title: The outcome of elderly patients with cognitive complaints but normal neuropsychological tests.
abstract: Elderly patients may present with prominent cognitive complaints and have performances in neuropsychological tests within the normal range for the age and education, and thus do not fulfill the criteria for mild cognitive impairment (MCI). There is insufficient evidence to support the clinical decision in these cases ("pre-MCI"). Forty-three subjects, 11 controls, 15 "pre-MCI," and 17 MCI, were followed for about three and half years with neuropsychological testing and magnetic resonance imaging including volumetric measurements of the hippocampus and amygdala. Two of the "pre-MCI" subjects suffered cognitive and functional deterioration and were diagnosed with dementia. Although the "pre-MCI" subjects as a group had no significant deterioration in neuropsychological tests, they suffered a decline in the total hippocampal volume (P=0.04) along the follow-up time. In contrast, all control subjects remained stable and had no volumetric decreases. As expected, MCI patients underwent significant deterioration in several neuropsychological tests, often progressed to Alzheimer's disease, and showed decreases both in total hippocampal and amygdalar volumes. Elderly people presenting with cognitive complaints may be in an initial phase of a degenerative disorder and should be followed clinically, even if they have normal neuropsychological tests.
authors.affiliation: Magnetic Resonance Centre of Caselas, Lisbon, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Nunes
authors.forename: Isabel
authors.initials: I
authors.lastname: Fragata
authors.forename: Filipa
authors.initials: F
authors.lastname: Ribeiro
authors.forename: Teresa
authors.initials: T
authors.lastname: Palma
authors.forename: João
authors.initials: J
authors.lastname: Maroco
authors.forename: Jorge
authors.initials: J
authors.lastname: Cannas
authors.forename: Mário
authors.initials: M
authors.lastname: Secca
authors.forename: Cristina
authors.initials: C
authors.lastname: Menezes
authors.forename: Isabel
authors.initials: I
authors.lastname: Carmo
authors.forename: Gil
authors.initials: G
authors.lastname: Cunha
authors.forename: Miguel
authors.initials: M
authors.lastname: Castelo Branco
authors.forename: Manuela
authors.initials: M
authors.lastname: Guerreiro
authors.forename: Alexandre
authors.initials: A
authors.lastname: de Mendonça
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology*; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests