scholarly journals Mild Cognitive Impairment in Clinical Practice: A Review Article

2018 ◽  
Vol 33 (8) ◽  
pp. 500-507 ◽  
Author(s):  
Sukanya Jongsiriyanyong ◽  
Panita Limpawattana

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.

2016 ◽  
Vol 33 (S1) ◽  
pp. S190-S191
Author(s):  
G. Sobreira ◽  
M.A. Aleixo ◽  
C. Moreia ◽  
J. Oliveira

IntroductionDepression and mild cognitive impairment are common among the elderly. Half the patients with late-life depression also present some degree of cognitive decline, making the distinction between these conditions difficult.ObjectivesTo conduct a database review in order to understand the relationship between these entities, and treatment approaches.AimsTo create and implement clinical guidelines at our institution, to evaluate and treat elderly patients presenting with depression and mild cognitive impairment.MethodsA PubMed database search using as keywords “late life depression”, “depression”; “cognitive impairment”; “mild cognitive impairment” and “dementia” between the year 2008 and 2015.ResultsLate-life depression and cognitive impairment are frequent among the elderly (10–20%). Depression is also common in the early stages of dementia decreasing as the cognitive decline progresses. The causal relationship between these entities is not well understood and some authors advocate a multifactorial model (genetic risk factors; neuroendocrine changes; vascular risk factors) and the cognitive impairment of said changes is dependent on the individual's cognitive reserve. Regarding treatment of depression in patients with cognitive impairment, most authors advocate a stepped approach with watchful waiting and then, if symptoms persist, the introduction of pharmacotherapy and psychosocial intervention.ConclusionsThe relationship between cognitive impairment and depression is still not clear and probably multifactorial. The diagnosis of depressive symptoms in patients with severe cognitive impairment can be difficult and most forms of pharmacological treatment in this population are not beneficial, making it important to carefully evaluate the benefits of introducing new medication.Disclosure of interestThe authors have not supplied their declaration of competing interest.


CNS Spectrums ◽  
2008 ◽  
Vol 13 (S16) ◽  
pp. 18-20 ◽  
Author(s):  
Liana G. Apostolova

Problems with memory are a very common complaint in the elderly and are not synonymous with dementia. Some degree of cognitive decline, manifested as greater difficulty in learning and retrieving new information for instance, develops with normal aging. Thus many older patients do not perform at the same level they did when they were younger but they do perform well when compared to their peers. For many, cognitive change ends at this stage and they proceed to lead normal, healthy, dementia-free lives.The cohort that has cognitive changes beyond what is expected in normal aging but does not yet meet criteria for dementia concerns clinicians greatly as many of these patients eventually become demented. These patients usually go through a latent stage in which neurodegenerative pathology silently spreads in the brain. Once there is enough pathological burden, cognitive decline beyond what is expected for normal aging can be detected by formal neuropsychological testing. Frequently such patients go through a state called mild cognitive impairment (MCI). In this state patients are still functionally intact and live independently, but show cognitive impairment relative to the age- and education-adjusted norms.The MCI state in itself is a prominent risk factor for developing dementia. Most patients with amnestic MCI develop Alzheimer’s disease (AD) dementia over time. At six years, as many as 80% progress to AD. Thus, MCI is a very important topic of research and an increasingly important topic of clinical care.


2008 ◽  
Vol 30 (4) ◽  
pp. 346-349 ◽  
Author(s):  
Izabella Dutra de Abreu ◽  
Paula Villela Nunes ◽  
Breno Satler Diniz ◽  
Orestes Vicente Forlenza

OBJECTIVE: To determine the diagnostic accuracy of the Mini-Mental State Examination combined to the Informant Questionnaire on Cognitive Decline in the Elderly for the identification of mild cognitive impairment. METHOD: 191 elderly subjects were assessed with the Mini-Mental State Examination, and their informants were assessed with the Informant Questionnaire on Cognitive Decline in the Elderly. Subjects were divided into three groups according to their cognitive state (controls: n = 67, mild cognitive impairment: n = 65 and dementia: n = 59), which was ascertained by clinical and neuropsychological evaluation. The diagnostic accuracy of each test in the discrimination of diagnostic groups (mild cognitive impairment vs. controls, mild cognitive impairment vs. dementia and dementia vs. controls) was examined with the aid of ROC curves. We additionally verified if the combination of both tests would increase diagnostic accuracy for mild cognitive impairment and control identification. RESULTS: The combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly scores did not increase the Mini-Mental State Examination diagnostic accuracy in the identification of patients with mild cognitive impairment. CONCLUSIONS: The present data do not warrant the combination of the Mini-Mental State Examination and the Informant Questionnaire on Cognitive Decline in the Elderly as a sufficient diagnostic tool in the diagnostic screening for mild cognitive impairment.


