0-TESTO COMPLETO.pdf - Fondazione Santa Lucia

Sezione III: Attività per progetti
U.O.1 – Laboratorio di Neuropsichiatria
Gianfranco Spalletta
Specific contribution of the unit to the project
Mild cognitive impairment (MCI) refers to the clinical state of cognition
and functional ability that is intermediate between normal aging and mild
dementia. According to cognitive domains impaired it has been classified into
four subtypes as follows: (1) single domain amnestic MCI, characterized by
only memory impairment, (2) multiple domain amnestic MCI, with impairment
of memory and other cognitive domains, (3) multiple domain nonamnestic
MCI, in which memory is unaffected but multiple other domains of
cognitive function are impaired, (4) single domain non-amnestic MCI, that is
similar to multiple domain non-amnestic MCI but with only one domain
impaired.
People with Mild MCI appear to develop Alzheimer disease at a higher
rate than the general elderly population: patients with MCI convert to AD at
approximately 12% per year, although the rate of the onset of AD in healthy
elderly people is 1–2% per year. For that reason, instruments focused upon
MCI measurement would provide useful screening information for decisions
concerning full diagnostic evaluations for AD. Specific neuropsychological
tests may represent valid tools that predict progression from MCI to AD. Main
aim of this unit will be to select a neuropsychiatric and neuropsychological
test battery able to predict, with high reliability, the progression from MCI to
dementia in a group of 34 subjects and to highlight the conversion rate differences
among the different MCI subtypes.
Methods
In the present unit 34 subjects with MCI will be enrolled. All patients will
be recruited in neurological or geriatric units. Before the inclusion of all
patients, this unit will train all clinicians until they will demonstrate an interrater
reliability of 0.80 (k coefficient) for all the psychometric tests used.
All patients will sign an informed consent. Specific inclusion criteria will
be: 1) diagnostic evidence of MCI; 2) Mini Mental State Examination (MMSE)
score >24 and Clinical Dementia Rating Scale (CDR) score = 0.5; 3) vision and
hearing sufficient for compliance with testing procedures; 4) laboratory values
within the appropriate reference intervals. Specific exclusion criteria will
be: 1) major medical illnesses; 2) comorbidity of primary psychiatric or neurological
disorders and any other significant mental or neurological disorder;
3) known or suspected history of alcoholism or drug dependence and abuse
during lifetime; 4) MRI evidence of focal parenchymal abnormalities and/or
MRI evidence of neoplasm; 5) Hachinski ischemic score ≥ 4.
At the starting visit all subjects will undergo clinical and neuropsychiatric
evaluation. The neuropsychiatric evaluation will include the following psychometric
tests: Mini-Mental State Examination (MMSE), Hamilton Depression
722 2009