APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial.

Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center's routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R2 = .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R2 = .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R2 = .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R2 = .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.Trial registration: Trial retrospectively registered on January 29th, 2020-(ClinicalTrials.gov -NCT04245579).

Social Loneliness in Older Adults with Mild Cognitive Impairment: Predictive Factors and Associated Clinical Characteristics.

BACKGROUND: Loneliness and social isolation are considered public health problems among older individuals. In addition, both increase the risk of developing cognitive impairment and dementia. The Social Loneliness construct has been proposed to refer to these harmful social interaction-related factors. OBJECTIVE: To define the risk factors of Social Loneliness in individuals with mild cognitive impairment (MCI) and to analyze cognitive, emotional, and functional differences according to the participant's degree of Social Loneliness. METHODS: Through convenience sampling, 105 participants over 60 diagnosed with MCI were selected. The evaluation consisted of anamnesis and a comprehensive neuropsychological examination. The ESTE-II questionnaire was used to assess Social Loneliness and its three factors: perceived social support, social participation, and use of communication technologies. Personality was measured with the NEO-FFI questionnaire. RESULTS: The predictors of the Social Loneliness factors were as follows; 1) perceived social support (R2 = 0.33): Neuroticism (ß= 0.353), depression (ß= 0.205), and perceived health (ß= 0.133); 2) social participation (R2 = 0.24): Conscientiousness (ß= -0.344) and Extraversion (ß= -0.263); 3) use of communication technologies (R2 = 0.44): age (ß= 0.409), type of cohabitation (ß= 0.331), cognitive reserve (ß= -0.303), and Conscientiousness (ß= -0.247); all p < 0.05. The participants with a higher degree of Social Loneliness showed more depressive symptoms (R2 = 0.133), more memory complaints (R2 = 0.086), worse perceived health (R2 = 0.147), lower attentional performance/processing speed (R2 = 0.094), and more naming difficulties (R2 = 0.132); all p < 0.05. CONCLUSIONS: This research represents an advance in detecting individuals with MCI and an increased risk of developing Social Loneliness, which influences the configuration of the clinical profile of MCI.

Genetic Predictors of Change in Episodic Verbal Memory by Cognitive Intervention: ACT, PICALM, BDNF, NRG1, APOE Genes and Their Interactions in Situations of Cognitive Demand.

BACKGROUND: Cognitive interventions (CIs) in the elderly are activities that seek to improve cognitive performance and delay its deterioration. Our objectives were to study potential genetic predictors of how a CI program may influence immediate and delayed episodic verbal memory (EVM). METHODS: 162 participants were elderly individuals without dementia who were randomized into parallel control and experimental groups. Participants underwent genetic testing to analyze the PICALM, ACT, NRG1, BDNF and APOE genes. We performed a broad neuropsychological assessment before and 6 months after the CI. The CI involved multifactorial training (30 sessions). The control group undertook the centre's standard activities. The main outcome measures were the genotype studied as a predictor of post-intervention changes in EVM. RESULTS: We found the CI was associated with improvements in several cognitive functions, including immediate and delayed EVM. While no individual gene was associated with any such change, the interaction between PICALM/ACT (p = 0.008; Eta2 = 0.23) and PICALM/NRG1 (p = 0.029; Eta2 = 0.19) was associated with improved immediate EVM, and the NRG1/BDNF interaction was associated with improved delayed EVM (p = 0.009; Eta2 = 0.21). The APOEε4 genotype was not associated with any change in EVM. CONCLUSIONS: Our study shows that the participants' genotype can have an impact on the results of CIs. Cognitive stress may stimulate the interaction of various genes and as such, different types of CI should be established for distinct groups of people taking into account the individual's characteristics, like genotype, to improve the results of this type of health prevention and promotion activity.

Loneliness in the elderly: association with health variables, pain, and cognitive performance. A population-based study / La soledad en personas mayores: asociación con las variables de salud, el dolor y el rendimiento cognitivo. Estudio poblacional

