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Mild Cognitive Impairment: An Overview

Published online by Cambridge University Press:  07 November 2014

Abstract

Mild cognitive impairment (MCI) refers to the transitional state between the cognitive changes of normal aging and very early dementia. MCI has generated a great deal of research from both clinical and research perspectives. Several population- and community-based studies have documented an accelerated rate of progression to dementia and Alzheimer's disease in individuals diagnosed with MCI. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. Progression factors, including genetic, neuroimaging, biomarker, and clinical characteristics, are discussed. Neuropathological studies indicating an intermediate state between normal aging and early dementia in subjects with MCI are presented. The recently completed clinical trials as well as neuropsychological and nutritional interventions are discussed. Finally, the clinical utility of MCI, and directions for future research are proposed.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2008

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References

REFERENCES

1.Sloane, PD, Zimmerman, S, Suchindran, C. The public health impact of Alzheimer's disease, 2000–2050: potential implication of treatment advances. Annu Rev Pub Health. 2002;23:213231.CrossRefGoogle ScholarPubMed
2.Kral, VA. Senescent forgetfulness: benign and malignant. Can Med Assoc J. 1962;86:257260.Google ScholarPubMed
3.Crook, T, Bartus, RT, Ferris, SH, Whitehouse, P, Cohen, GD, Gershon, S. Age-associated memory impairment: proposed diagnositc criteria and measures of clinical change-report of a National Institute of Mental Health Work Group. Dev Neuropsycol. 1986;2:261276.Google Scholar
4.Levy, R. Aging-associated cognitive decline. Int Psychogeriatr. 1994;6:6368.Google ScholarPubMed
5.Graham, JE, Rockwood, K, Beattie, BL, et al.Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet. 1997;349:17931796.Google Scholar
6.Fisk, JD, Merry, HR, Rockwood, K. Variations in case definition affect prevalence but not outcomes of mild cognitive impairment. Neurology. 2003;61:11791184.Google Scholar
7.Reisberg, B, Ferris, SH, de Leon, MJ, Crook, T. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry. 1982;139:11361139.Google Scholar
8.Flicker, C, Ferris, SH, Reisberg, B. Mild cognitive impairment in the elderly: predictors of dementia. Neurology. 1991;41:10061009.Google Scholar
9.Reisberg, B, Ferris, SH, de Leon, MJ, et al.Stage-specific behavioral cognitive and in vivo changes in community residing subjects with age-associated memory impairment and primary degenerative dementia of the Alzheimer's Type. Drug Dev Res. 1988;15:101114.Google Scholar
10.Morris, JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43:24122414.Google Scholar
11.Morris, JC, Storandt, M, Miller, JP, et al.Mild cognitive impairment represents early-stage Alzheimer's disease. Arch Neurol. 2001;58:397405.CrossRefGoogle Scholar
12.Petersen, RC. Conceptual overview. In: Petersen, RC, ed. Mild Cognitive Impairment Aging to Alzheimer's Disease. New York, NY: Oxford University Press, Inc.; 2003:114.Google Scholar
13.Petersen, RC, Stevens, JC, Ganguli, M, Tangalos, EG, Cummings, JL, DeKosky, ST. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2001;56:11331142.Google Scholar
14.Petersen, RC, Smith, GE, Waring, SC, Ivnik, RJ, Tangalos, EG, Kokmen, E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303308.CrossRefGoogle ScholarPubMed
15.Winblad, B, Palmer, K, Kivipelto, M, et al.Mild cognitive impairment-beyond controversies, towards a consensus. J Intern Med. 2004;256:240246.CrossRefGoogle ScholarPubMed
16.Petersen, RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256:183194.CrossRefGoogle ScholarPubMed
