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Ronald C Petersen - One of the best experts on this subject based on the ideXlab platform.
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Mild Cognitive Impairment in Geriatrics.
Clinics in geriatric medicine, 2018Co-Authors: Eric G. Tangalos, Ronald C PetersenAbstract:Mild Cognitive Impairment remains a clinical diagnosis, aided by history, neurologic examination, screening mental status examination, and secondary testing. It can be difficult to distinguish from normal aging without understanding a patient's prior level of intellectual function and new complaint. Geriatricians encounter patients with Mild Cognitive Impairment in all long-term care settings. Making the diagnosis allows patients and their families to understand limits and develop strategies to maximize function. Etiologies associated with Mild Cognitive Impairment include degenerative and vascular processes, psychiatric causes, and comorbid medical conditions. Treatable medical conditions may also present as Mild Cognitive Impairment and have reversible outcomes.
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Mild Cognitive Impairment and Risk of Critical Illness.
Critical care medicine, 2016Co-Authors: D. Alex Teeters, Teng Moua, Rahul Kashyap, Michelle Biehl, Rupinder Kaur, Ognjen Gajic, Bradley F. Boeve, Erik K. St. Louis, Ronald C PetersenAbstract:Objectives Approximately half of ICU admissions are comprised of patients older than 65 years old. Mild Cognitive Impairment is a common disorder affecting 10-20% of patients in the same age group. A need exists for exploring Mild Cognitive Impairment and risk of critical illness. As Mild Cognitive Impairment may be a contributor to poorer overall health or be a result of it, we sought to determine whether the presence of Mild Cognitive Impairment independently increases the risk of critical illness admissions. Design Data from the Mayo Clinic Study of Aging were analyzed. All study participants underwent prospective comprehensive Cognitive testing and expert panel consensus diagnosis of both Cognitive function and clinical state at baseline and subsequent visits. Comparisons were made between those with normal Cognitive function and Mild Cognitive Impairment regarding baseline health and frequency of critical illness. Setting Single-center population-based cohort out of Olmsted County, MN. Participants All individuals 70-89 years old were screened for prospective enrollment in the Mayo Clinic Study of Aging. Patients with preexisting dementia and ICU admission within 3 years of entry to the study were excluded from this analysis. Interventions None. Measurements and main results Of 2,425 patients analyzed from the Mayo Clinic Study of Aging, 1,734 patients (71%) were included in the current study. Clinical factors associated with baseline Mild Cognitive Impairment included age, male gender, stroke, and poorer health self-rating. Using a Cox regression model adjusting for these and a priori variables of baseline health, the presence of Mild Cognitive Impairment remained a significant predictor of ICU admission (hazard ratio, 1.50 [1.15-1.96]; p = 0.003). Conclusions and relevance The presence of Mild Cognitive Impairment is independently associated with increased critical illness admission. Further prospective studies are needed to analyze the impact of critical illness on Cognitive function.
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Mild Cognitive Impairment and Mild Dementia: A Clinical Perspective
Mayo Clinic proceedings, 2014Co-Authors: David S. Knopman, Ronald C PetersenAbstract:Mild Cognitive Impairment and Mild dementia are common problems in the elderly. Primary care physicians are the first point of contact for most patients with these disorders and should be familiar with their diagnosis, prognosis, and management. Both Mild Cognitive Impairment and Mild dementia are characterized by objective evidence of Cognitive Impairment. The main distinctions between Mild Cognitive Impairment and Mild dementia are that in the latter, more than one Cognitive domain is invariably involved and substantial interference with daily life is evident. The diagnosis of Mild Cognitive Impairment and Mild dementia is based mainly on the history and Cognitive examination. The prognosis for Mild Cognitive Impairment and Mild dementia is an important motivation for diagnosis because in both, there is a heightened risk for further Cognitive decline. The etiology of Mild Cognitive Impairment and Mild dementia can often be established through the clinical examination, although imaging and other laboratory tests may also contribute. Although Alzheimer disease is the most common cause of both, cerebrovascular disease and Lewy body disease make important contributions. Pharmacological treatments are of modest value in Mild dementia due to Alzheimer disease, and there are no approved pharmacological treatments for Mild Cognitive Impairment of any etiology. Nonetheless, new-onset Cognitive Impairment is a worrisome symptom to patients and families that demands answers and advice. If a patient is having difficulties managing medications, finances, or transportation independently, diagnosis and intervention are necessary to ensure the health and safety of the patient.
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Mild Cognitive Impairment: ten years later.
Archives of neurology, 2009Co-Authors: Ronald C Petersen, Bradley F. Boeve, David S. Knopman, Rosebud O. Roberts, Yonas E. Geda, Robert J. Ivnik, Glenn E. Smith, Clifford R. JackAbstract:In the past 10 years, there has been a virtual explosion in the literature concerning the construct of Mild Cognitive Impairment. The interest in this topic demonstrates the increasing emphasis on the identification of the earliest features of Cognitive disorders such as Alzheimer disease and other dementias. Mild Cognitive Impairment represents the earliest clinical features of these conditions and, hence, has become a focus of clinical, epidemiologic, neuroimaging, biomarker, neuropathological, disease mechanism, and clinical trials research. This review summarizes the progress that has been made while also recognizing the challenges that remain.