The aim of this population-based study is to analyze the association of loneliness and physical health, pain, health-related quality of life, mental health, cognitive performance, morbidity, and use of health services. Based on the census, a stratified random sampling was chosen. A telephone interview was conducted with 2,060 people over 65 years old, using the GHQ-12 and the COOP-Wonca. An association of loneliness with General Mental Health (GHQ-12) was found, OR = 1.43 (1.34, 1.52) and depression, OR = 2.34 (1.54, 3.53). In cognitive performance the highest effect variable was “memory problems disturb your daily life”, OR = 3.11 (1.25, 7.72); illnesses-related variables: the highest effect variables were perception of health status, OR = 1.37 (1.13, 1. 67) and quality of life (COOP-Wonca), OR = 3.03 (2.32, 3.94); pain-related variables: the highest effect variables were non-localized pain, OR = 2.67 (1.87, 3.83) and arthritis/arthrosis, OR = 1.94 (1.38, 2.72); impaired vision, OR = 2. 62 (1.84, 3.73) and hearing, OR = 1.81 (1.21, 2.72). It is concluded that loneliness is a complex phenomenon associated with variables of different nature. This fact should be taken into account at the time of planning possible solutions. (AU)

El objetivo de este estudio poblacional es analizar la asociación de la soledad no deseada (SND) con salud física, dolor, calidad de vida relacionada con la salud, salud mental, rendimiento cognitivo, morbilidad y uso de servicios de salud. Recurriendo al censo, se realizó un muestreo aleatorio estratificado en Madrid. Se llevó a cabo una entrevista telefónica a 2,060 mayores de 65 años utilizando el GHQ-12 y el COOP-Wonca. Encontramos asociación de la SND y la salud mental general (GHQ-12), OR = 1.43 (1.34, 1.52) y depresión, OR = 2.34 (1.54, 3.53). En rendimiento cognitivo, la variable de mayor efecto fue “los problemas de memoria alteran su vida cotidiana”, OR = 3.11 (1.25, 7.72); variables relacionadas con enfermedad: las de mayor efecto fueron “percepción del estado de salud”, OR = 1.37 (1.13, 1.67) y calidad de vida (COOP-Wonca), OR = 3.03 (2.32, 3.94); variables de dolor: dolor general, OR = 2.67 (1.87, 3.83) y artritis/artrosis, OR = 1.94 (1.38, 2.72); dificultades para ver, OR = 2.62 (1.84, 3.73) y oír, OR = 1.81 (1.21, 2.72). Se concluye que la SND es una situación compleja, lo que debe considerarse al programar soluciones que sean efectivas. (AU)

Diffusion Tensor Imaging Measures of Brain Connectivity for the Early Diagnosis of Alzheimer's Disease.

The prognostic capacity of the diffusion tensor imaging measures fractional anisotropy (FA) and mean diffusivity (MD) to detect mild cognitive impairment (MCI) progression to Alzheimer's disease (AD) was assessed in 135 MCI patients and 72 healthy subjects over a median follow-up of 40 months. Forty-nine MCI patients (36.3%) developed AD. The factors MD left hippocampus, FA left cingulate, and FA left hippocampus emerged as predictors of progression. Age (hazard ratio [HR] 1.21), delayed text recall (HR 0.89), FA left uncinate (HR 1.90), FA left hippocampus (HR 2.21), and carrying at least one ApoE4 allele (HR 2.86) were associated with a high conversion rate. FA measures revealed the greatest discriminative capacity (Harrell's C = 0.73 versus 0.65 without FA; p = 0.034). The inclusion of FA structural connectivity data in our model improved discrimination between subjects with MCI progressing or not to dementia.

Subjective Memory Complaints in healthy older adults: Fewer complaints associated with depression and perceived health, more complaints also associated with lower memory performance.

OBJECTIVES: (i) To analyze if general cognitive performance, perceived health and depression are predictors of Subjective Memory Complaints (SMC) contrasting their effect sizes; (ii) to analyze the relationship between SMC and objective memory by comparing a test that measures memory in daily life and a classical test of associated pairs; (iii) to examine if different subgroups, formed according to the MFE score, might have different behaviors regarding the studied variables. METHODS: Sample: 3921 community-dwelling people (mean age 70.41±4.70) without cognitive impairment. Consecutive non-probabilistic recruitment. ASSESSMENT: Mini Cognitive Exam (MCE), daily memory Rivermead Behavioural Memory Test (RBMT), Paired Associates Learning (PAL), Geriatric Depression Scale (GDS), Nottingham Health Profile (NHP). Dependent variable: Memory Failures Everyday Questionnaire (MFE). RESULTS: Two different dimensions to explain SMC were found: One subjective (MFE, GDS, NHP) and other objective (RBMT, PAL, MCE), the first more strongly associated with SMC. SMC predictors were NHP, GDS, RBMT and PAL, in this order according to effect size. Considering MFE scores we subdivided the sample into three groups (low, medium, higher scores): low MFE group was associated with GDS; medium, with GDS, NPH and RBMT, and higher, with age as well. Effect size for every variable tended to grow as the MFE score was higher. CONCLUSION: SMC were associated with both health profile and depressive symptoms and, in a lesser degree, with memory and overall cognitive performance. In people with fewer SMC, these are only associated with depressive symptomatology. More SMC are associated with depression, poor health perception and lower memory.

