- Email: [email protected]
Characteristics of cognitive faculties in elderly depressive patients complaining of decline in memory and amnestic Mild Cognitive Impairment patients
Poster Presentations P2 P2-134
APOE E4 CARRIERS ARE ASSOCIATED WITH AMNESTIC BUT NOT NONAMNESTIC MILD COGNITIVE IMPAIRMENT IN AN ELDERLY COMMUNITY SAMPLE
Karen A. Mather1, Arezoo Assareh2, Nicole Kochan1, John Crawford1, Kristan Kang1, Simone Reppermund1, Julian Trollor3, John Kwok2, Brian Draper4, Peter Schofield2, Henry Brodaty5, Perminder Sachdev1, 1 Brain & Ageing Research Program, School of Psychiatry, University New South Wales, Sydney, Australia; 2Prince of Wales Medical Research Institute, Sydney, Australia; 3Department Developmental Disability Neuropsychiatry, School of Psychiatry, University New South Wales, Sydney, Australia; 4Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia; 5Primary Dementia Collaborative Research Centre, School of Psychiatry, University New South Wales, Sydney, Australia. Contact e-mail: [email protected] Background: The diagnosis of mild cognitive impairment may represent a prodromal dementia condition, as a proportion of MCI cases go on to develop dementia. The nosology of mild cognitive impairment is complex, but it has recently been sub-categorised into amnestic and non-amnestic categories, with amnestic MCI more likely to represent an early stage of Alzheimer’s disease (AD). The major identified genetic risk factor for sporadic AD is the APOE E4 allele. However, little is known about the prevalence of the APOE E4 allele in the different MCI diagnostic categories. This study sought to investigate the prevalence of APOE E4 carriers in (i) amnestic and (ii) non-amnestic MCI cases compared to individuals without MCI from a population sample of non-demented older adults. Methods: Participants were drawn from the Sydney Memory and Ageing Study (MAS), a community study of 1037 non-demented adults aged 70 to 90 years, who were recruited from the community. Health, physical, cognitive and demographic data were collected and biological samples donated for genetic analyses. Informants also provided information on the participants’ cognitive and daily functioning. APOE E2/3/4 genotypes were determined and participants were classified as either APOE E4 carriers or non-carriers. Performance on comprehensive neuropsychological testing and instrumental activities of daily living, together with informant information were used to classify participants into MCI subtypes according to international consensus criteria (Petersen, 2004; Winblad et al., 2004). Amnestic and non-amnestic MCI groups included both the single and multiple domain subtypes. Results: There were 156 cases of amnestic MCI, 115 cases of non-amnestic MCI and 447 controls with APOE genotypes. There was a greater prevalence of APOE E4 carriers in the amnestic MCI group compared to controls (c2 ¼ 6.408; df ¼ 1, p ¼ .011) but not for non-amnestic MCI in comparison to controls (p > .05). The presence of one or more APOE E4 alleles was associated with an increased risk of amnestic MCI (O.R. ¼ 1.7, p ¼ .010) when adjusted for age, sex and education. Conclusions: APOE E4 carriers were significantly more common in amnestic MCI cases than in controls, suggesting that the subtyping of MCI may have some biological basis and prognostic value. P2-135
CHARACTERISTICS OF COGNITIVE FACULTIES IN ELDERLY DEPRESSIVE PATIENTS COMPLAINING OF DECLINE IN MEMORY AND AMNESTIC MILD COGNITIVE IMPAIRMENT PATIENTS
Seung-Ho Ryu1, In-Kwa Jung2, 1Konkuk University Medical Center, Seoul, Republic of Korea; 2Korea University, Seoul, Republic of Korea. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD) is often misdiagnosed as a depression. Depressive symptoms often are presented in the early phase of AD and they are assumed to be prodromal symptoms of AD. It is difficult to distinguish the difference between Mild Cognitive Impairment (MCI), which is presumed to be an pre-stage of AD and depression even though specialists assess patients. The purpose of current study is comparing neuropsychological characteristics of patients with amnestic Mild Cognitive Impairment
S353
(aMCI) to those of patients with depression. Methods: A community-dwelling older people and patients visiting Konkuk Medical Center aged over 60 years were enrolled for this study. Among them, we compared 24 patients with aMCI, 23 for depression, 26 normal elderly. Demographic data, KMMSE, comprehensive neurophychological test, and Geriatric Depression Scale (GDS) were assessed by trained psychologist in all groups. Results: In the neuropsychological assessment, there were differences in AVLT(Auditory Verbal Learning Test)1w5, recall, recognition, Digit span forward, Digit Symbol substitution, Number Stroop test, Category Fluency Test, Boston Naming Test, Trail making test B(p < 0.05). After post hoc analysis, both patients with aMCI and depression had significant differences from normal controls in AVLT 1, recall, Digit Symbol substitution, Category Fluency Test and Boston Naming Test (p < 0.05). Only the group of patients with aMCI showed differences from normal controls in AVLT 2w5, recognition(p < 0.05) and patients with depression had significant differences from normal controls in Number Stroop 1st trial, Trail making test A, Trail making test B(p < 0.05). Conclusions: We could not find the cognitive difference between depression and aMCI. However, patients with aMCI showed cognitive declines than normal older people in learning and recognition. Patients with depression have declines in attention and executive functions. To understand the clinical difference and underlying pathophysiology of aMCI and depression, the precise criteria of aMCI and gathering more homogeneous group of depression in severity and onset time will be needed. P2-136
