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. 2019 Sep 10;14(9):e0221873.
doi: 10.1371/journal.pone.0221873. eCollection 2019.

Distinguishing mild cognitive impairment from healthy aging and Alzheimer's Disease: The contribution of the INECO Frontal Screening (IFS)

Helena S Moreira  1 , Ana Sofia Costa  2   3   4 , Álvaro Machado  2 , São Luís Castro  1 , César F Lima  1   5 , Selene G Vicente  1
Affiliations

Distinguishing mild cognitive impairment from healthy aging and Alzheimer's Disease: The contribution of the INECO Frontal Screening (IFS)

Helena S Moreira et al. PLoS One. .

Abstract

Executive functions are affected differently in healthy aging, Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), and evaluating them is important for differential diagnosis. The INECO Frontal Screening (IFS) is a brief neuropsychological screening tool, developed to assess executive dysfunction in neurodegenerative disorders.

Goals: We aimed to examine whether and how MCI patients can be differentiated from cognitively healthy controls (HC) and mild to moderate AD patients based on IFS performance. We also explored how IFS scores are associated with age, years of education, and depressive/anxious symptoms (as assessed by the Hospital Anxiety and Depression Scale).

Method: IFS total scores were compared between 26 HC, 32 MCI and 21 mild to moderate AD patients. The three groups were matched for age and education. The Area Under the Curve (AUC) was analyzed and optimal cut-offs were determined.

Results: Healthy participants had higher IFS scores than both clinical groups, and MCI patients had higher scores than AD patients. IFS showed high diagnostic accuracy for the detection of MCI (AUC = .89, p < .001) and AD (AUC = .99, p < .001), and for the differentiation between the clinical groups (AUC = .76, p < .001). We provide optimal cut-offs for the identification of MCI and AD and for their differentiation. We also found that, in general, higher education predicted higher IFS scores (no associations with age and depressive/anxious symptoms were observed). Altogether, these findings indicate that evaluating executive functions with the IFS can be valuable for the identification of MCI, a high-risk group for dementia, and for differentiating this condition from healthy aging and AD.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Total IFS total scores for control and clinical groups.
HC, Healthy Controls; MCI, patients with Mild Cognitive Impairment (MCI); AD, patients with Alzheimer’s dementia. Error bars represent standard error. * p < .05.
Fig 2
Fig 2. Receiver operating characteristic (ROC) curves of the IFS in the differentiation between control and clinical groups, as well as between the two clinical groups.
HC from MCI patients (left) and AD patients (center); MCI from AD patients (right).
See this image and copyright information in PMC

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