Is amnestic mild cognitive impairment a useful concept?

Elissa L. Ash, Amos D. Korczyn

Research output: Contribution to journalArticlepeer-review

Abstract

As the worlds population continues to age, the issues of age-related memory impairment become increasingly important and relevant to individual health and quality of life, as well as an increasing public health and societal concern. The concept of mild cognitive impairment (MCI) has emerged as a response to the desire and need to identify an indolent clinical condition that would reliably predict progression to dementia, particularly Alzheimers disease (AD). As a result of decades of research in the field of neurodegeneration, it is becoming increasingly evident that neurodegenerative diseases begin years before the onset of clinical symptoms, and that standard clinical practice may be relatively insensitive at identifying early neurodegenerative states. The MCI concept was developed to identify the clinical parameters that define the earliest stages of the neurodegenerative process. The essence of the MCI classification is that of mild but measurable cognitive changes indicating a predisposition to progression to dementia, prior to the onset of functional decline. MCI and, more specifically, amnestic MCI were initially proposed as pathological transitional states that ultimately progress to full blown AD. However, after more than a decade of observations, it has been found that MCI subjects do not uniformly progress to dementia or AD and may revert back to normal cognitive states. While the concept of MCI may represent a valid model for characterization of the earliest stages of dementia and for delineation of risk factors, the operational definition may not adequately convey the intended concepts, and as such should be viewed with caution. Additional modifications to the concept and its operationalization are suggested in order to better identify patients with incipient AD and to guide clinical and research practices.

Original languageEnglish
Pages (from-to)107-122
Number of pages16
JournalAging Health
Volume7
Issue number1
DOIs
StatePublished - Feb 2011

Keywords

  • Alzheimers disease
  • aging
  • dementia
  • memory
  • mild cognitive impairment

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