Mild cognitive impairment: cognitive screening or neuropsychological assessment?
OBJECTIVE
To describe the neuropsychological profile of mild cognitive impairment subtypes (amnestic, non-amnestic and multiple-domain) of a clinical sample. We further address the diagnostic properties of the Mini-Mental State Examination and the Cambridge Cognitive Examination for the identification of the different mild cognitive impairment subtypes in clinical practice.


METHODS
Cross-sectional clinical and neuropsychological evaluation of 249 elderly patients attending a memory clinic at a university hospital in Sao Paulo, Brazil.


RESULTS
The performance of patients with mild cognitive impairment was heterogeneous across the different subtests of the neuropsychological battery, with a trend towards an overall worse performance for amnestic (particularly multiple domain) mild cognitive impairment as compared to non-amnestic subtypes. Screening tests for dementia (Mini-Mental State Examination and Cambridge Cognitive Examination) adequately discriminated cases of mild Alzheimer's disease from controls, but they were not accurate to discriminate patients with mild cognitive impairment (all subtypes) from control subjects.


CONCLUSIONS
The discrimination of mild cognitive impairment subtypes was possible only with the aid of a comprehensive neuropsychological assessment. It is necessary to develop new strategies for mild cognitive impairment screening in clinical practice.
Diniz
Breno Satler
BS
Psychogeriatric Clinic and Laboratory of Neuroscience (LIM 27), Department and Institute of Psychiatry, School of Medicine, Universidade de São Paulo, São Paulo, SP, Brazil. breno_satler@uol.com.br
Nunes
Paula Villela
PV
Yassuda
Monica S
MS
Pereira
Fernanda S
FS
Flaks
Mariana K
MK
Viola
Luciane F
LF
Radanovic
Marcia
M
Abreu
Izabella Dutra de
ID
Borelli
Danilo T
DT
Gattaz
Wagner F
WF
Forlenza
Orestes Vicente
OV
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D000647:Amnesia / Q000175:diagnosis*; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D015203:Reproducibility of Results