Course Title: CE 09: MCI and Preclinical AD: Concepts in Need of Input from Neuropsychology to Improve Diagnostic Precision and Prediction (Bondi)

Credit Hours: 1.5

Instructor(s) Mark Bondi

Mark W. Bondi, PhD, ABPP/CN Professor of Psychiatry, UC San Diego Director, Neuropsychological Assessment Unit, VA San Diego Healthcare System
CE Workshop # 9: MCI and Preclinical AD: Concepts in Need of Input from Neuropsychology to Improve Diagnostic Precision and Prediction
Abstract & Learning Objectives: This workshop will present updated diagnostic criteria, with a focus on the neuropsychological features of mild cognitive impairment (MCI) and subtle cognitive deficits of preclinical Alzheimer’s disease (AD), in the context of characteristic cognitive changes leading to AD dementia. Seeking to refine diagnostic and prediction models, in a series of studies we have compared conventional criteria used to diagnose MCI with our actuarial neuropsychological methods. Results from these studies suggest that conventional criteria are susceptible to both false positive and false negative diagnostic errors, whereas MCI participants diagnosed via neuropsychological criteria yield specific cognitive profiles, significant biomarker associations (e.g., cerebrospinal fluid concentrations of abnormal Alzheimer-related proteins such as amyloid and tau), more stable diagnoses, and greater percentages who progress to dementia than conventional MCI diagnostic criteria. We further extend this actuarial method to support refinement of research criteria for objective subtle cognitive decline in preclinical AD diagnosis. This workshop will thus reflect the research and clinical advances in identifying MCI and preclinical AD, examining its biomarker signatures, and offer new possibilities for improving diagnostic precision. The evidence reviewed in this workshop concludes that a multi-faceted approach that integrates neuropsychological and biomarker assessments will likely be needed to characterize the preclinical phase of AD and ends with the suggestion that neuropsychological assessment provides a central and non-interchangeable role in the diagnosis of the older adult, and that cognitive measures are among the best predictors of the initial symptomatic stages of an evolving dementia. Upon conclusion of this course, learners will be able to:
  • Describe the relative value of biomarkers and cognitive measures to diagnosis
  • Assess actuarial neuropsychological diagnostic criteria in MCI and subtle cognitive decline
  • Critique their roles in prediction of progression along the aging-MCI-AD continuum
Speaker Biography: Dr. Mark Bondi is Professor of Psychiatry at the University of California San Diego, and Director of the Neuropsychological Assessment Unit at the VA San Diego Healthcare System. He has served on the boards of the American Psychological Association’s Continuing Education Committee and Commission for the Recognition of Specialties and Proficiencies in Professional Psychology, board of directors of the American Board of Clinical Neuropsychology, board of governors of the International Neuropsychological Society, and is former president of the Society for Clinical Neuropsychology (Division 40). He has received continuous funding from NIH, VA, and private foundation grants since 1991, and he is a sponsor or co-sponsor of 20 NIH, NSF, VA and private foundation career development awards of his current and former trainees. His research centers on the cognitive and brain changes of individuals at risk for dementia, he has published more than 200 articles and book chapters, and he is co-author of the book Mild Cognitive Impairment and Dementia: Definitions, Diagnosis and Treatment. He has served on the editorial boards of several neuropsychology journals (e.g., JCEN, JINS, Neuropsychology, TCN), and currently is a Senior Editor for the Journal of Alzheimer’s Disease. In addition to his research in aging and dementia, he is an active clinician, teacher and supervisor for his institution’s doctoral training, internship, and postdoctoral fellowship programs.