EMOTIONAL AGNOSIA BUT NOT PROSOAGNOSIA IN ALZHEIMER’S DISEASE AND MCI PATIENTS
Alexandra Varjassyova1, Daniel Horinek2, Hana Magerova1, Martin Vyhnalek1, Jan Laczo1, Iva Holmerova3, Jakub Hort1, 1Memory Disorders Unit, Department of Neurology, 2nd Medical School, Charles University and Motol Hospital, Prague, Czech Republic; 2Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic; 3 Gerontologic Center, Prague, Czech Republic. Contact e-mail: yooma@ seznam.cz Background: Mild cognitive impairment (MCI) is a clinical entity insufficiently severe to be classified as dementia, when subjects maintain their functional capacity. Several longitudinal studies have suggested that subjects with amnestic MCI multiple domain have a higher rate of progression to dementia during the follow-up period. Neuroimaging and neuropathological studies in MCI subjects with isolated memory impairment have demonsrated an atrophy and pathological changes of amygdala, a structure that plays an important role in facial expression processing as well as emotional recognition of visual stimuli. Methods: Study included 23 AD patiens, 31 amnesticMCI patients and 19 controls. Amnestic MCI patients were separated into two subgroups - single and multiple domain. All patients were assessed by Facial Emotion Recognition Test the examine emotional agnosia and Identify familiar faces test to examine to ability to recognize faces and rutine neuropsychological tests (memory, attention and processing speed, fontal, and executive function) were evaluated in the subjects. Results: AD patients (p < 0,01) and multiple aMCI patiens (p < 0,05) performed worse in recognition of facial emotions than controls, but any diference was not shown in identification of familiar faces between these groups. Conclusions: Our results support the hypothesis that facial emotion recognition are separate processes. Decreased capacity to recognize emotions in patients with AD may contribute to patients distress and caregivers burden. Medical staff should be aware of this disability and treat the parients accordingly. P2-137
THE SENSITIVITY OF THE MOCA AND MMSE TO COGNITIVE DECLINE: A LONGITUDINAL STUDY
Sandra Freitas1, Isabel Santana2, Mario Rodrigues Simoes1, 1Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal; 2Department of Neurology, Coimbra University Hospital, Coimbra, Portugal. Contact e-mail: [email protected]
APOE E4 CARRIERS ARE ASSOCIATED WITH AMNESTIC BUT NOT NONAMNESTIC MILD COGNITIVE IMPAIRMENT IN AN ELDERLY COMMUNITY SAMPLE
Karen A. Mather1, Arezoo Assareh2, Nicole Kochan1, John Crawford1, Kristan Kang1, Simone Reppermund1, Julian Trollor3, John Kwok2, Brian Draper4, Peter Schofield2, Henry Brodaty5, Perminder Sachdev1, 1 Brain & Ageing Research Program, School of Psychiatry, University New South Wales, Sydney, Australia; 2Prince of Wales Medical Research Institute, Sydney, Australia; 3Department Developmental Disability Neuropsychiatry, School of Psychiatry, University New South Wales, Sydney, Australia; 4Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia; 5Primary Dementia Collaborative Research Centre, School of Psychiatry, University New South Wales, Sydney, Australia. Contact e-mail: [email protected] Background: The diagnosis of mild cognitive impairment may represent a prodromal dementia condition, as a proportion of MCI cases go on to develop dementia. The nosology of mild cognitive impairment is complex, but it has recently been sub-categorised into amnestic and non-amnestic categories, with amnestic MCI more likely to represent an early stage of Alzheimer’s disease (AD). The major identified genetic risk factor for sporadic AD is the APOE E4 allele. However, little is known about the prevalence of the APOE E4 allele in the different MCI diagnostic categories. This study sought to investigate the prevalence of APOE E4 carriers in (i) amnestic and (ii) non-amnestic MCI cases compared to individuals without MCI from a population sample of non-demented older adults. Methods: Participants were drawn from the Sydney Memory and Ageing Study (MAS), a community study of 1037 non-demented adults aged 70 to 90 years, who were recruited from the community. Health, physical, cognitive and demographic data were collected and biological samples donated for genetic analyses. Informants also provided information on the participants’ cognitive and daily functioning. APOE E2/3/4 genotypes were determined and participants were classified as either APOE E4 carriers or non-carriers. Performance on comprehensive neuropsychological testing and instrumental activities of daily living, together with informant information were used to classify participants into MCI subtypes according to international consensus criteria (Petersen, 2004; Winblad et al., 2004). Amnestic and non-amnestic MCI groups included both the single and multiple domain subtypes. Results: There were 156 cases of amnestic MCI, 115 cases of non-amnestic MCI and 447 controls with APOE genotypes. There was a greater prevalence of APOE E4 carriers in the amnestic MCI group compared to controls (c2 ¼ 6.408; df ¼ 1, p ¼ .011) but not for non-amnestic MCI in comparison to controls (p > .05). The presence of one or more APOE E4 alleles was associated with an increased risk of amnestic MCI (O.R. ¼ 1.7, p ¼ .010) when adjusted for age, sex and education. Conclusions: APOE E4 carriers were significantly more common in amnestic MCI cases than in controls, suggesting that the subtyping of MCI may have some biological basis and prognostic value. P2-135