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Mild Cognitive Impairment.
Handbook of clinical neurology, 2008Co-Authors: Andrew R. Frank, Ronald C PetersenAbstract:Publisher Summary This chapter describes Mild Cognitive Impairment (MCI) as a degree of Cognitive Impairment, which is abnormal for a given individual, and yet is insufficient to warrant a diagnosis of dementia. The chapter explains that the diagnosis of MCI requires only a subjective complaint of Cognitive deterioration and some objective evidence of Cognitive Impairment on standardized neuroCognitive testing. MCI has been included in the American academy of neurology practice parameters as a clinical entity worthy of recognition, in that it carries increased risk of symptom progression to dementia, and gives patients and physicians better insight into the presence or absence of underlying disease. The chapter identifies patients who may be most benefited by therapeutics aimed at slowing the biochemical processes that give rise to neurodegeneration. If such therapeutics is shown to be effective, the diagnosis of Mild Cognitive Impairment stands to become one of the most vital to both individuals and to society at large.
David A Bennett - One of the best experts on this subject based on the ideXlab platform.
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Mild Cognitive Impairment
The Lancet, 2006Co-Authors: Serge Gauthier, Barry Reisberg, Michael Zaudig, Ronald C Petersen, Karen Ritchie, Karl Broich, Sylvie Belleville, Henry Brodaty, David A Bennett, Howard ChertkowAbstract:Mild Cognitive Impairment is a syndrome defined as Cognitive decline greater than expected for an individual's age and education level but that does not interfere notably with activities of daily life. Prevalence in population-based epidemiological studies ranges from 3% to 19% in adults older than 65 years. Some people with Mild Cognitive Impairment seem to remain stable or return to normal over time, but more than half progress to dementia within 5 years. Mild Cognitive Impairment can thus be regarded as a risk state for dementia, and its identification could lead to secondary prevention by controlling risk factors such as systolic hypertension. The amnestic subtype of Mild Cognitive Impairment has a high risk of progression to Alzheimer's disease, and it could constitute a prodromal stage of this disorder. Other definitions and subtypes of Mild Cognitive Impairment need to be studied as potential prodromes of Alzheimer's disease and other types of dementia.
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Update on Mild Cognitive Impairment.
Current neurology and neuroscience reports, 2003Co-Authors: David A BennettAbstract:Mild Cognitive Impairment (MCI) refers to persons whose memory or other Cognitive abilities are not normal, but who do not have clinically diagnosed dementia. MCI has received considerable attention in the medical literature over the past few years. There were 63 original reports in the English language literature with the term "Mild Cognitive Impairment" in the title in 2001 and 2002, in contrast to only 26 articles in the prior decade. Although criteria for MCI are not a matter of secure agreement, a consensus is emerging that MCI is common, is associated with significant mortality and morbidity, particularly the development of AD, and is due, in large part, to the same pathologic processes responsible for Alzheimer’s disease (AD). Current research efforts are geared towards understanding factors that contribute to the development of dementia among persons with MCI and towards intervention studies aimed at preventing the development of dementia among persons with MCI.
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Natural history of Mild Cognitive Impairment in older persons.
Neurology, 2002Co-Authors: David A Bennett, R. S. Wilson, Julie A. Schneider, Denis A. Evans, Laurel A. Beckett, Neelum T. Aggarwal, Lisa L. Barnes, Jacob H. Fox, Julie BachAbstract:Background: Cognitive abilities of older persons range from normal, to Mild Cognitive Impairment, to dementia. Few large longitudinal studies have compared the natural history of Mild Cognitive Impairment with similar persons without Cognitive Impairment. Methods: Participants were older Catholic clergy without dementia, 211 with Mild Cognitive Impairment and 587 without Cognitive Impairment, who underwent annual clinical evaluation for AD and an assessment of different Cognitive abilities. Cognitive performance tests were summarized to yield a composite measure of global Cognitive function and separate summary measures of episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability. The authors compared the risk of death, risk of incident AD, and rates of change in global cognition and different Cognitive domains among persons with Mild Cognitive Impairment to those without Cognitive Impairment. All models controlled for age, sex, and education. Results: On average, persons with Mild Cognitive Impairment had significantly lower scores at baseline in all Cognitive domains. Over an average of 4.5 years of follow-up, 30% of persons with Mild Cognitive Impairment died, a rate 1.7 times higher than those without Cognitive Impairment (95% CI, 1.2 to 2.5). In addition, 64 (34%) persons with Mild Cognitive Impairment developed AD, a rate 3.1 times higher than those without Cognitive Impairment (95% CI, 2.1 to 4.5). Finally, persons with Mild Cognitive Impairment declined significantly faster on measures of episodic memory, semantic memory, and perceptual speed, but not on measures of working memory or visuospatial ability, as compared with persons without Cognitive Impairment. Conclusions: Mild Cognitive Impairment is associated with an increased risk of death and incident AD, and a greater rate of decline in selected Cognitive abilities.
