The role of Neuropsychological assessment in the Differential Diagnoses of Late-Onset Depression, Dementia, and Mild Cognitive Impairment

Authors

  • Gulin MORKAVUK Department of Neurology, Faculty of Medicine, Ufuk University, Ankara, Turkey.
  • Gokce Sirvanli Department of Neurology, Faculty of Medicine, Ufuk University, Ankara, Turkey.

DOI:

https://doi.org/10.22317/jcms.v9i3.1233

Keywords:

neuropsychological assessment, mild cognitive impairment, depression, dementia

Abstract

Objective: The present study aimed to compare the neuropsychological test parameters of dementia, depression, and MCI patients and determine the disease-specific test characteristics and their relationship with electroencephalography.

Methods: Ninety-one patients who were admitted to the neurology outpatient clinic with forgetfulness complaints between October 2019 and March 2022 and whose neuropsychological tests were performed were included in the study. The files of these 91 patients were reviewed retrospectively and their sociodemographic data were recorded. Furthermore, the EEG results which were taken during the patients' evaluation period due to forgetfulness were evaluated. Neuropsychological tests were compared between patients with dementia, MCI and depression. It was also investigated whether there was a relationship between NPT test parameters and EEG in patients with EEG results.

Results: The study was completed with 87 patients. Of these 87 patients, 54 were female and 33 were male. Twenty-four patients had depression, 16 MCI, and 47 dementia. All of the dementia patients had Alzheimer's type dementia. When dementia, depression, and MCI groups were compared, the age difference was statistically significant (p=0.001). The mean age of the depression group was 66.5, the MCI group was 73.5, and the dementia group was 77. WMS-I, WMS-II, WMS-III, WMS-IV, similarities test, clock drawing test, trail making test, shape copying, language, and mood evaluation tests were statistically significantly different between the groups.  There was no statistically significant difference between the groups regarding gender, education level, dominant hand, and occupation. EEG background activity frequencies were also examined between the groups, and there was no statistically significant difference.

Conclusion: In conclusion, when evaluating patients who present with the complaint of forgetfulness, a detailed neuropsychological evaluation must be performed in addition to other diagnostic tests. Sensitive tests should be included to confirm the diagnosis, especially in cases where being in between for the differential diagnosis. Thus, further studies are needed on this subject.

References

Mitchell AJ, Shiri‐Feshki M. Rate of progression of mild cognitive impairment to dementia–meta‐analysis of 41 robust inception cohort studies. Acta psychiatrica scandinavica. 2009;119(4):252-265.

Gillis C, Mirzaei F, Potashman M, Ikram MA, Maserejian N. The incidence of mild cognitive impairment: A systematic review and data synthesis. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. 2019;11:248-256.

Canevelli M, Grande G, Lacorte E, et al. Spontaneous reversion of mild cognitive impairment to normal cognition: a systematic review of literature and meta-analysis. Journal of the American Medical Directors Association. 2016;17(10):943-948.

Zhuang L, Yang Y, Gao J. Cognitive assessment tools for mild cognitive impairment screening. Journal of neurology. 2021;268(5):1615-1622.

Kliegel M, Zimprich D. Predictors of cognitive complaints in older adults: A mixture regression approach. European Journal of Ageing. 2005;2(1):13-23.

Mahapatra A, Sharma P, Khandelwal SK. Late onset depression: A recent update. Journal of Mental Health and Human Behaviour. 2015;20(1):4.

Koenig AM, Bhalla RK, Butters MA. Cognitive functioning and late-life depression. Journal of the International Neuropsychological Society. 2014;20(5):461-467.

Wright SL, Persad C. Distinguishing between depression and dementia in older persons: neuropsychological and neuropathological correlates. Journal of geriatric psychiatry and neurology. 2007;20(4):189-198.

Petersen RC. Mild cognitive impairment as a diagnostic entity. Journal of internal medicine. 2004;256(3):183-194.

Salami O, Lyketsos CG. Clinical Features of Alzheimer's Disease: Cognitive and Non‐Cognitive. Principles and Practice of Geriatric Psychiatry. 2010:226-231.

Zubenko GS, Zubenko WN, McPherson S, et al. A collaborative study of the emergence and clinical features of the major depressive syndrome of Alzheimer’s disease. American Journal of Psychiatry. 2003;160(5):857-866.

Gilley DW, Bienias J, Wilson R, Bennett D, Beck T, Evans D. Influence of behavioral symptoms on rates of institutionalization for persons with Alzheimer's disease. Psychological Medicine. 2004;34(6):1129-1135.

Suh GH, Kil Yeon B, Shah A, Lee JY. Mortality in Alzheimer's disease: a comparative prospective Korean study in the community and nursing homes. International Journal of Geriatric Psychiatry: A journal of the psychiatry of late life and allied sciences. 2005;20(1):26-34.

Boldrini M, Underwood MD, Hen R, et al. Antidepressants increase neural progenitor cells in the human hippocampus. Neuropsychopharmacology. 2009;34(11):2376-2389.

Lauriola M, Mangiacotti A, D’Onofrio G, et al. Late-life depression versus amnestic mild cognitive impairment: Alzheimer’s disease incidence in 4 years of follow-up. Dementia and Geriatric Cognitive Disorders. 2018;46(3-4):140-153.