Quejas subjetivas de memoria en adultos jóvenes y su relación con rendimiento de memoria, depresión, calidad de vida y rasgos de personalidad / Subjective memory complaints in young adults and their relationship to memory performance, depression, quality of life and personality traits

Introducción y objetivos: Hay enfermedades degenerativas que pueden presentarse en adultos jóvenes y que afectan a la memoria; para ellas es importante un diagnóstico precoz. Las quejas subjetivas de memoria (QSM) son cada vez más frecuentes en adultos jóvenes, pero han sido o bjeto de pocos estudios. Nuestro objetivo es analizar la relación entre las QSM y el rendimiento objetivo de memoria, y determinar la asociación de las QSM con variables relacionadas con el estado de ánimo, los rasgos de personalidad y la percepción de la calidad de vida relacionada con la salud. Material y métodos: Estudiamos a 102 sujetos, de entre 23-64 años y sin deterioro cognitivo. Evaluación: Cuestionario de Fallos de Memoria, Escala de Memoria de Wechsler, Escala de Depresión-Ansiedad de Goldberg, Escala de Resiliencia y Cuestionario de Salud SF-12. Se realizaron correlaciones y regresión lineal jerárquica en tres bloques: variables sociodemográficas, de salud y de rendimiento de memoria. El tamaño del efecto se estudió con R2. Resultados: No hay correlación significativa entre QSM y edad, estudios, memoria auditiva y visual, ansiedad y resiliencia. Existe una correlación estadísticamente significativa con sintomatología depresiva (r=0,35; p<0,01) y percepción de salud (r=0,37; p<0,01). Varios factores del SF-12 y de personalidad se asociaron a las QSM. Entre todas las variables, la única con valor predictivo en la regresión fue Salud mental (F=3,561; p=0,004; R2=0,23). Conclusión: Nuestro estudio destaca el aspecto subjetivo de las QSM frente al objetivo. En adultos jóvenes que acuden a la consulta con QSM hay que valorar factores como la ansiedad la depresión, la falta de confianza en uno mismo y la calidad de vida, y no sólo el rendimiento de memoria(AU)

Introduction and aims: There are degenerative diseases in young adults that can affect memory; for these diseases an early diagnosis is important. Subjective memory complaints (SMC) are becoming more common in young adults but there are few studies on this topic. Our aim is to analyze the relationship between SMC and objective memory performance and to establish the association between SMC and mood, personality traits or perception of quality of life related to health. Methods: We studied 102 subjects, between 23-64 years without cognitive impairment. Assessment: Questionnaire of Memory Failures of Everyday, Wechsler Memory Scale, Goldberg Anxiety and Depression Scale, Resilience Scale and Health Survey (SF-12). Statistical analysis: Correlations and hierarchical linear regression in three blocks: sociodemographic factors, health factors and memory performance. The effect size was studied using R2. Results: No significant correlation between SMC and age, education, auditory and visual memory, anxiety and resilience, was found. There is a statistically significant correlation with depressive symptoms ('r' = 0.35, p<0.01) and health perception ('r' = 0.37, p<0.01). Several SF-12 and personality factors were associated with SMC. Among all variables, the only one with predictive value in the regression was 'Mental Health' (F=3.561, P=0.004, R2=0.23). Conclusion: Our study highlights the subjective aspect of the SMC against the objective one. Attending young adults with SMC we must evaluate factors such as anxiety, depression, lack of self-confidence and quality of life and not only memory performance(AU)

The Memory Failures of Everyday (MFE) test: normative data in adults.

