Dynamics of Pre-Mild Cognitive Decline in Middle-Aged and Elderly Patients

According to research data, the dynamics of pre-mild cognitive decline (PMCD) in the form of subsequent deterioration of cognitive functions is not unambiguous, there is no Russian data on this issue.

The aim of the study: to evaluate the dynamics of the cognitive status of patients with PMCD.

Material and methods. 56 middle-aged and elderly patients (61.05 ± 9.88 years old) with PMCD were re-examined on average after 3.60 ± 2.50 years (from 2 to 11 years old). To assess the cognitive status, quantitative neuropsychological scales and tests were used: to assess memory — a 12-word recall test with assessment of immediate and delayed recall, Literal and Categorical Association Test, Benton Visual Memory Test, Trail making test (parts A, B), Munsterberg Test, Symbol Digit Modalities Test, Clock Drawing Test; Mini-Mental State Examination (MMSE), executive functions — the Frontal Assessment Battery (FAB).

Results. 41% of patients demonstrated cognitive decline, including the transition from subjective cognitive decline to subtle cognitive decline. This decline was measured by tests assessing information processing speed (Trail making test, part А), attention (Munsterberg test and Symbol Digit Modalities Test), memory (12-Word Memory Test), and executive functions (Trail making test, parts В, FAB). There were no statistically signifi cant diff erences in the Clock Drawing Test. The most signifi cant diff erences in the fi nal scores concerned the MMSE, Trail making test, parts А and В, Symbol Digit Modalities Test and the immediate recall scores in the memory test, indicating an increase in general cognitive defi cits, as well as impairments in executive functions, memory, and attention. Progression of cognitive defi cit to mild cognitive impairment was observed in 19 patients (34%) and was represented by a decrease in scores of the MMSE and FAB screening scales, attention, memory and executive functions. Progression of cognitive decline was associated with older age, lower education, and a longer follow-up period.

Conclusion. Our fi ndings indicate a dynamic increase in general cognitive defi cits, as well as impairments in executive functions, memory, and attention, in patients with PMCD. This provides grounds for potential prevention of further cognitive deterioration. This study confi rms the role of education as a protective factor of subsequent cognitive decline.

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