Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-6bf8c574d5-n2sc8 Total loading time: 0 Render date: 2025-03-09T17:08:31.481Z Has data issue: false hasContentIssue false

13 - Mild cognitive impairment

Published online by Cambridge University Press:  31 July 2009

By
Brendan J. Kelley  and
Ronald C. Petersen
Edited by
Bruce L. Miller  and
Bradley F. Boeve
Bruce L. Miller
Affiliation:
University of California, San Francisco
Bradley F. Boeve
Affiliation:
Mayo Foundation, Minnesota
Get access

Summary

Introduction

Most degenerative conditions are characterized by insidious onset and gradually progressive decline. Therefore, the presumption of an early stage in the development of a degenerative disorder in which a person might be “partially symptomatic” is quite plausible. Applied to Alzheimer's disease (AD), the prodromal phase might represent an individual who is slightly forgetful with preservation of other cognitive and functional abilities. Mild cognitive impairment (MCI) refers to the transitional state between normal cognitive changes of aging and the earliest clinical features of dementia. As such, it has become an important topic in clinical practice and research. As initially conceived, MCI referred to memory impairment with preserved non-memory cognitive performance and functional abilities, but more recently, the term has been expanded to include other cognitive domains besides memory. Most literature refers to the amnestic (memory predominant) form of MCI (aMCI), a likely precursor of Alzheimer's disease (AD).

In recent years, a tremendous amount of information has been published regarding the early diagnosis of dementia. Consequently, a more general construct of MCI and of specific subtypes of MCI has been adopted as the prodromal phases of various diseases. The general framework of MCI as the incipient phase of a degenerative disease remains an important concept. Research since the mid 1990s on MCI has shown the criteria to be reliable, and the outcomes of patients are known. Some predictors of progression from MCI to AD are known and others are still being evaluated.

