MMSE, Cholinesterase Inhibitors, Donepezil"/> Mild Cognitive Impairment (MCI) Symptoms, Definition, Diagnosis, Detection, Treatment | PsychVisit
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Mild Cognitive Impairment (MCI)

Any information regarding treatments in this page are provided as a reference only, and are not intended as treatment advice.

Before dementia has fully set in, individuals may already start to experience some memory difficulties or shortcomings in other cognitive areas. Mild Cognitive Impairment (MCI) is the term given to this condition. Differentiating between normal aging and the early signs of dementia can be difficult. The following criteria have been proposed to define MCI [ref]:

  1. Subjective cognitive complaints
  2. Evidence of objective deficits in cognitive function based on age- and education-adjusted norms on standardized neuropsychological tests
  3. Intact daily functioning
  4. Evidence of cognitive decline from a prior level, and
  5. Evidence of not meeting the criteria for dementia

Predicting the outcome of Mild Cognitive Impairment (MCI)

About half of all individuals who meet these criteria for MCI will go on to develop dementia, though predicting who these people are remains difficult [ref].

However, there is increasing evidence that certain clinical tests can identify a subset of people with MCI who are likely to go on to develop Alzheimer's Disease. One such test involves measuring the amyloid beta-42/tau ratio in the cerebrospinal fluid (CSF) [ref]. There is also a relatively simple memory test, called the Free and Cued Selective Reminding Test (FCSRT), which seems to work well for this purpose [ref].

It is also recommended that individuals with MCI be followed and their cognitive abilities measured on a regular basis with instruments such as the MMSE, so that if full dementia develops, this can be detected quickly [ref].

Treatment for Mild Cognitive Impairment (MCI)

Ideally, identifying individuals with MCI would be important if there were treatments that could be given to prevent the progression to dementia. Unfortunately, so far no such treatments have been found. Cholinesterase Inhibitors have been studied for this purpose, but do not seem to be very effective when given to people with MCI [ref, ref, ref].

However, based on the evidence that Cholinesterase Inhibitors such as Donepezil are effective for treating early-stage Alzheimer's Disease [ref], it remains to be seen whether these medications may also be useful for treating the sub-group of patients with MCI who are likely to develop Alzheimer's Disease, as described above.

 

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