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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.

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



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


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.


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.


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.


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

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