Resumo

BARBOSA, Eduarda Naidel Barboza e et al. Neuropsychological profiles of Mild Cognitive Impairment (MCI) during aging. Neuropsicologia Latinoamericana [online]. 2015, vol.7, n.2, pp. 15-23. ISSN 2075-9479.  http://dx.doi.org/10.5579/rnl.2015.0257.

Identifying the preclinical phase of dementia is critical for planning an early intervention. Objective: To investigate the role of a neuropsychological assessment in the classification of Mild Cognitive Impairment (MCI) and identify MCI's neuropsychological profiles based on the use of a cognitive algorithm. Method: Eighty-eight elderly adults from a geriatric outpatient public hospital in Rio de Janeiro were studied. All patients were classified as having MCI according to a medical evaluation and their performance on a Brief Cognitive Screening Battery (BCSB). Elderly adults diagnosed with dementia by the medical team were excluded from the study. In order to discuss the role of a neuropsychological assessment for the concept of MCI, the patients were assessed by a battery composed of the Mattis Dementia Rating Scale (MDRS) and the Rey Auditory-Verbal Learning Test (RAVLT). A cognitive algorithm was proposed and elderly adults with MCI were classified into the following neuropsychological profiles: 1) preservation of cognitive functions (normal), 2) amnestic single domain, 3) amnestic multiple domains, 4) non-amnestic, and 5) amnestic multiple domains with impaired global cognitive functioning (Alzheimer's Disease - AD). Results: The DA (33%) and non-amnestic (33%) neuropsychological profiles were the most frequently observed, followed by the amnesic (20%) and normal (14%) profiles. The AD profile showed impairment in MDRS Total, as well as all other MDRS subscales and RAVLT variables. The predominant impairment in the non-amnestic profile was in MDRS Construction, and the impairment observed for the amnestic profile was in MDRS Memory and in Free Evocation after delay in RAVLT A7. The variables that best discriminate among neuropsychological profiles are A7 and MDRS Construction, based on an ANOVA followed by a Bonferroni post-hoc test. Conclusion: These results indicate that, although all the elderly adults had a MCI diagnosis, their neuropsychological profiles varied when a comprehensive neuropsychological evaluation, standardized for age and education, was employed. The definition of a specific algorithm and the selection of cognitive tests may enable the identification of different patterns of MCI neuropsychological profiles and foster discussions about the diagnostic heterogeneity of this clinical entity and, thus, about the different therapeutic approaches aimed at each neurocognitive profile.

Palavras-chave : Mild Cognitive Impairment; Neuropsychological tests; Mattis Dementia Rating Scale; Rey Auditory-Verbal Learning Test; Aging.

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