UNLABELLED: One approach to the study of everyday memory failures is to use multiple-item questionnaires. The Memory Failures of Everyday (MFE) test is one of the most frequently used in Spain. Our objective is to provide normative data from the MFE in a sample of healthy, Spanish, adult participants for use in clinical practice. The sample consists of 647 employees at a large company ranging in age from 19-64 years-old. Everyday memory failures were evaluated by means of the MFE with the following response format: 0-2 (0 = never or rarely; 1 = occasionally, sometimes; 2 = frequently, often). RESULTS: Mean MFE = 15.25 (SD = 7.50), range 0-40. Correlation with age: .133 (p = .001); and with years of education: - .059 (n.s.). A constant increase in MFE was not observed across age groups (F = 4, 59; p = .003, eta2 = .02), but differences were revealed between the 19-29 and 40-49 age groups; no differences were observed between the remaining age groups. Only slight differences between men and women occurred, the women's mean being slightly higher than the men's, but the confidence intervals overlapped (F = 5, 71; p = .017, eta2 = .01). These results indicate that age, years of education, and sex had no significant effects. In light of the above, the sample was viewed as a whole when computing the percentiles reported here.

The memory failures of everyday (MFE) test: normative data in adults

One approach to the study of everyday memory failures is to use multiple-item questionnaires. The Memory Failures of Everyday (MFE) test is one of the most frequently used in Spain. Our objective is to provide normative data from the MFE in a sample of healthy, Spanish, adult participants for use in clinical practice. The sample consists of 647 employees at a large company ranging in age from 19-64 years-old. Everyday memory failures were evaluated by means of the MFE with the following response format: 0-2 (0 = never or rarely; 1 = occasionally, sometimes; 2 = frequently, often). Results: Mean MFE = 15.25 (SD = 7.50), range 0- 40. Correlation with age: .133 (p = .001); and with years of education: - .059 (n.s.). A constant increase in MFE was not observed across age groups (F = 4, 59; p = .003, η2 = .02), but differences were revealed between the 19-29 and 40-49 age groups; no differences were observed between the remaining age groups. Only slight differences between men and women occurred, the women’s mean being slightly higher than the men’s, but the confidence intervals overlapped (F = 5, 71; p = .017, η2 = .01). These results indicate that age, years of education, and sex had no significant effects. In light of the above, the sample was viewed as a whole when computing the percentiles reported here (AU)

Un modo de abordar el estudio de los fallos de memoria de la vida diaria es utilizar cuestionarios de múltiples ítems. Uno de los más utilizados en nuestro medio es el Cuestionario de Fallos de Memoria de la Vida Cotidiana (MFE). Nuestro objetivo es presentar datos normativos para población adulta española del MFE para su utilización en la práctica clínica. La muestra está formada por 647 sujetos (19-64 años), trabajadores de una gran empresa. Se han evaluado los olvidos cotidianos mediante el MFE con la valoración 0-2 (0 = nunca, raras veces; 1 = pocas veces, algunas veces; 2 = con frecuencia, muchas veces). Resultados: La media del MFE es 15.25 (DT = 7.50), rango 0-40; correlación con la edad = .133 (p = .001); con años de estudios: - .059 (n.s.). Entre los grupos de edad no se observa un incremento constante en MFE (F = 4, 59; p = .003, η2 = .02), las diferencias se encuentran entre el grupo de 19-29 años y el de 40-49; no hay diferencias significativas entre las demás comparaciones. Respecto al sexo, hay pocas diferencias y los intervalos de confianza se solapan (F = 5, 71; p = .017 ; η2 = .01). Concluimos que no hay variaciones importantes por edad, sexo ni años de estudios. Teniendo esto en cuenta se considera al grupo como un todo para obtener los percentiles que se presentan (AU)

Nueva versión reducida del test de denominación de Boston para mayores de 65 años: aproximación desde la teoría de respuesta al ítem / A new shortened version of the Boston Naming Test for those aged over 65: an approach from item response theory

Introducción. Uno de los tests más utilizados para la evaluación de la afasia en la práctica clínica es el test de denominación de Boston (BNT), una prueba clásica en la que se presentan 60 láminas con dibujos en blanco y negro que valoran la capacidad de los sujetos para denominar dichos dibujos. Pese a su bondad psicométrica, resulta necesario reducir el número de ítems de la prueba con el fin de disminuir su tiempo de aplicación. Sujetos y métodos. Se reclutó una muestra de 547 sujetos mayores de 65 años a los que se les aplicó un protocolo de evaluación neuropsicológica, que incluía el BNT, para determinar sus estados cognitivos; 405 sujetos no presentaron alteraciones cognitivas relevantes, frente a 142 sujetos que fueron diagnosticados de deterioro cognitivo leve. Resultados. La reducción del número de ítems se realizó de acuerdo con los supuestos de la teoría de respuesta al ítem. Puesto que tanto la edad como el nivel educativo mostraron un efecto significativo en el rendimiento de la prueba, ambas variables fueron utilizadas para hallar los puntos de corte de la nueva versión reducida. Ésta presentó una adecuada fiabilidad (alfa = 0,765) y una elevada correlación con la prueba original (r = 0,876). Conclusiones. La nueva versión reducida consta de 15 ítems ordenados en función de su dificultad. Se trata de una tarea con un elevado poder discriminativo de utilidad en la clínica diaria para la detección de alteraciones del lenguaje en personas mayores (AU)

