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Alzheimers Dement (Amst). 2019 Feb 22;11:170-179. doi: 10.1016/j.dadm.2018.12.010. eCollection 2019 Dec.

Breadth and depth of working memory and executive function compromises in mild cognitive impairment and their relationships to frontal lobe morphometry and functional competence.

Author information

1
Department of Psychiatry, University of Oviedo, Oviedo, Spain.
2
Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Spain.
3
Fundación para la Investigación e Innovación Biosanitaria del Principado de Asturias (Finba), Oviedo, Spain.
4
The Litwin-Zucker Alzheimer's Research Center, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
5
FIDMAG Hermanas Hospitalarias Research Foundation, SantBoi de Llobregat, Spain.
6
Division of Geriatric Psychiatry, Psychiatry, Columbia University Medical Center, NY, USA.

Abstract

Introduction:

The extent of working memory (WM) and executive function (EF) impairment in mild cognitive impairment (MCI) is not well-characterized.

Methods:

We compared 48 patients with MCI, 124 noncognitively impaired elderly healthy controls, and 57 patients with Alzheimer's disease (AD) on multiple WM/EF measures, frontal lobe integrity indexes, and functioning.

Results:

Patients with MCI demonstrated worse performance on nearly all WM/EF tests. This profile of impairment was refined in a factor analysis that identified three primary WM/EF constructs: WM storage; speed and controlled visual search; and manipulation of information and problem solving. EF impairments were associated with reductions in prefrontal cortical thickness. WM/EF accounted for over 50% of the variance in functional competence.

Discussion:

In MCI, WM/EF impairments are far from rare, based on specific compromises to frontal cortex circuitry, and are associated with loss of everyday functioning. WM/EF impairments, even at this potentially prodromal stage of AD, have clinically deleterious consequences.

KEYWORDS:

Executive function; Frontal cortex; Functional competence; Mild cognitive impairment (MCI); Working memory

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