Type
Chapter
Information
The Behavioral Neurology of Dementia , pp. 172 - 187
Publisher: Cambridge University Press
Print publication year: 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Petersen, RC. Mild Cognitive Impairment: Aging to Alzheimer's Disease. Oxford: Oxford University Press; 2003.Google Scholar
Petersen, RC, Doody, R, Kurz, Aet al. Current concepts in mild cognitive impairment. Arch Neurol 2001;58(12):1985–1992.CrossRefGoogle ScholarPubMed
Petersen, RC, Smith, GE, Waring, SCet al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56(3):303–308.CrossRefGoogle ScholarPubMed
Sloane, PD, Zimmerman, S, Suchindran, Cet al. The public health impact of Alzheimer's disease, 2000–2050: potential implication of treatment advances. Annu Rev Public Health 2002;23:213–231.CrossRefGoogle ScholarPubMed
Gauthier, S, Reisberg, B, Zaudig, Met al. Mild cognitive impairment. Lancet 2006;367(9518):1262–1270.CrossRefGoogle ScholarPubMed
Lopez, OL, Jagust, WJ, DeKosky, STet al. Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study: Part 1. Arch Neurol 2003;60(10):1385–1389.CrossRefGoogle ScholarPubMed
Busse, A, Hensel, A, Guhne, U, Angermeyer, MC, Riedel-Heller, SG. Mild cognitive impairment: long-term course of four clinical subtypes. Neurology 2006;67(12):2176–2185.CrossRefGoogle ScholarPubMed
Graham, JE, Rockwood, K, Beattie, BLet al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349(9068):1793–1796.CrossRefGoogle Scholar
Unverzagt, FW, Gao, S, Baiyewu, Oet al. Prevalence of cognitive impairment: data from the Indianapolis Study of Health and Aging. Neurology 2001;57(9):1655–1662.CrossRefGoogle ScholarPubMed
Bennett, DA, Wilson, RS, Schneider, JAet al. Natural history of mild cognitive impairment in older persons. Neurology 2002;59(2):198–205.CrossRefGoogle ScholarPubMed
Ritchie, K, Artero, S, Touchon, J. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 2001;56(1):37–42.CrossRefGoogle ScholarPubMed
Hanninen, T, Hallikainen, M, Tuomainen, S, Vanhanen, M, Soininen, H. Prevalence of mild cognitive impairment: a population-based study in elderly subjects. Acta Neurol Scand 2002;106(3):148–154.CrossRefGoogle ScholarPubMed
Boeve, B, McCormick, J, Smith, Get al. Mild cognitive impairment in the oldest old. Neurology 2003;60(3):477–480.CrossRefGoogle ScholarPubMed
Petersen, R, Roberts, R, Knopman, Det al. Prevalence of mild cognitive impairment in a population-based study. Neurology 2007;68(Suppl 1):A237.Google Scholar
Jungwirth, S, Weissgram, S, Zehetmayer, S, Tragl, KH, Fischer, P. VITA: subtypes of mild cognitive impairment in a community-based cohort at the age of 75 years. Int J Geriatr Psychiatry 2005;20(5):452–458.CrossRefGoogle Scholar
Di Carlo, A, Lamassa, M, Baldereschi, Met al. CIND and MCI in the Italian elderly: frequency, vascular risk factors, progression to dementia. Neurology 2007;68(22):1909–1916.CrossRefGoogle Scholar
Das, SK, Bose, P, Biswas, Aet al. An epidemiologic study of mild cognitive impairment in Kolkata, India. Neurology 2007;68(23):2019–2026.CrossRefGoogle ScholarPubMed
Larrieu, S, Letenneur, L, Orgogozo, JMet al. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology 2002;59(10):1594–1599.CrossRefGoogle Scholar
Petersen, RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256(3):183–194.CrossRefGoogle ScholarPubMed
Winblad, B, Palmer, K, Kivipelto, Met al. Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256(3):240–246.CrossRefGoogle Scholar
Mueller, SG, Weiner, MW, Thal, LJet al. The Alzheimer's disease neuroimaging initiative. Neuroimaging Clin N Am 2005;15(4):869–877, xi–xii.CrossRefGoogle ScholarPubMed
Daly, E, Zaitchik, D, Copeland, Met al. Predicting conversion to Alzheimer disease using standardized clinical information. Arch Neurol 2000;57(5):675–680.CrossRefGoogle ScholarPubMed
Petersen, RC, Thomas, RG, Grundman, Met al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med 2005;352(23):2379–2388.CrossRefGoogle ScholarPubMed
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(11):1479–1484.CrossRefGoogle ScholarPubMed