Introduction. One of the tests that is mostly widely used to evaluate aphasia in clinical practice is the Boston Naming Test (BNT), a classic test in which 60 black and white pictures are presented to subjects in order to evaluate their capacity to put a name to such pictures. Despite its psychometric goodness, the number of items in the test has to be reduced in order to lower the time required to apply it. Subjects and methods. Researchers recruited a sample of 547 subjects over the age of 65, who were then administered a neuropsychological evaluation protocol, including the BNT, to determine their cognitive statuses. No relevant cognitive alterations were observed in 405 subjects versus 142 who were diagnosed with mild cognitive impairment. Results. The number of items was reduced in accordance with the premises of the item response theory. Since both age and level of schooling were found to have a significant effect on performance in the test, the two variables were used to find the cut-off points of the shortened version. This new version presented an adequate degree of reliability (alpha = 0.765) and a high correlation with the original test (r = 0.876). Conclusions. The new shortened version consists of 15 items that are ordered according to the degree of difficulty. It is a task with a high level of discriminating power that is useful in day-to-day clinical practice for detecting alterations in the anguage of the elderly (AU)

[A new shortened version of the Boston Naming Test for those aged over 65: an approach from item response theory]. / Nueva versión reducida del test de denominación de Boston para mayores de 65 años: aproximación desde la teoría de respuesta al ítem.

INTRODUCTION: One of the tests that is mostly widely used to evaluate aphasia in clinical practice is the Boston Naming Test (BNT), a classic test in which 60 black and white pictures are presented to subjects in order to evaluate their capacity to put a name to such pictures. Despite its psychometric goodness, the number of items in the test has to be reduced in order to lower the time required to apply it. SUBJECTS AND METHODS: Researchers recruited a sample of 547 subjects over the age of 65, who were then administered a neuropsychological evaluation protocol, including the BNT, to determine their cognitive statuses. No relevant cognitive alterations were observed in 405 subjects versus 142 who were diagnosed with mild cognitive impairment. RESULTS: The number of items was reduced in accordance with the premises of the item response theory. Since both age and level of schooling were found to have a significant effect on performance in the test, the two variables were used to find the cut-off points of the shortened version. This new version presented an adequate degree of reliability (alpha = 0.765) and a high correlation with the original test (r = 0.876). CONCLUSIONS: The new shortened version consists of 15 items that are ordered according to the degree of difficulty. It is a task with a high level of discriminating power that is useful in day-to-day clinical practice for detecting alterations in the language of the elderly.

The memory failures of everyday questionnaire (MFE): internal consistency and reliability.

The Memory Failures of Everyday Questionnaire (MFE) is one of the most widely-used instruments to assess memory failures in daily life. The original scale has nine response options, making it difficult to apply; we created a three-point scale (0-1-2) with response choices that make it easier to administer. We examined the two versions' equivalence in a sample of 193 participants between 19 and 64 years of age. The test-retest reliability and internal consistency of the version we propose were also computed in a sample of 113 people. Several indicators attest to the two forms' equivalence: the correlation between the items' means (r = .94; p < .001) and the order of the items' frequencies (r = .92; p < .001). However, the correlation between global scores on the two forms was not very high (r = .67; p < .001). The results indicate this new version has adequate reliability and internal consistency (r(xx) = .83; p < .001; alpha = .83; p < .001) equivalent to those of the MFE 1-9. The MFE 0-2 provides a brief, simple evaluation, so we recommend it for use in clinical practice as well as research.

