scale-III in healthy older adults. Journal of the International Neuropsychological Society, 14(3), 463–478.CrossRefGoogle ScholarPubMed
Brooks, B.L., Iverson, G.L., White, T. (2007). Substantial risk of “accidential MCI” in healthy older adults: Base rates of low memory scores in neuropsychological assessment. Journal of the International Neuropsychological Society, 13, 490–500.CrossRefGoogle Scholar
Busse, A., Bischkopf, J., Riedel-Heller, S.G., Angermeyer, M.C. (2003). Mild cognitive impairment: Prevalence and incidence according to different diagnostic criteria: Results of the Leipzig Longitudinal Study of the Aged. British Journal of Psychiatry, 182, 449–454.CrossRefGoogle ScholarPubMed
Caracciolo, B., Gatz, M., Xu, W., Pedersen, N.L., Fratiglioni, L. (2012). Differential distribution of subjective and objective cognitive impairment in the population: A nation-wide twin-study. Journal of Alzheimer's Disease, 29(2), 393–403.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.Google Scholar
Cook, S.E., Marsiske, M. (2006). Subjective memory beliefs and cognitive performance in normal and mildly impaired older adults. Aging and Mental Health, 10, 413–423.CrossRefGoogle ScholarPubMed
Cooney, T.M., Schaie, K.W., Willis, S.L. (1988). The relationship between prior functioning on cognitive and personality dimensions and subject attrition in longitudinal research. Journal of Gerontology, 43, 12–17.CrossRefGoogle ScholarPubMed
Crowe, M., Andel, R., Wadley, V., Cook, S., Unverzagt, F., Marsiske, M., Ball, K. (2006). Subjective cognitive function and decline among older adults with psychometrically defined amnestic MCI. International Journal of Geriatric Psychiatry, 21, 1187–1192.CrossRefGoogle ScholarPubMed
DeJager, C., Blackwell, A.D., Budge, M.M., Sahakian, B.J. (2005). Predicting cognitive decline in healthy older adults. American Journal of Geriatric Psychiatry, 13, 735–740.CrossRefGoogle Scholar
Ebly, E.M., Hogan, D.B., Parhad, I.M. (1995). Cognitive impairment in the nondemented elderly: Results from the Canadian Study of Health and Aging. Archives of Neurology, 52, 612–619.CrossRefGoogle ScholarPubMed
Ekstrom, R.B., French, J.W., Harman, H., Derman, D. (1976). Kit of factor referenced cognitive tests- revised edition. Princeton, NJ: Educational Testing Services.Google Scholar
Feldman, H.H., Jacova, C. (2005). Mild cognitive impairment. American Journal of Geriatric Psychiatry, 13, 645–655.CrossRefGoogle ScholarPubMed
Fisk, J.D., Merry, H.R., Rockwood, K. (2003). Variations in case definition affect prevalence but not outcome of mild cognitive impairment. Neurology, 61, 1179–1184.CrossRefGoogle Scholar
Folstein, M.F., Folstein, S.E., McHugh, P.R. (1975). Mini-mental state: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Ganguli, M., Chang, C.C., Snitz, B.E., Saxton, J.A., Vanderbilt, J., Lee, C.W. (2010). Prevalence of mild cognitive impairment by multiple classifications: The Monongahela-Youghiogheny Healthy Aging Team (MYHAT) project. American Journal of Geriatric Psychiatry, 18, 674–683.CrossRefGoogle ScholarPubMed
Ganguli, M., Dodge, H.H., Shen, C., DeKosky, S.T. (2004). Mild cognitive impairment amnestic type: An epidemiologic study. Neurology, 63, 115–121.CrossRefGoogle ScholarPubMed
Gonda, J., Schaie, K.W. (1985). Schaie-Thurstone Mental Abilities Test: Word Series Test. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Goveas, J.S., Espeland, M.A., Woods, N.F., Wassertheil-Smoller, S., Kotchen, J.M. (2011). Depressive symptoms and incidence of mild cognitive impairment and probable dementia in elderly women: The Women's Health Initiative Memory Study. Journal of the American Geriatrics Society, 59, 57–66.CrossRefGoogle ScholarPubMed