Fischer, P, Jungwirth, S, Zehetmayer, Set al. Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology 2007;68(4):288–291.CrossRefGoogle ScholarPubMed
Hunderfund, AL, Roberts, RO, Slusser, TCet al. Mortality in amnestic mild cognitive impairment: a prospective community study. Neurology 2006;67(10):1764–1768.CrossRefGoogle ScholarPubMed
Jack, CR, Petersen, RC, Xu, YCet al. Prediction of AD with MRI-based hippocampal volume in mild cognitive impairment. Neurology 1999;52(7):1397–1403.CrossRefGoogle ScholarPubMed
Jack, CR, Shiung, MM, Weigand, SDet al. Brain atrophy rates predict subsequent clinical conversion in normal elderly and amnestic MCI. Neurology 2005;65(8):1227–1231.CrossRefGoogle ScholarPubMed
Devanand, DP, Pradhaban, G, Liu, Xet al. Hippocampal and entorhinal atrophy in mild cognitive impairment: prediction of Alzheimer disease. Neurology 2007;68(11):828–836.CrossRefGoogle ScholarPubMed
DeCarli, C, Frisoni, GB, Clark, CMet al. Qualitative estimates of medial temporal atrophy as a predictor of progression from mild cognitive impairment to dementia. Arch Neurol 2007;64(1):108–115.CrossRefGoogle Scholar
Corder, EH, Saunders, AM, Strittmatter, WJet al. Gene dose of apolipoprotein E type 4 allele and the risk of Alzheimer's disease in late onset families. Science 1993;261(5123):921–923.CrossRefGoogle ScholarPubMed
Aggarwal, NT, Wilson, RS, Beck, TLet al. The apolipoprotein E epsilon4 allele and incident Alzheimer's disease in persons with mild cognitive impairment. Neurocase 2005;11(1):3–7.CrossRefGoogle ScholarPubMed
Tierney, MC, Szalai, JP, Snow, WGet al. A prospective study of the clinical utility of ApoE genotype in the prediction of outcome in patients with memory impairment. Neurology 1996;46(1):149–154.CrossRefGoogle ScholarPubMed
Petersen, RC, Smith, GE, Ivnik, RJet al. Apolipoprotein E status as a predictor of the development of Alzheimer's disease in memory-impaired individuals. JAMA 1995;273(16):1274–1278.CrossRefGoogle ScholarPubMed
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(6):282–289.CrossRefGoogle ScholarPubMed
Farrer, , Cupples, , Haines, JLet al. Effects of age, sex, and ethnicity on the association between apolipoprotein E genotype and Alzheimer disease. A meta-analysis. APOE and Alzheimer Disease Meta Analysis Consortium. JAMA 1997;278(16):1349–1356.CrossRefGoogle ScholarPubMed
Galasko, D, Chang, L, Motter, Ret al. High cerebrospinal fluid tau and low amyloid beta42 levels in the clinical diagnosis of Alzheimer disease and relation to apolipoprotein E genotype. Arch Neurol 1998;55(7):937–945.CrossRefGoogle ScholarPubMed
Galasko, D, Clark, C, Chang, Let al. Assessment of CSF levels of tau protein in mildly demented patients with Alzheimer's disease. Neurology 1997;48(3):632–635.CrossRefGoogle ScholarPubMed
Growdon, JH. Biomarkers of Alzheimer disease. Arch Neurol 1999;56(3):281–3.CrossRefGoogle Scholar
Sunderland, T, Wolozin, B, Galasko, Det al. Longitudinal stability of CSF tau levels in Alzheimer patients. Biol Psychiatry 1999;46(6):750–755.CrossRefGoogle ScholarPubMed
Stefani, A, Martorana, A, Bernardini, Set al. CSF markers in Alzheimer disease patients are not related to the different degree of cognitive impairment. J Neurol Sci 2006;251(1–2):124–128.CrossRefGoogle Scholar
Buerger, K, Teipel, SJ, Zinkowski, Ret al. CSF tau protein phosphorylated at threonine 231 correlates with cognitive decline in MCI subjects. Neurology 2002;59(4):627–629.CrossRefGoogle ScholarPubMed
Buerger, K, Ewers, M, Pirttila, Tet al. CSF phosphorylated tau protein correlates with neocortical neurofibrillary pathology in Alzheimer's disease. Brain 2006;129(Pt 11):3035–3041.CrossRefGoogle ScholarPubMed
Hansson, O, Zetterberg, H, Buchhave, Pet al. Association between CSF biomarkers and incipient Alzheimer's disease in patients with mild cognitive impairment: a follow-up study. Lancet Neurol 2006;5(3):228–234.CrossRefGoogle ScholarPubMed
Bateman, RJ, Wen, G, Morris, JC, Holtzman, DM. Fluctuations of CSF amyloid-beta levels: implications for a diagnostic and therapeutic biomarker. Neurology 2007;68(9):666–669.CrossRefGoogle ScholarPubMed