17.Mueller, SG, Weiner, MW, Thal, LJ, et al.The Alzheimer's Disease Neuroimaging Initiative. In: Pettrella, JR, Doraiswamy, PM, eds. Neuroimaging Clinics of North America: Alzheimer's Disease—100 Years of Progress. Philadelphia, Penn: Elsevier Saunders; 2005:869877.Google Scholar
18.Daly, E, Zaitchik, D, Copeland, M, Schmahmann, J, Gunther, J, Albert, M. Predicting conversion to Alzheimer's disease using standardized clinical information. Arch Neurol. 2000;57:675680.Google Scholar
19.Boeve, B, Ferman, TJ, Smith, GE, et al.Mild Cognitive Impairment preceding dementia with Lewy Bodies. Neurology. 2004;62(suppl 5):A86.Google Scholar
20.Ganguli, M, Dodge, HH, Shen, C, DeKosky, ST. Mild cognitive impairment, amnestic type. An epidemiologic study. Neurology. 2004;63:115121.Google Scholar
21.Ritchie, K, Artero, S, Touchon, J. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology. 2001;56:3742.Google Scholar
22.Larrieu, S, Letenneur, L, Orgogozo, JM, et al.Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology. 2002;59:15941599.Google Scholar
23.Petersen, RC, Smith, GE, Waring, SC, Ivnik, RJ, Tangalos, EG, Kokmen, E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999;56:303308.Google Scholar
24.Gauthier, S, Reisberg, B, Zaudig, M, et al.International Psychogeriatric Association Expert Conference on mild cognitive impairment. Lancet. 2006;367:12621270.Google Scholar
25.Busse, A, Hensel, A, Guhne, U, Angermeyer, MC, Riedel-Heller, SG. Mild cognitive impairment: long-term course of four clinical subtypes. Neurology. 2006;67:21762185.Google Scholar
26.Corder, EH, Saunders, AM, Strittmatter, WJ, et al.Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. Science. 1993;261:921923.Google Scholar
27.Aggarwal, NT, Wilson, RS, Beck, TL, Bienias, JL, Bennett, DA. Mild cognitive impairment in different functional domains and incident Alzheimer's disease. J Neurol Neurosurg Psychiatry. 2005;76:14791484.CrossRefGoogle ScholarPubMed
28.Tierney, MC, Szalai, JP, Snow, WG, et al.A prospective study of the clinical utility of ApoE genotype in the prediction of outcome in patients with memory impairment. Neurology. 1996;46:149154.CrossRefGoogle ScholarPubMed
29.Petersen, RC, Smith, GE, Ivnik, RJ, et al.Apolipoprotein E status as a predictor of the development of Alzheimer's disease in memory-impaired individuals. JAMA. 1995;273:12741278.Google Scholar
30.Jak, AJ, Houston, WS, Nagel, BJ, Corey-Bloom, J, Bondi, MW. Differential cross-sectional and longitudinal impact of APOE genotype on hippocampal volumes in nondemented older adults. Dement Geriatr Cogn Disord. 2007;23:382389.CrossRefGoogle ScholarPubMed
31.Farrer, LA, Cupples, A, Haines, JL, et al.Effects of age, sex, and ethnicity on the association between Apolipoprotein E genotype and Alzheimer's disease. JAMA. 1997;278:13491356.Google Scholar
32.Hunderfund, AL, Roberts, RO, Slusser, TC, et al.Mortality in amnestic mild cognitive impairment: a prospective community study. Neurology. 2006;67:17641768.CrossRefGoogle ScholarPubMed
33.Fox, NC, Crum, WR, Scahill, RI, Stevens, JM, Janssen, JC, Rossor, MN. Imaging of onset and progression of Alzheimer's disease with voxel-compression mapping of serial magnetic resonance images. Lancet. 2001;358:201205.Google Scholar
34.Jack, CR Jr. Magnetic resonance imaging. In: Petersen, RC, ed. Mild Cognitive Impairment: Aging to Alzheimer's Disease. New York, NY: Oxford University Press, Inc.; 2003:105132.Google Scholar
35.Killiany, RJ, Gomez-Isla, T, Moss, M, et al.Use of structural magnetic resonance imaging to predict who will get Alzheimer's disease. Ann Neurol. 2000;47:430439.Google Scholar
36.Jack, CR Jr, Petersen, RC, Xu, YC, et al.Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment. Neurology. 1999;52:13971403.CrossRefGoogle ScholarPubMed
