Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild Cognitive Impairment Group.

BACKGROUND: There is insufficient available information on behavioral changes in the absence of cognitive impairment as factors increasing the risk of conversion to dementia. OBJECTIVE: To observe and analyze patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a psychiatry group (PG) to compare the risk of progression to dementia. METHODS: From 677 initially assessed ≥60-year-old patients, a series of 348 patients was studied for a five-year period until censoring or conversion to dementia: 96 with MBI, 87 with MCI, and 165 with general psychiatry disorders, including 4 subgroups: Anxiety, Depression, Psychosis and Others. All patients were assessed with clinical, psychiatric, neurological, neuropsychological, and neuroimaging studies. RESULTS: From 348 patients, 126 evolved to dementia (36.2%). Conversion was significantly higher in MBI (71.5%), followed by the MCI-MBI overlap (59.6%) and MCI (37.8%) groups, compared to PG (13.9%) (Log-rank p < 0.001). MCI patients mostly converted to Alzheimer's dementia, while MBI converted to frontotemporal dementia and Lewy body dementia. Patients in PG converted to Lewy body dementia and frontotemporal dementia. CONCLUSION: Conversion to dementia is significantly higher in patients with neuropsychiatric symptoms. The MBI concept generates a new milestone in the refining of diagnosis of neurodegenerative diseases and the possibility of creating neuropsychiatric profiles. Its earlier identification will allow new possibilities for therapeutic intervention.

Subclinical naming errors in mild cognitive impairment: A semantic deficit?

Mild cognitive impairment (MCI) is the transitional stage between normal aging and Alzheimer's disease (AD). Impairments in semantic memory have been demonstrated to be a critical factor in early AD. The Boston Naming Test (BNT) is a straightforward method of examining semantic or visuo-perceptual processing and therefore represents a potential diagnostic tool. The objective of this study was to examine naming ability and identify error types in patients with amnestic mild cognitive impairment (aMCI). METHODS: Twenty aMCI patients, twenty AD patients and twenty-one normal controls, matched by age, sex and education level were evaluated. As part of a further neuropsychological evaluation, all subjects performed the BNT. A comprehensive classification of error types was devised in order to compare performance and ascertain semantic or perceptual origin of errors. RESULTS: AD patients obtained significantly lower total scores on the BNT than aMCI patients and controls. aMCI patients did not obtain significant differences in total scores, but showed significantly higher semantic errors compared to controls. CONCLUSION: This study reveals that semantic processing is impaired during confrontation naming in aMCI.

Comprometimento cognitivo leve (CCL) é um estágio de transição entre o envelhecimento normal e a doença de Alzheimer (DA). Comprometimento da memória semântica tem sido demonstrado como um fator crítico na DA precoce. O Teste de Nomeação de Boston (TNB) é um meio fácil para examinar o processamento semântico e viso-espacial e também um instrumento potencial de diagnóstico. OBJETIVO: Examinar a habilidade de nomeação e discriminar os tipos de erros em pacientes com CCL amnéstico (CCLa). MÉTODOS: Vinte pacientes com CCLa, 20 pacientes com DA e 21 controles normais pareados por idade, sexo e nível educacional foram avaliados. Como parte da avaliação neuropsicológica a todos foi administrado o TNB. Uma ampla classificação dos tipos de erros foi realizada a fim de comparar o desempenho e conhecer a origem semântica ou perceptiva dos erros. RESULTADOS: Os pacientes com DA obtiveram piores escores totais no TNB do que os pacientes com CCLa e controles. Os pacientes com CCLa não tiveram diferenças significativas nos escores totais, porém, mostraram um número maior e significativo de erros semânticos comparados aos controles. CONCLUSÃO: Este estudo revela que o processamento semântico está comprometido durante a nomeação por confrontação no CCLa.