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Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment

Published online by Cambridge University Press:  01 November 2009

AMY J. JAK ,
STEPHANIE URBAN ,
ASHLEY McCAULEY ,
KATHERINE J. BANGEN ,
LISA DELANO-WOOD ,
JODY COREY-BLOOM  and
MARK W. BONDI
AMY J. JAK*
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
STEPHANIE URBAN
Affiliation:
Ohio University College of Osteopathic Medicine, Athens, Ohio
ASHLEY McCAULEY
Affiliation:
Veterans Medical Research Foundation, San Diego, California
KATHERINE J. BANGEN
Affiliation:
University of California, San Diego/San Diego State University Joint Doctoral Program, San Diego, California
LISA DELANO-WOOD
Affiliation:
Research Service, VA San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, San Diego, California
JODY COREY-BLOOM
Affiliation:
Department of Neurosciences, University of California, San Diego, San Diego, California Neurology Service, VA San Diego Healthcare System, San Diego, California
MARK W. BONDI
Affiliation:
Department of Psychiatry, University of California, San Diego, San Diego, California Psychology Service, VA San Diego Healthcare System, San Diego, California
*
*Correspondence and reprint requests to: Amy J. Jak, VA San Diego Healthcare System, 3350 La Jolla Village Drive (151B), San Diego, California 92161. E-mail: ajak@ucsd.edu
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Abstract

Wide-ranging conceptual and diagnostic approaches to defining mild cognitive impairment (MCI) have led to highly variable prevalence and progression rates. We sought to examine whether bilateral hippocampal volumes and cerebrovascular risk factors in individuals characterized by two different neuropsychological definitions of MCI subtypes would also differ. Participants were 65 nondemented, community-dwelling, older adults, ages 62–91 years, drawn from a larger group of individuals enrolled in a longitudinal study of normal aging. A comprehensive neuropsychological definition of MCI that required the presence of more than one impaired score in a cognitive domain resulted in expected anatomical results; hippocampal volumes were significantly smaller in the aMCI group as compared to cognitively normal or nonamnestic MCI participants. However, a typical definitional scheme for classifying MCI based only on the presence of one impaired score within a cognitive domain did not result in hippocampal differences between groups. Global stroke risk factors did not differ between the two definitional schemes, although the relationship between stroke risk variables and neuropsychological performance did vary by diagnostic approach. The comprehensive approach demonstrated associations between stroke risk and cognition, whereas the typical approach did not. Use of more sophisticated clinical decision-making and diagnostic approaches that incorporate comprehensive neuropsychological assessment techniques is supported by this convergence of neuropsychological, neuropathological, and stroke risk findings. (JINS, 2009, 15, 890–897.)

Keywords

Mild cognitive impairmentNeuroimagingNeuropsychologyOlder adultsMemoryExecutive functioningStroke riskDiagnosisAmnesticNonamnestic
Type
MCI Series
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 6 , November 2009 , pp. 890 - 897
Copyright
Copyright © The International Neuropsychological Society 2009

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