37.Jack, CR Jr, Shiung, MM, Weigand, SD, et al.Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI. Neurology. 2005;65:12271231.Google Scholar
38.Reiman, EM, Caselli, RJ, Yun, LS, et al.Preclinical evidence of Alzheimer's disease in persons homozygous for the E4 allele for apolipoprotein E. N Engl J Med. 1996;334:752758.Google Scholar
39.Small, GW, Mazziotta, JC, Collins, MT, et al.Apolipoprotein E Type 4 allele and cerebral glucose metabolism in relatives at risk for familial Alzheimer's disease. JAMA. 1995;273:942947.Google Scholar
40.Drzezga, A, Grimmer, T, Riemenschneider, M, et al.Prediction of individual clinical outcome in MCI by means of genetic assessment and (18)F-FDG PET. J Nucl Med. 2005;46:16251632.Google Scholar
41.Klunk, WE, Engler, H, Nordberg, A, et al.Imaging brain amyloid in Alzheimer's disease with Pittsburgh Compound-B. Ann Neurol. 2004;55:303305.Google Scholar
42.Small, GW, Kepe, V, Ercoli, LM, et al.FDDNP-PET binding differentiates MCI from dementia and increases with clinical progression. Alzheimers Dement. 2006:2(suppl 1):53185319.Google Scholar
43.Hansson, O, Zetterberg, H, Buchhave, P, Londos, E, Blennow, K, Minthon, L. Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurol. 2006;5:228234.CrossRefGoogle ScholarPubMed
44.Markesbery, WR, Schmitt, FA, Kryscio, RJ, Davis, DG, Smith, CD, Wekstein, DR. Neuropathologic substrate of mild cognitive impairment. Arch Neurol. 2006;63:3846.Google Scholar
45.Bennett, DA, Schneider, JA, Bienias, JL, Evans, DA, Wilson, RS. Mild cognitive impairment is related to Alzheimer's disease pathology and cerebral infarctions. Neurology. 2005;64:834841.Google Scholar
46.Jicha, GA, Parisi, JE, Dickson, DW, et al.Neuropathologic outcome of mild cognitive impairment following progression to clinical dementia. Arch Neurol. 2006;63:674681.Google Scholar
47.Petersen, RC, Parisi, JE, Dickson, DW, et al.Neuropathologic features of amnestic mild cognitive impairment. Arch Neurol. 2006;63:665672.Google Scholar
48.Geda, YE, Petersen, RC. Clinical trials in mild cognitive impairment. In: Gauthier, S, Cummings, JL, eds. Alzheimer's Disease and Related Disorders Annual 2001. London, England: Martin Dunitz; 2001:6983.Google Scholar
49.Petersen, R. Mild cognitive impairment clinical trials. Nat Rev Drug Discov. 2003;2:646653.Google Scholar
50.Gauthier, S. Pharmacotherapy of mild cognitive impairment. Dialogues Clin Neurosci. 2004;6:391395.CrossRefGoogle ScholarPubMed
51.Petersen, RC, Thomas, RG, Grundman, M, et al.Donepezil and vitamin E in the treatment of mild cognitive impairment. N Engl J Med. 2005;352:23792388.Google Scholar
52.Gold, M, Francke, S, Nye, JS, et al.Impact of APOE genotype on the efficacy of galantamine for the treatment of mild cognitive impairment. Neurobiol Aging. 2004;25:S521.Google Scholar
53.Feldman, H, Scheltens, P, Scarpini, E, et al.Behavioral symptoms in mild cognitive impairment. Neurology. 2004;62:11991201.CrossRefGoogle ScholarPubMed
54.Thal, LJ, Ferris, SH, Kirby, L, et al.A randomized, double-blind, study of rofecoxib in patients with mild cognitive impairment. Neuropsychopharmacology. 2005;30:12041215.CrossRefGoogle ScholarPubMed
55.Petersen, RC, Smith, GE, Ivnik, RJ, et al.Apolipoprotein E status as a predictor of the development of Alzheimer's disease in memory-impaired individuals. JAMA. 1995;273:12741278.CrossRefGoogle ScholarPubMed
56.Cooper, JK, Mungas, D, Verma, M, Weiler, PG. Psychotic symptoms in Alzheimer's disease. Int J Geriatr Psychiatry. 1991;6:721726.Google Scholar
57.Petersen, RC, O'Brien, J. Mild cognitive impairment should be considered for DSM-V. J Geriatr Psychiatry Neurol. 2006;19:147154.Google Scholar
58.Petersen, RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004;256:183194.CrossRefGoogle ScholarPubMed