Mild Cognitive Impairment - A Preclinical State of Alzheimer's Disease?

Mild Cognitive Impairment - A Preclinical State of Alzheimer's Disease?

Cathleen Hänse, K Herholz, Wolf-Dieter Heiss
Published: European Neurological Disease 2006 Issue 2
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With a prevalence of 4,886,252 cases, dementia is one of the leading brain disorders in the European Community and is responsible for estimated total costs of €55 billion.1 The prevalence of dementia is dependent on the age group with a mean of 2.1 cases/100 of the population in the group 65–74 years, of 6.9/100 in the group 75–84 years and 27/100 in the group beyond 84 years.2

A considerable larger population suffers from a transition phase between healthy cognitive ageing and dementia for which several definitions and names were coined:3 benign senescent forgetfulness,4 ageassociated memory impairment (AAMI),5 late-life forgetfulness,6 ageing-associated cognitive decline,7 cognitive impairment – no dementia (CIND)8 and mild cognitive impairment (MCI).9

Some of these definitions also were introduced into Diagnostic and Statistical Manual of Mental Disorders IV (DSM IV) (American Psychiatric Association 1994) and International Classification of Diseases (ICD).10

The prevalence of these conditions is dependent on the definition resulting in large differences, ranging from 20% for AAMI 10 and 16.8% for CIND8 to 3% for MCI9 of the population studied. First, the concept of MCI defined by Petersen et al. in 1997 was restricted to only memory impairment and leads to the identification of people at a high risk of progression to Alzheimer’s disease.11

Due to the heterogeneity of the clinical presentation and the different neuropsychological profiles as well as the clinical course and outcome of numerous MCI subjects (some patients will regain normal cognitive function, some will remain stable and some will show a progression of symptoms to different types of dementia) Petersen extended the primarily concept to a syndrome-type classification:12

• amnestic MCI which is characterised by the following criteria; – memory complaint, preferably corroborated by an informant and/ or by the subjects themselves; – objective impaired memory function relative for age and education; – preserved general cognitive function; – intact basic activities of daily living; and – no dementia.

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