Ganguli M, Du Y, Dodge HH, Ratcliff GG, Chang C-CH. Depressive symptoms and cognitive decline in late life: a prospective epidemiological study. Archives of general psychiatry. 2006;63(2):153-160.

Elderkin-Thompson V, Kumar A, Mintz J, Boone K, Bahng E, Lavretsky H. Executive dysfunction and visuospatial ability among depressed elders in a community setting. Archives of Clinical Neuropsychology. 2004;19(5):597-611.

Butters MA, Whyte EM, Nebes RD, et al. The nature and determinants of neuropsychological functioning in late-lifedepression. Archives of general psychiatry. 2004;61(6):587-595.

Squire LR. Memory systems of the brain: a brief history and current perspective. Neurobiology of learning and memory. 2004;82(3):171-177.

Mesulam M-M. Principles of behavioral and cognitive neurology: Oxford University Press; 2000.

Ashendorf L, Alosco ML, Bing-Canar H, et al. Clinical utility of select neuropsychological assessment battery tests in predicting functional abilities in dementia. Archives of Clinical Neuropsychology. 2018;33(5):530-540.

Gold DA. An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment. Journal of clinical and experimental neuropsychology. 2012;34(1):11-34.

Goldberg TE, Koppel J, Keehlisen L, et al. Performance-based measures of everyday function in mild cognitive impairment. American Journal of Psychiatry. 2010;167(7):845-853.

Sadek JR, Stricker N, Adair JC, Haaland KY. Performance-based everyday functioning after stroke: relationship with IADL questionnaire and neurocognitive performance. Journal of the International Neuropsychological Society. 2011;17(5):832-840.

Marshall GA, Amariglio RE, Sperling RA, Rentz DM. Activities of daily living: where do they fit in the diagnosis of Alzheimer’s disease? Neurodegenerative disease management. 2012;2(5):483-491.

Marshall GA, Dekhtyar M, Bruno JM, et al. The Harvard Automated Phone Task: new performance-based activities of daily living tests for early Alzheimer’s disease. The journal of prevention of Alzheimer's disease. 2015;2(4):242.

Bondi MW, Jak AJ, Delano-Wood L, Jacobson MW, Delis DC, Salmon DP. Neuropsychological contributions to the early identification of Alzheimer’s disease. Neuropsychology review. 2008;18(1):73-90.

Thomas KR, Edmonds EC, Eppig J, Salmon DP, Bondi MW, Initiative AsDN. Using neuropsychological process scores to identify subtle cognitive decline and predict progression to mild cognitive impairment. Journal of Alzheimer's Disease. 2018;64(1):195-204.

Rentz DM, Parra Rodriguez MA, Amariglio R, Stern Y, Sperling R, Ferris S. Promising developments in neuropsychological approaches for the detection of preclinical Alzheimer’s disease: a selective review. Alzheimer's research & therapy. 2013;5(6):1-10.

Loewenstein DA, Curiel RE, Duara R, Buschke H. Novel cognitive paradigms for the detection of memory impairment in preclinical Alzheimer’s disease. Assessment. 2018;25(3):348-359.

Xie L, Wisse LE, Das SR, et al. Longitudinal atrophy in early Braak regions in preclinical Alzheimer's disease. Human brain mapping. 2020;41(16):4704-4717.

Papp KV, Rentz DM, Orlovsky I, Sperling RA, Mormino EC. Optimizing the preclinical Alzheimer's cognitive composite with semantic processing: the PACC5. Alzheimer's & Dementia: Translational Research & Clinical Interventions. 2017;3(4):668-677.

Vonk JM, Flores RJ, Rosado D, et al. Semantic network function captured by word frequency in nondemented APOE ε4 carriers. Neuropsychology. 2019;33(2):256.

Papagno C, Lucchelli F, Muggia S, Rizzo S. Idiom comprehension in Alzheimer’s disease: The role of the central executive. Brain. 2003;126(11):2419-2430.

Cardoso S, Silva D, Maroco J, De Mendonça A, Guerreiro M. Non‐literal language deficits in mild cognitive impairment. Psychogeriatrics. 2014;14(4):222-228.

Klooster N, Humphries S, Cardillo E, et al. Sensitive Measures of Cognition in Mild Cognitive Impairment. Journal of Alzheimer's Disease. 2021;82(3):1123-1136.

Lehrner J, Gufler R, Guttmann G, et al. Annual conversion to Alzheimer disease among patients with memory complaints attending an outpatient memory clinic: the influence of amnestic mild cognitive impairment and the predictive value of neuropsychological testing. Wiener Klinische Wochenschrift. 2005;117(18):629-635.

Benson AD, Slavin MJ, Tran T-T, Petrella JR, Doraiswamy PM. Screening for early Alzheimer’s disease: is there still a role for the mini-mental state examination. Prim Care Companion J Clin Psychiatry. 2005;7(2):62-69.

Downloads

Published

2023-06-26

How to Cite

MORKAVUK, G., & Sirvanli, G. (2023). The role of Neuropsychological assessment in the Differential Diagnoses of Late-Onset Depression, Dementia, and Mild Cognitive Impairment. Journal of Contemporary Medical Sciences, 9(3), 179–186. https://doi.org/10.22317/jcms.v9i3.1233