Cognitive Impairment in Older Adults Without Dementia: Clinical and Pathologic Outcomes in a Community-Based Sample

• Published in: Journal of geriatric psychiatry and neurology Vol. 22; no. 4; pp. 256 - 265
• Main Authors: Wang, Lucy Y., Leverenz, James B., Larson, Eric B., Vavrek, Darcy A., Kukull, Walter A., McCormick, Wayne, Bowen, James D., Teri, Linda, Montine, Thomas, Tsuang, Debby W.
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01-12-2009; Sage Publications
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer Disease - pathology; Biological and medical sciences; Brain - pathology; Cognition Disorders - diagnosis; Cognition Disorders - pathology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Dementia - diagnosis; Dementia - pathology; Disease Progression; Female; Fundamental and applied biological sciences. Psychology; Geriatrics; Humans; Male; Medical sciences; Neurology; Neuropsychological Tests; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries; Vertebrates: nervous system and sense organs; dementia; mild cognitive impairment; autopsy; neuropathology; Human; Prognosis; Cognitive disorder; Central nervous system; Neurology; Anatomic pathology; Gerontology; Autopsy; Evolution; Degenerative disease; Elderly; Psychiatry; Community; Dementia; Geriatrics
• ISSN: 0891-9887; 1552-5708
• DOI: 10.1177/0891988709335796

This study examines clinical and neuropathologic characteristics of 37 participants in a community-based dementia series who had cognitive complaints at enrollment but did not meet dementia criteria. Participants had neuropsychological testing, were followed until death, and underwent autopsy. Twenty-four participants progressed to dementia, and their baseline characteristics were analyzed. Of the 24, 13 met criteria for neuropathologic Alzheimer disease (AD). The 13 participants who progressed to neuropathologic AD (mean intake age 78.5 ± 7.7, mean enrollment 6.4 ± 2.1 years) performed worse than the 11 who progressed to neuropathologic non-AD dementias (mean intake age 79.0 ± 6.0, mean enrollment 6.0 ± 3.2 years) on baseline Wechsler Memory Scale (WMS) delayed logical memory (3.4 ± 2.9 vs 6.3 ± 3.9, P = .05) and delayed visual reproduction (1.4 ± 2.1 vs 3.1 ± 2.7, P = .02). These observations are consistent with the view that nondemented patients with underlying AD may be more likely to present with memory than nonmemory cognitive impairment.