Graff-Radford, NR, Crook, JE, Lucas, Jet al. Association of low plasma Abeta42/Abeta40 ratios with increased imminent risk for mild cognitive impairment and Alzheimer disease. Arch Neurol 2007;64(3):354–362.CrossRefGoogle ScholarPubMed
Oijen, M, Hofman, A, Soares, HD, Koudstaal, PJ, Breteler, MM. Plasma Abeta(1–40) and Abeta(1–42) and the risk of dementia: a prospective case-cohort study. [See comment.]Lancet Neurol 2006;5(8):655–660.CrossRefGoogle Scholar
Small, GW, Mazziotta, JC, Collins, MTet al. Apolipoprotein E type 4 allele and cerebral glucose metabolism in relatives at risk for familial Alzheimer disease. JAMA 1995;273(12):942–947.CrossRefGoogle ScholarPubMed
Reiman, EM, Caselli, RJ, Yun, LSet al. Preclinical evidence of Alzheimer's disease in persons homozygous for the epsilon 4 allele for apolipoprotein E. N Engl J Med 1996;334(12):752–758.CrossRefGoogle ScholarPubMed
Drzezga, A, Grimmer, T, Riemenschneider, Met al. Prediction of individual clinical outcome in MCI by means of genetic assessment and (18)F-FDG PET. J Nucl Med 2005;46(10):1625–1632.Google Scholar
Anchisi, D, Borroni, B, Franceschi, Met al. Heterogeneity of brain glucose metabolism in mild cognitive impairment and clinical progression to Alzheimer disease. Arch Neurol 2005;62(11):1728–1733.CrossRefGoogle ScholarPubMed
Klunk, WE, Engler, H, Nordberg, Aet al. Imaging brain amyloid in Alzheimer's disease with Pittsburgh Compound-B. Ann Neurol 2004;55(3):306–319.CrossRefGoogle ScholarPubMed
Small, GW, Kepe, V, Ercoli, LMet al. PET of brain amyloid and tau in mild cognitive impairment. N Engl J Med 2006;355(25):2652–2663.CrossRefGoogle Scholar
Markesbery, WR, Schmitt, FA, Kryscio, RJet al. Neuropathologic substrate of mild cognitive impairment. Arch Neurol 2006;63(1):38–46.CrossRefGoogle ScholarPubMed
Morris, JC, Storandt, M, Miller, JPet al. Mild cognitive impairment represents early-stage Alzheimer disease. Arch Neurol 2001;58(3):397–405.CrossRefGoogle ScholarPubMed
Bennett, DA, Schneider, JA, Bienias, JL, Evans, DA, Wilson, RS. Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions. Neurology 2005;64(5):834–841.CrossRefGoogle ScholarPubMed
Petersen, RC, Parisi, JE, Dickson, DWet al. Neuropathologic features of amnestic mild cognitive impairment. Arch Neurol 2006;63(5):665–672.CrossRefGoogle ScholarPubMed
Jicha, GA, Parisi, JE, Dickson, DWet al. Neuropathologic outcome of mild cognitive impairment following progression to clinical dementia. Arch Neurol 2006;63(5):674–681.CrossRefGoogle ScholarPubMed
Petersen, RC. Mild cognitive impairment continuum. Lifelong Learn Neurol 2007;13(2):15–38.CrossRefGoogle Scholar
Gold, M, Francke, S, Nye, JSet al. Impact of APOE genotype on the efficacy of galantamine for the treatment of mild cognitive impairment. Neurobiol Aging 2004;25(Suppl 2):S521.CrossRefGoogle Scholar
Feldman, HH, Ferris, S, Winblad, Bet al. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol 2007;6(6):501–512.CrossRefGoogle Scholar
Thal, LJ, Ferris, SH, Kirby, Let al. A randomized, double-blind, study of rofecoxib in patients with mild cognitive impairment. Neuropsychopharmacology 2005;30(6):1204–1215.CrossRefGoogle ScholarPubMed
Petersen, RC. Mild cognitive impairment clinical trials. Nat Rev Drug Discov 2003;2(8):646–653.CrossRefGoogle ScholarPubMed
Petersen, RC. MCI treatment trials: failure or not?Lancet Neurol 2007;6(6):473–475.CrossRefGoogle ScholarPubMed
Petersen, RC, Stevens, JC, Ganguli, Met al. 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(9):1133–1142.CrossRefGoogle Scholar
Fratiglioni, L, Paillard-Borg, S, Winblad, B. An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 2004;3(6):343–353.CrossRefGoogle Scholar
Rovio, S, Kareholt, I, Helkala, ELet al. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer's disease. Lancet Neurol 2005;4(11):705–711.CrossRefGoogle ScholarPubMed
Petersen, RC, O'Brien, J. Mild cognitive impairment should be considered for DSM-V. J Geriatr Psychiatry Neurol 2006;19(3):147–154.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×