title: Course and etiology of dysexecutive MCI in a community sample.
abstract: BACKGROUND
  Amnestic mild cognitive impairment (aMCI) is associated with an elevated risk of progressing to Alzheimer's disease. Much less is known about the course of dysexecutive mild cognitive impairment (dMCI). The goals of this study were to determine how the profile of cognitive deficits differs over time between patients with dMCI and aMCI, and control subjects; if the type of dementia differs between dMCI and aMCI in patients who progress to dementia; and if dMCI is more associated with stroke and white matter hyperintensity on magnetic resonance imaging (MRI) than aMCI.
  
  
  METHODS
  The authors undertook a prospective evaluation of an inception cohort of 1167 ethnically diverse elders recruited from an urban community-based sample monitored with clinical and neuropsychological testing for an average of 4.5 years (standard deviation, 0.8 year). A subset of the subjects underwent MRI. We compared four groups of MCI patients: single-domain amnestic and dysexecutive MCI, and multiple-domain MCI with and without executive dysfunction.
  
  
  RESULTS
  Compared with aMCI, dMCI was less likely to involve other areas of cognition over time and progress to dementia. None of the 33 single-domain dMCI patients progressed to dementia. The presence of executive dysfunction in multiple-domain MCI did not increase risk of progression to dementia. Patients with multiple-domain MCI with executive dysfunction who progressed to dementia were less likely to have an Alzheimer's-type dementia than MCI patients without executive dysfunction. Patients with dMCI were more likely to experience stroke, but not white matter hyperintensity, detected via MRI than patients with aMCI.
  
  
  CONCLUSIONS
  dMCI appears to follow a different course, and is less associated with Alzheimer's disease and more associated with stroke than aMCI.
authors: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA; Division of Geriatric Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Electronic address: edh2126@columbia.edu.
authors: Edward D
authors: ED
authors: Huey
authors: Jennifer J
authors: JJ
authors: Manly
authors: Ming-X
authors: MX
authors: Tang
authors: Nicole
authors: N
authors: Schupf
authors: Adam M
authors: AM
authors: Brickman
authors: Masood
authors: M
authors: Manoochehri
authors: Jesse
authors: J
authors: Mez
authors: Charles
authors: C
authors: DeCarli
authors: Davangere P
authors: DP
authors: Devanand
authors: Richard
authors: R
authors: Mayeux
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D003704:Dementia / Q000503:physiopathology; D018450:Disease Progression; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D012111:Residence Characteristics; D016019:Survival Analysis; D013997:Time Factors
keywords: Dementia; Executive function; MRI; Mild cognitive impairment