Graham, J.E., Rockwood, K., Beattie, B.L. (1997). Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet, 349, 1793–1796.CrossRefGoogle Scholar
Jak, A.J., Bondi, M.W., Delano-Wood, L., Wierenga, C., Corey-Bloom, J., Salmon, D.P., Delis, D.C. (2009). Quantification of five neuropsychological approaches to defining mild cognitive impairment. American Journal of Geriatric Psychiatry, 17, 368–375.CrossRefGoogle ScholarPubMed
Jak, A.J., Bangen, K.J., Wierenga, C.E., Delano-Wood, L., Corey-Bloom, J., Bondi, M.W. (2009). Contributions of neuropsychology and neuroimaging to understanding clinical subtypes of mild cognitive impairment. International Review of Neurobiology, 84, 81–103.CrossRefGoogle ScholarPubMed
Jorm, A.F., Christensen, H., Korten, A.E., Henderson, A.S., Jacomb, P.A., Mackinnon, A. (1997). Do cognitive complaints either predict future cognitive decline or reflect past cognitive decline? A longitudinal study of an elderly community sample. Psychological Medicine, 27, 91–98.CrossRefGoogle ScholarPubMed
Larrieu, S., Letenneur, L., Orgogozo, J.M., Fabrigoule, C., Amieva, H., Le Carret, N., Dartigues, J.F. (2002). Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology, 59, 1594–1599.CrossRefGoogle Scholar
Manly, J.J., Bell-McGinty, S., Tang, M.X., Schupf, N., Stern, Y., Mayeux, R. (2005). Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community. Archives of Neurology, 62, 1739–1746.CrossRefGoogle Scholar
Manly, J.J., Tang, M.X., Schupf, N., Stern, Y., Vonsattel, J.G., Mayeux, R. (2008). Frequency and course of mild cognitive impairment in a multiethnic community. Annals of Neurology, 63, 494–506.CrossRefGoogle Scholar
Marsiske, M., Margrett, J.A. (2006). Everyday problem solving and decision making. In J.E. Birren & K.W. Schaie (Eds.), Handbook of the psychology of aging (pp. 315–342). New York: Academic Press.CrossRefGoogle Scholar
Morris, J.N., Fries, B.E., Steel, K., Ikegami, N., Bernabei, R., Carpenter, G.I., Topinkova, E. (1997). Comprehensive clinical assessment in community setting: Applicability of the MDS-HC. Journal of the American Geriatrics Society, 45, 1017–1024.CrossRefGoogle ScholarPubMed
Palmer, K., Backman, L., Winblad, B., Fratiglioni, L. (2003). Detection of Alzheimer's disease and dementia in the preclinical phase: Population based cohort study. British Medical Journal, 326, 245–249.CrossRefGoogle ScholarPubMed
Panza, F., D'Introno, A., Colaciccio, A.M., Capurso, C., Del Parigi, A., Caselli, R.J., Solfrizzi, V. (2005). Current epidemiology of mild cognitive impairment and other predementia syndromes. American Journal of Geriatric Psychiatry, 13, 633–644.CrossRefGoogle ScholarPubMed
Panza, F., Frisardi, V., Capurso, C., D'Introno, A., Colacicco, A.M., Solfrizzi, V. (2010). Late-life depression, mild cognitive impairment, and dementia: Possible continuum? American Journal of Geriatric Psychiatry, 18, 98–116.CrossRefGoogle ScholarPubMed
Petersen, R.C. (1995). Normal aging, mild cognitive impairment, and early Alzheimer's disease. Neurologist, 1, 326–344.Google Scholar
Petersen, R.C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.CrossRefGoogle ScholarPubMed
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., Kokmen, E. (1999). Mild cognitive impairment: Clinical characterization and outcome. Archives of Neurology, 56, 303–308.CrossRefGoogle ScholarPubMed
