Operationalizing mild cognitive impairment criteria in small vessel disease: the VMCI-Tuscany Study

Abstract

Introduction: Mild cognitive impairment (MCI) prodromic of vascular dementia is expected to have a multidomain profile.

Methods: In a sample of cerebral small vessel disease (SVD) patients, we assessed MCI subtypes distributions according to different operationalization of Winblad criteria and compared the neuroimaging features of single versus multidomain MCI. We applied three MCI diagnostic scenarios in which the cutoffs for objective impairment and the number of considered neuropsychological tests varied.

Results: Passing from a liberal to more conservative diagnostic scenarios, of 153 patients, 5% were no longer classified as MCI, amnestic multidomain frequency decreased, and nonamnestic single domain increased. Considering neuroimaging features, severe medial temporal lobe atrophy was more frequent in multidomain compared with single domain.

Discussion: Operationalizing MCI criteria changes the relative frequency of MCI subtypes. Nonamnestic single domain MCI may be a previously nonrecognized type of MCI associated with SVD.

Trial registration: ClinicalTrials.gov NCT02033850.

Keywords: Cerebrovascular disease; Cognitive aging; Mild cognitive impairment; Neuropsychology; Vascular dementia.