2017 ◽  
Author(s):  
Shashank Beesam ◽  
George Grossberg ◽  
Eric Marin

Alzheimer disease is thought to have an insidious progression, with asymptomatic brain changes occurring decades prior to formal diagnosis. In recent years, efforts have been made to identify and characterize these changes into a spectrum beginning with subjective cognitive decline through the development of major neurocognitive disorder. Through this process, progress has been made into the predictive factors, prevention, and treatment modalities for the various stages of cognitive decline. In addition to pharmacologic therapies, studies have shown the value in physical, mental, social, and spiritual activity combined with support from physicians, family, and caregivers. Furthermore, individualized care, open and honest physician-patient dialogue, and emphasis on lifestyle modifications have been shown to achieve optimal quality of life and may also decrease the rate of cognitive decline. This review contains 5 figures, 5 tables, and 36 references. Key words: age-related cognitive decline, Alzheimer disease, major neurocognitive disorder, mild cognitive impairment, mild neurocognitive disorder, senior moment, subjective cognitive impairment


2021 ◽  
Vol 14 (4) ◽  
pp. 305
Author(s):  
Carlo Tomino ◽  
Sara Ilari ◽  
Vincenzo Solfrizzi ◽  
Valentina Malafoglia ◽  
Guglielmo Zilio ◽  
...  

Mild cognitive impairment (MCI) and dementia are clinically prevalent in the elderly. There is a high risk of cognitive decline in patients diagnosed with MCI or dementia. This review describes the effectiveness of Ginkgo biloba leaf special extract EGb 761® for the treatment of dementia syndromes and EGb 761® combination therapy with other medications for symptomatic dementia. This drug has shown convincing results, improving cognitive function, neuropsychiatric symptoms and consequent reduction of caregiver stress and maintenance of autonomy in patients with age-related cognitive decline, MCI and mild to moderate dementia. Currently, there is little evidence to support the combination therapy with anti-dementia drugs and, therefore, more evidence is needed to evaluate the role of EGb 761® in mixed therapy.


2019 ◽  
Vol 4 (2) ◽  
pp. 27-31
Author(s):  
Fatenkov OV ◽  
Simerzin VV ◽  
Krasovskaya MA ◽  
Sytdykov IKh

The review article describes the characteristics of curable involutive cognitive impairment in the elderly. It is noted that mild cognitive impairment is predominantly neurodynamic in nature, but over time it can transform into a syndrome of moderate cognitive impairment, which, sometimes, is a precursor of dementia. Special attention is given to the clinical manifestations of mild and moderate cognitive impairment, diagnostic criteria, the course of the disease, and its medical and social impact.


2021 ◽  
Vol 3 (1) ◽  
pp. 149-154
Author(s):  
Fithry Rahma

Mild cognitive impairment (MCI) is a stage of aging that occurs between normal aging and dementia (precedes dementia). Patients with MCI have memory loss who is otherwise functioning normally and does not match the clinical diagnosis criteria for dementia.  MCI is frequently accompanied by cognitive deficits and non-cognitive. One of the most frequent non-cognitive deficiencies is depression. Depression and mild cognitive impairment are closely associate particularly in the elderly and can progress into neurodegenerative disorders like dementia. This indicates that there is a connection that needs to be explored further. Through this review article, a theoretical review of the relationship between MCI with depression and its conversion to dementia.


Author(s):  
Sum-Yuet Joyce Lau ◽  
Harry Agius

AbstractCognitive decline is common in the elderly. As a result, a range of cognitive rehabilitation games have been proposed to supplement or replace traditional rehabilitative training by offering benefits such as improved engagement. In this paper, we focus on mild cognitive impairment (MCI), an initial stage of cognitive decline that does not affect functioning in daily life, but which may progress towards more serious cognitive deteriorations, notably dementia. Unfortunately, while a variety of serious game frameworks and rehabilitative serious games have been proposed, there is a distinct lack of those which support the distinctive characteristics of MCI patients. Consequently, to optimise the advantages of serious games for MCI, we propose the MCI-GaTE (MCI-Game Therapy Experience) framework that may be used to develop serious games as effective cognitive and physical rehabilitation tools. The framework is derived from a combination of a survey of related research literature in the area, analysis of resident profiles from a nursing home, and in-depth interviews with occupational therapists (OTs) who work with MCI patients on a daily basis. The conceptual framework comprises four sectors that may be used to guide game design and development: an MCI player profile that represents the capabilities of a player with MCI, core gaming elements that support gameful and playful activities, therapeutic elements that support cognitive and physical rehabilitation through tasks and scenarios according to the player’s abilities, and motivational elements to enhance the player’s attitude towards the serious tasks. Together, they provide support for rehabilitation needs and may also serve as a set of comprehensive and established criteria by which an MCI serious game may be evaluated. To demonstrate the use of MCI-GaTE, we also present A-go!, an immersive gesture-based serious game that exploits the framework to enable MCI-diagnosed players to undertake therapeutic tasks supported by an assigned OT. Evaluation with OTs revealed that the immersive game potentially offers more effective support to MCI patients than traditional methods, contributing new possibilities for enhancing MCI rehabilitative training, while a comparative assessment of MCI-GaTE demonstrated that it provides a comprehensive approach not currently offered by state-of-the-art rehabilitative frameworks.


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