Can We Further Divide Amnestic Mild Cognitive Impairment Based on the Pattern of Memory Deficit?: A Preliminary Study

Eun Hye Jeong; Hee-Young Kim; Jae-Hong Lee

doi:10.12779/dnd.2012.11.1.18

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Jeong, Kim, and Lee: Can We Further Divide Amnestic Mild Cognitive Impairment Based on the Pattern of Memory Deficit?: A Preliminary Study

Original Article

Dementia and Neurocognitive Disorders

Dementia and Neurocognitive Disorders 2012; 11(1): 18-24.

Published online: 31 March 2012

DOI: https://doi.org/10.12779/dnd.2012.11.1.18

Can We Further Divide Amnestic Mild Cognitive Impairment Based on the Pattern of Memory Deficit?: A Preliminary Study

Eun Hye Jeong, M.D., Hee-Young Kim, M.D., Jae-Hong Lee, M.D.

Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Address for correspondence: Jae-Hong Lee, M.D. Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap-2 dong, Songpa-gu, Seoul 138-736, Korea. Tel: +82-2-3010-3446, Fax: +82-2-474-4691, jhlee@amc.seoul.kr

Received 23 December 2011 Revised 23 March 2012 Accepted 23 March 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

Mild cognitive impairment (MCI) is considered as a transitional state between normal aging and dementia and can be subdivided into amnestic vs. nonamnestic and single vs. multiple domains types. It is suggested that these clinical subtypes may have different underlying etiologies and outcomes. The amnestic MCI differs in the performance profile on memory testing: retention vs. retrieval deficit. Generally, the retention deficit is attributed to the medial temporal dysfunction and the retrieval deficit to the frontal dysfunction. We tried to determine whether there could be distinctive subtypes available even in the amnestic MCI.

Methods

Sixty-two patients with amnestic MCI-single domain were included in this retrospective study. They were divided into the retention- vs. the retrieval-deficit groups according to the results of Seoul Verbal Learning Test (SVLT). We compared baseline characteristics including vascular risk factors and neuropsychological profiles. We also measured the medial temporal atrophy (MTA) using a visual rating scale and assessed lacunar infarcts and white matter hyperintensities (WMH).

Results

Of 62 patients, 41 had retention deficit and 21 had retrieval deficit on SVLT. Among baseline clinical and demographic variables, only the frequency of hypertension was higher in the retrieval-deficit group (p=0.005). There were no differences in neuropsychological profiles between the two groups other than a lower immediate recall score in the retention-deficit group (p=0.012) and a higher recognition score in the retrieval-deficit group (p=0.001). Severities of WMH and MTA were not different between the two groups, nor was the number of lacunar infarcts and microbleeds.

Conclusions

We could not find any significant difference except for the frequency of hypertension between the two subgroups of amnestic MCI, suggesting that there may be no further gain in subdividing a single domain amnestic MCI.

Keywords: Amnestic mild cognitive impairment, Memory, Retention, Retrieval, Medial temporal atrophy, White matter hyperintensities

Figures and Tables

Table 1

Baseline characteristics according to the two amnestic MCI subtypes

Values are presented as mean±standard deviation or as number (percentage) of patients. The statistical analysis between two groups was done by the t-test and chi-square or Fisher's exact test.

^*p<0.05.

MCI, mild cognitive impairment; K-MMSE, Korean version of Mini-Mental State Examination; CDR, Clinical Dementia Rating; CDR-SB, CDR-sum of boxes.

Table 2

Neuropsychological profiles of the two amnestic MCI subtypes

Values are presented as mean±standard deviation. The statistical analysis between two groups was done by the t-test or Mann-Whitney test.

^*p<0.05.

MCI, mild cognitive impairment; K-BNT, Korean-Boston Naming Test; RCFT, Rey Complex Figure test; COWAT, Controlled Oral Word Association Test; K-CWST, Korean-Color Word Stroop Test.

Table 3

MRI findings of the two amnestic MCI subtypes

The statistical analysis between two groups was done by the Fisher's exact test.

MRI, magnetic resonance imaging; MCI, mild cognitive impairment; MTA, medial temporal lobe atrophy; WMH, white matter hyperintensities.

Notes

This study was supported by a grant from the Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (A102065) and a grant from Bayer Korea.

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