Preliminary evidence for an increased likelihood of a stable trajectory in mild cognitive impairment in individuals with higher motivational abilities

BMC Geriatr. 2018 Aug 13;18(1):181. doi: 10.1186/s12877-018-0865-5.

Abstract

Background: Motivational abilities (MA), that describe skills in relation to goal-oriented behavior, have recently been found to be associated with neuropathological aging. Here we examine the impact of MA on the long-term course of mild cognitive impairment (MCI).

Methods: We followed-up N = 64 individuals diagnosed with MCI (Mage = 73 years, 44% female) for 3 years. MA were assessed by long-term informants of the participants using two scales: motivation and decision regulation [Volitional Components Questionnaires, VCQ, (Kuhl and Fuhrmann, Decomposing self-regulation and self-control: the volitional components inventory, 1998)]. Cognitive abilities were assessed with the Mini Mental State Examination (J Psychiatr Res 12:189-98, 1975). Survival analyses and multilevel modeling (MLM) were applied to determine the predicting effect of informant-rated MA at baseline on the likelihood of MCI stability and on the trajectory of cognitive abilities.

Results: Fifty percent (n = 32) of the MCI participants remained stable, while 32.8% (n = 21) and 17.2% (n = 11) converted to Alzheimer's disease (AD) or dropped-out, respectively. Survival analyses revealed that MCI cases with higher-rated MA at baseline were more likely to exert a stable course in MCI over 3 years (p = 0.036) when controlling for demographic characteristics and executive function. MLM analyses indicated that higher informant-rated MA at baseline were significantly related to higher cognitive abilities, even when controlling for MCI subtype (p = 0.030).

Conclusions: This study provides preliminary longitudinal evidence for a lower risk of conversion to AD and higher cognitive abilities by higher rated MA at an early stage of MCI.

Keywords: Informant-rated motivational abilities; Mild cognitive impairment; Stability.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / epidemiology
  • Alzheimer Disease / psychology
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / psychology*
  • Disease Progression*
  • Executive Function / physiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Motivation* / physiology
  • Neuropsychological Tests
  • Surveys and Questionnaires