Heterogeneity of the mild cognitive impairment syndrome (specialized outpatient service data analysis)

Abstract

Timely diagnosis and optimal management of patients with cognitive impairment (CI) without dementia can potentially reduce the risk of their progression to dementia. In our study, we assessed the features of mild CI (MCI) syndrome in patients with neurological disorders based on the specialized outpatient service data analysis.Objective: to analyze clinical, neuropsychological, and neuroimaging characteristics of MCI syndrome in the Russian population in real clinical practice.Patients and methods. We enrolled 515 patients (209 men and 306 women, mean age – 71.2±8.0 years) with memory and/or other cognitive complaints. Seventy healthy volunteers (25 men and 45 women, mean age – 69.5±5.71 years) without cognitive complaints and central nervous system or mental disorders were enrolled in the control group. DSM-V diagnostic criteria for mild neurocognitive disorder were used. Participants underwent comprehensive neuropsychological testing with a qualitative and quantitative assessment of the results. In some of them (29.13%), brain magnetic resonance imaging (MRI) was performed.Results and discussion. The following types of MCI were identified in study participants: monofunctional non-amnestic type (MFNAT) – 1.2%, monofunctional amnestic type (MFAT) – 12.6%, polyfunctional amnestic type (PFAT) – 22.9%, polyfunctional non-amnestic type (PFNAT) – 63.3%. We found a higher prevalence of executive dysfunction and attention deficit in PFNAT, and executive dysfunction, attention deficit, and memory decline in PFAT. Cardiovascular risk factors and signs of vascular leukoencephalopathy on MRI were more frequently observed in PFNAT and PFAT.Conclusion. The clinical and neuropsychological analysis allows us to assume the pathophysiology of CI before the development of dementia. In the Russian population, cerebrovascular insufficiency plays a significant role in the development of MCI syndrome.