The memory failures of everyday questionnaire (MFE): internal consistency and reliability

The Memory Failures of Everyday Questionnaire (MFE) is one of the most widely-used instruments to assess memory failures in daily life. The original scale has nine response options, making it difficult to apply; we created a three-point scale (0-1-2) with response choices that make it easier to administer. We examined the two versions’ equivalence in a sample of 193 participants between 19 and 64 years of age. The test-retest reliability and internal consistency of the version we propose were also computed in a sample of 113 people. Several indicators attest to the two forms’ equivalence: the correlation between the items’ means (r = .94; p < .001) and the order of the items’ frequencies (r = .92; p < .001). However, the correlation between global scores on the two forms was not very high (r = .67; p < .001). The results indicate this new version has adequate reliability and internal consistency (rxx’ = .83; p < .001; α = .83; p < .001) equivalent to those of the MFE 1-9. The MFE 0-2 provides a brief, simple evaluation, so we recommend it for use in clinical practice as well as research (AU)

El Cuestionario de Fallos de Memoria de la Vida Cotidiana (MFE) es uno de los instrumentos más utilizados para valorar los olvidos cotidianos. La escala original tiene nueve opciones de respuesta lo que dificulta su aplicación; hemos elaborado una nueva escala de tres opciones de respuestas (0-1-2) más sencilla de administrar. La equivalencia entre ambas versiones se estudió en una muestra de 193 participantes de 19 a 64 años. También se estimó la fiabilidad test-retest y consistencia interna de la versión propuesta en otra muestra de 113 personas. Varios indicadores mostraron la equivalencia entre ambas formas: la correlación entre las medias de los elementos (r = .94; p < .001) y el orden de las frecuencias de los ítems (r = .92; p < .001). Sin embargo la correlación entre las puntuaciones globales de las dos formas no fue muy elevada (r = .67; p < .001). Respecto a la fiabilidad y consistencia interna de la nueva versión los resultados fueron adecuados (rxx’ = .83; p < .001; α = .83; p < .001), y equivalentes a los del MFE 1-9. El MFE 0-2 ofrece un sistema de valorar breve y sencillo por lo que recomendamos su uso en la práctica clínica y en la investigación (AU)

Evaluación y diagnóstico del deterioro cognitivo leve / Evaluation and diagnosis of mild cognitive impairment

El deterioro cognitivo leve o ligero (DCL) es la disminución mantenida de las funciones cognitivas que no es suficientemente severa como para ser considerada una demencia. Actualmente el DCL está infradiagnosticado y el reto supone detectarlo en la fase prodrómica dado que es un proceso que con frecuencia evoluciona a la enfermedad de Alzheimer (EA). Los nuevos criterios de diagnóstico del DCL incluyen biomarcadores, pero, en la práctica diaria, la historia clínica y la evaluación de diversas esferas, sobre todo la neuropsicológica, siguen siendo las herramientas más eficaces. El paciente suele acudir a consulta con quejas de memoria aunque a veces es llevado por los familiares que observan olvidos importantes. El primer paso es detectar que haya deterioro cognitivo con pruebas de cribaje entre las que se encuentran el MMSE o el Test 7 Minutos. Para confirmar la sospecha se completa la evaluación por áreas, sobre todo la memoria, o empleando baterías especiales para deterioro cognitivo y/o demencia. Es preciso evaluar las capacidades funcionales mediante escalas de valoración de las actividades de la vida diaria y explorar los síntomas neurológicos y psiquiátricos. También se realizan pruebas complementarias para descartar posibles causas de deterioro cognitivo reversible. Un diagnóstico precoz del DCL nos permitirá poner en marcha cuanto antes terapias no farmacológicas y en breve, terapias farmacológicas, así como enlentecer el desarrollo del deterioro cognitivo (AU)

Mild cognitive impairment (MCI) is a sustained decrease of cognitive functions that is insufficiently severe to warrant a diagnosis of dementia. Currently, MCI is underdiagnosed. Since MCI often progresses to Alzheimer's disease, the challenge is to identify this process in the prodromal phase. New diagnostic criteria include the use of biomarkers. However, in daily practice, clinical history and the assessment of diverse areas, mainly neuropsychological, remain the most effective tools. The patient usually attends consultations with memory complaints, but is sometimes brought by relatives who observe substantial memory failures. The first step is to detect that there is cognitive impairment with screening tests such as the Mini Mental State Examination or the Seven Minute Test. To confirm suspicion, the evaluation is completed by assessing cognitive areas, especially memory, or by using specific batteries for cognitive deterioration and/or dementia. Complex functional tasks should be evaluated through scales of activities of daily living. Neurological and psychiatric symptoms should also be assessed. Additional studies (laboratory tests) are used to exclude reversible causes of cognitive impairment. Early diagnosis of MCI allows non-pharmacological therapies and, shortly, pharmacological treatments to be started as early as possible, thus slowing the development of cognitive deterioration (AU)