Plassman, B.L., Langa, K.M., Fisher, G.G., Heeringa, S.G., Weir, D.R., Ofstedal, M.B, Wallace, R.B (2008). Prevalence of cognitive impairment without dementia in the United States. Annals of Internal Medicine, 148, 427–434.CrossRefGoogle ScholarPubMed
Radloff, L.S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Rey, A. (1941). L'examen psychologique dans les cas d'encephalopathie tramatique. Archives de Psychologie, 28, 21.Google Scholar
Ritchie, K., Artero, S., Touchon, J. (2001). Classification criteria for mild cognitive impairment: A population-based validation study. Neurology, 56, 37–42.CrossRefGoogle ScholarPubMed
Storandt, M., Grant, E.A., Miller, J.P., Morris, J.C. (2002). Rates of progression in mild cognitive impairment and early Alzheimer's disease. Neurology, 59(7), 1034–1041.CrossRefGoogle ScholarPubMed
Tuokko, H.A., McDowell, I. (2006). An overview of mild cognitive impairment. In H.A. Tuokko & D.F. Hultsch, (Eds.), Mild cognitive impairment: International perspectives (pp. 3–28). New York: Taylor and Francis.Google Scholar
Unverzagt, F.W., Gao, S., Baiyewu, O., Ogunniyi, A.O., Gureje, O., Perkins, A., Hendrie, H.C. (2001). Prevalence of cognitive impairment: Data from the Indianapolis Study of Health and Aging. Neurology, 57, 1655–1662.CrossRefGoogle ScholarPubMed
Unverzagt, F.W., Guey, L.T., Jones, R.N., Marsiske, M., King, J., Wadley, V., Tennstedt, S.L. (2012). ACTIVE Cognitive training and rates of incident dementia. Journal of the International Neuropsychological Society, 18, 1–9.CrossRefGoogle ScholarPubMed
Unverzagt, F.W., Ogunniyi, A., Taler, V., Gao, S., Lane, K.A., Baiyewu, O., Hall, K.S. (2011). Incidence and risk factors for cognitive impairment no dementia and mild cognitive impairment in African Americans. Alzheimer Disease and Associated Disorders, 25, 4–10.CrossRefGoogle ScholarPubMed
U.S. Census Bureau. (2000). Census 2000, Summary File 1; generated by Michael Marsiske; using American FactFinder. Retrieved from http://factfinder.census.govGoogle Scholar
Wadley, V.G., Crowe, M., Marsiske, M., Cook, S.E., Unverzagt, F.W., Rosenberg, A.L., Rexroth, D. (2007). Changes in everyday function among individuals with psychometrically defined mild cognitive impairment in the Advanced Cognitive Training for Independent and Vital Elderly Study. Journal of the American Geriatrics Society, 55, 1192–1198.CrossRefGoogle ScholarPubMed
Ware, J.E., Sherbourne, C.D. (1992). The MOS 36-Item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30, 473–483.CrossRefGoogle ScholarPubMed
Wechsler, D. (1981). Manual for the Wechsler Adult Intelligence Scale—Revised. New York: The Psychological Corporation.Google Scholar
Willis, S.L., Marsiske, M. (1993). Manual for the Everyday Problems Test. University Park, PA: Pennsylvania State University.Google Scholar
Willis, S.L., Tennstedt, S.L., Marsiske, M., Ball, K., Elias, J., Mann Koepke, K., Wright, E. (2006). Long-term effects of cognitive training on everyday functional outcomes in older adults. Journal of the American Medical Association, 296, 2805–2814.CrossRefGoogle ScholarPubMed
Wilson, B., Cockburn, J., Baddeley, A. (1985). The Rivermead Behavioural Memory Test. Bury St. Edmunds, England: Thames Valley Test Company.Google Scholar
Winblad, B., Palmer, K., Kivipelto, M., Jelic, V., Fratiglioni, L., Wahlund, L.O., Petersen, R.C. (2004). Mild cognitive impairment- beyond controversies, towards a consensus: Report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.CrossRefGoogle Scholar