CHARACTERISTICS OF COGNITIVE FACULTIES IN ELDERLY DEPRESSIVE PATIENTS COMPLAINING OF DECLINE IN MEMORY AND AMNESTIC MILD COGNITIVE IMPAIRMENT PATIENTS
Seung-Ho Ryu1, In-Kwa Jung2, 1Konkuk University Medical Center, Seoul, Republic of Korea; 2Korea University, Seoul, Republic of Korea. Contact e-mail: [email protected] Background: Alzheimer’s disease (AD) is often misdiagnosed as a depression. Depressive symptoms often are presented in the early phase of AD and they are assumed to be prodromal symptoms of AD. It is difficult to distinguish the difference between Mild Cognitive Impairment (MCI), which is presumed to be an pre-stage of AD and depression even though specialists assess patients. The purpose of current study is comparing neuropsychological characteristics of patients with amnestic Mild Cognitive Impairment
S353
(aMCI) to those of patients with depression. Methods: A community-dwelling older people and patients visiting Konkuk Medical Center aged over 60 years were enrolled for this study. Among them, we compared 24 patients with aMCI, 23 for depression, 26 normal elderly. Demographic data, KMMSE, comprehensive neurophychological test, and Geriatric Depression Scale (GDS) were assessed by trained psychologist in all groups. Results: In the neuropsychological assessment, there were differences in AVLT(Auditory Verbal Learning Test)1w5, recall, recognition, Digit span forward, Digit Symbol substitution, Number Stroop test, Category Fluency Test, Boston Naming Test, Trail making test B(p < 0.05). After post hoc analysis, both patients with aMCI and depression had significant differences from normal controls in AVLT 1, recall, Digit Symbol substitution, Category Fluency Test and Boston Naming Test (p < 0.05). Only the group of patients with aMCI showed differences from normal controls in AVLT 2w5, recognition(p < 0.05) and patients with depression had significant differences from normal controls in Number Stroop 1st trial, Trail making test A, Trail making test B(p < 0.05). Conclusions: We could not find the cognitive difference between depression and aMCI. However, patients with aMCI showed cognitive declines than normal older people in learning and recognition. Patients with depression have declines in attention and executive functions. To understand the clinical difference and underlying pathophysiology of aMCI and depression, the precise criteria of aMCI and gathering more homogeneous group of depression in severity and onset time will be needed. P2-136
EMOTIONAL AGNOSIA BUT NOT PROSOAGNOSIA IN ALZHEIMER’S DISEASE AND MCI PATIENTS
Alexandra Varjassyova1, Daniel Horinek2, Hana Magerova1, Martin Vyhnalek1, Jan Laczo1, Iva Holmerova3, Jakub Hort1, 1Memory Disorders Unit, Department of Neurology, 2nd Medical School, Charles University and Motol Hospital, Prague, Czech Republic; 2Department of Neurosurgery, Central Military Hospital, Prague, Czech Republic; 3 Gerontologic Center, Prague, Czech Republic. Contact e-mail: yooma@ seznam.cz Background: Mild cognitive impairment (MCI) is a clinical entity insufficiently severe to be classified as dementia, when subjects maintain their functional capacity. Several longitudinal studies have suggested that subjects with amnestic MCI multiple domain have a higher rate of progression to dementia during the follow-up period. Neuroimaging and neuropathological studies in MCI subjects with isolated memory impairment have demonsrated an atrophy and pathological changes of amygdala, a structure that plays an important role in facial expression processing as well as emotional recognition of visual stimuli. Methods: Study included 23 AD patiens, 31 amnesticMCI patients and 19 controls. Amnestic MCI patients were separated into two subgroups - single and multiple domain. All patients were assessed by Facial Emotion Recognition Test the examine emotional agnosia and Identify familiar faces test to examine to ability to recognize faces and rutine neuropsychological tests (memory, attention and processing speed, fontal, and executive function) were evaluated in the subjects. Results: AD patients (p < 0,01) and multiple aMCI patiens (p < 0,05) performed worse in recognition of facial emotions than controls, but any diference was not shown in identification of familiar faces between these groups. Conclusions: Our results support the hypothesis that facial emotion recognition are separate processes. Decreased capacity to recognize emotions in patients with AD may contribute to patients distress and caregivers burden. Medical staff should be aware of this disability and treat the parients accordingly. P2-137
THE SENSITIVITY OF THE MOCA AND MMSE TO COGNITIVE DECLINE: A LONGITUDINAL STUDY
Sandra Freitas1, Isabel Santana2, Mario Rodrigues Simoes1, 1Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal; 2Department of Neurology, Coimbra University Hospital, Coimbra, Portugal. Contact e-mail: [email protected]