Alexandros N. Vgontzas - One of the best experts on this subject based on the ideXlab platform.
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The impact of Mild Cognitive Impairment on the self-regulation process: A comparison study of persons with Mild Cognitive Impairment and Cognitively healthy older adults:
Journal of health psychology, 2016Co-Authors: Evangelos C. Karademas, Panagiotis G. Simos, Ioannis Zaganas, Sofia Tziraki, Simeon Panagiotakis, Maria Basta, Alexandros N. VgontzasAbstract:This study examined whether Mild Cognitive Impairment affects the associations between personal expectations (i.e. optimism and self-efficacy), illness-related coping, and quality of life. In total, two groups of older adults participated: 127 persons diagnosed with Mild Cognitive Impairment and 225 Cognitively healthy older persons (Cognitively non-impaired group). Several significant relationships observed in the Cognitively non-impaired group did not reach significance among Mild Cognitive Impairment patients, with the opposite trend noted for others (e.g. between palliative coping and physical health). These findings indicate that Mild Cognitive Impairment may lead to problems in the self-regulation process and highlight the significance of the interplay between neuroCognitive and psychosocial aspects of self-regulation.
Rimona S. Weil - One of the best experts on this subject based on the ideXlab platform.
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Mild Cognitive Impairment in Parkinson's Disease-What Is It?
Current neurology and neuroscience reports, 2018Co-Authors: Rimona S. Weil, Alyssa A. Costantini, Anette SchragAbstract:Purpose of Review Mild Cognitive Impairment is a common feature of Parkinson’s disease, even at the earliest disease stages, but there is variation in the nature and severity of Cognitive involvement and in the risk of conversion to Parkinson’s disease dementia. This review aims to summarise current understanding of Mild Cognitive Impairment in Parkinson’s disease. We consider the presentation, rate of conversion to dementia, underlying pathophysiology and potential biomarkers of Mild Cognitive Impairment in Parkinson’s disease. Finally, we discuss challenges and controversies of Mild Cognitive Impairment in Parkinson’s disease.
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Mild Cognitive Impairment in Parkinson’s Disease—What Is It?
Current Neurology and Neuroscience Reports, 2018Co-Authors: Rimona S. Weil, Alyssa A. Costantini, Anette E. SchragAbstract:Purpose of Review Mild Cognitive Impairment is a common feature of Parkinson’s disease, even at the earliest disease stages, but there is variation in the nature and severity of Cognitive involvement and in the risk of conversion to Parkinson’s disease dementia. This review aims to summarise current understanding of Mild Cognitive Impairment in Parkinson’s disease. We consider the presentation, rate of conversion to dementia, underlying pathophysiology and potential biomarkers of Mild Cognitive Impairment in Parkinson’s disease. Finally, we discuss challenges and controversies of Mild Cognitive Impairment in Parkinson’s disease. Recent Findings Large-scale longitudinal studies have shown that Cognitive involvement is important and common in Parkinson’s disease and can present early in the disease course. Recent criteria for Mild Cognitive Impairment in Parkinson’s provide the basis for further study of Cognitive decline and for the progression of different Cognitive phenotypes and risk of conversion to dementia. Summary Improved understanding of the underlying pathology and progression of Cognitive change are likely to lead to opportunities for early intervention for this important aspect of Parkinson’s disease.
Steven T. Dekosky - One of the best experts on this subject based on the ideXlab platform.
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Making Sense of Mild Cognitive Impairment: A Qualitative Exploration of the Patient's Experience
The Gerontologist, 2006Co-Authors: Jennifer H. Lingler, Marcie C. Nightingale, Judith A. Erlen, April L. Kane, Charles F. Reynolds, Richard Schulz, Steven T. DekoskyAbstract:Purpose: The proposed dementia precursor state of Mild Cognitive Impairment is emerging as a primary target of aging research. Yet, little is known about the subjective experience of living with a diagnosis of Mild Cognitive Impairment. This study examines, from the patient’s perspective, the experience of living with and making sense of the diagnosis. Design and Methods: We recruited 12 older adults with amnestic or nonamnestic Mild Cognitive Impairment from a university-based memory disorders clinic. We conducted in-home, semistructured interviews in order to elicit rich descriptions of the personal experience of having Mild Cognitive Impairment. We used the qualitative method of grounded theory to analyze narrative data. Results: Understanding and coming to terms with the syndrome, or assigning meaning, constituted a fundamental aspect of living with a diagnosis of Mild Cognitive Impairment. This process comprised interrelated emotional and Cognitive dimensions. Participants employed a range of positive, neutral, and negative phrasing in order to depict their emotional reactions to receiving a diagnosis. Cognitive representations of Mild Cognitive Impairment included both prognosis-focused and face-value appraisals. Expectations of normal aging, personal experience with dementia, and concurrent health problems were key contextual factors that provided the backdrop against which participants assigned meaning to a diagnosis of Mild Cognitive Impairment. Implications: Clinicians who disclose diagnoses of Mild Cognitive Impairment need to be mindful of the potential for varying interpretations of
