scholarly journals Are Guidelines Needed for the Diagnosis and Management of Incipient Alzheimer's Disease and Mild Cognitive Impairment?

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Katie Palmer ◽  
Massimo Musicco ◽  
Carlo Caltagirone

Current research is aiming to push the boundaries of the point at which a diagnosis of Alzheimer Disease (AD) can be made. Clinical syndromes such as Mild Cognitive Impairment (MCI) and various clinical and biological markers of AD may help to identify people in the early stage of AD, before a full dementia syndrome is present. In the first part of this paper, we discuss whether MCI represents incipient AD, and examine some of the methods currently used in research to identify AD patients in the preclinical phase. In the second part, we discuss whether specific guidelines are needed for the diagnosis and management of MCI and incipient AD, and consider the potential impact of this on clinical practice and public health from the perspective of patients, caregivers, and healthcare providers.

2020 ◽  
pp. 1-10
Author(s):  
Christopher Gonzalez ◽  
Nicole S. Tommasi ◽  
Danielle Briggs ◽  
Michael J. Properzi ◽  
Rebecca E. Amariglio ◽  
...  

Background: Financial capacity is often one of the first instrumental activities of daily living to be affected in cognitively normal (CN) older adults who later progress to amnestic mild cognitive impairment (MCI) and Alzheimer’s disease (AD) dementia. Objective: The objective of this study was to investigate the association between financial capacity and regional cerebral tau. Methods: Cross-sectional financial capacity was assessed using the Financial Capacity Instrument –Short Form (FCI-SF) in 410 CN, 199 MCI, and 61 AD dementia participants who underwent flortaucipir tau positron emission tomography from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). Linear regression models with backward elimination were used with FCI-SF total score as the dependent variable and regional tau and tau-amyloid interaction as predictors of interest in separate analyses. Education, age sex, Rey Auditory Verbal Learning Test Total Learning, and Trail Making Test B were used as covariates. Results: Significant associations were found between FCI-SF and tau regions (entorhinal: p <  0.001; inferior temporal: p <  0.001; dorsolateral prefrontal: p = 0.01; posterior cingulate: p = 0.03; precuneus: p <  0.001; and supramarginal gyrus: p = 0.005) across all participants. For the tau-amyloid interaction, significant associations were found in four regions (amyloid and dorsolateral prefrontal tau interaction: p = 0.005; amyloid and posterior cingulate tau interaction: p = 0.005; amyloid and precuneus tau interaction: p <  0.001; and amyloid and supramarginal tau interaction: p = 0.002). Conclusion: Greater regional tau burden was modestly associated with financial capacity impairment in early-stage AD. Extending this work with longitudinal analyses will further illustrate the utility of such assessments in detecting clinically meaningful decline, which may aid clinical trials of early-stage AD.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yumei Wang ◽  
Xiaochuan Zhao ◽  
Shunjiang Xu ◽  
Lulu Yu ◽  
Lan Wang ◽  
...  

Most patients with mild cognitive impairment (MCI) are thought to be in an early stage of Alzheimer’s disease (AD). Resting-state functional magnetic resonance imaging reflects spontaneous brain activity and/or the endogenous/background neurophysiological process of the human brain. Regional homogeneity (ReHo) rapidly maps regional brain activity across the whole brain. In the present study, we used the ReHo index to explore whole brain spontaneous activity pattern in MCI. Our results showed that MCI subjects displayed an increased ReHo index in the paracentral lobe, precuneus, and postcentral and a decreased ReHo index in the medial temporal gyrus and hippocampus. Impairments in the medial temporal gyrus and hippocampus may serve as important markers distinguishing MCI from healthy aging. Moreover, the increased ReHo index observed in the postcentral and paracentral lobes might indicate compensation for the cognitive function losses in individuals with MCI.


2017 ◽  
Vol 30 (3) ◽  
pp. 375-384 ◽  
Author(s):  
Ching-Lin Wang ◽  
Li-Min Kuo ◽  
Yi-Chen Chiu ◽  
Hsiu-Li Huang ◽  
Huei-Ling Huang ◽  
...  

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.


2021 ◽  
pp. 155005942110582
Author(s):  
Sophie A. Stewart ◽  
Laura Pimer ◽  
John D. Fisk ◽  
Benjamin Rusak ◽  
Ron A. Leslie ◽  
...  

Parkinson's disease (PD) is a neurodegenerative disorder that is typified by motor signs and symptoms but can also lead to significant cognitive impairment and dementia Parkinson's Disease Dementia (PDD). While dementia is considered a nonmotor feature of PD that typically occurs later, individuals with PD may experience mild cognitive impairment (PD-MCI) earlier in the disease course. Olfactory deficit (OD) is considered another nonmotor symptom of PD and often presents even before the motor signs and diagnosis of PD. We examined potential links among cognitive impairment, olfactory functioning, and white matter integrity of olfactory brain regions in persons with early-stage PD. Cognitive tests were used to established groups with PD-MCI and with normal cognition (PD-NC). Olfactory functioning was examined using the University of Pennsylvania Smell Identification Test (UPSIT) while the white matter integrity of the anterior olfactory structures (AOS) was examined using magnetic resonance imaging (MRI) diffusion tensor imaging (DTI) analysis. Those with PD-MCI demonstrated poorer olfactory functioning and abnormalities based on all DTI parameters in the AOS, relative to PD-NC individuals. OD and microstructural changes in the AOS of individuals with PD may serve as additional biological markers of PD-MCI.


2012 ◽  
Vol 8 (4S_Part_7) ◽  
pp. P266-P267
Author(s):  
Milene Gonçalves ◽  
Isabel Santana ◽  
Natália Francisco ◽  
Catarina Cunha ◽  
Sonia Batista ◽  
...  

2021 ◽  
Vol 12 (1) ◽  
pp. 11
Author(s):  
Takao Yamasaki ◽  
Shuzo Kumagai

Patients show subtle changes in daily behavioral patterns, revealed by traditional assessments (e.g., performance- or questionnaire-based assessments) even in the early stage of Alzheimer’s disease (AD; i.e., the mild cognitive impairment (MCI) stage). An increase in studies on the assessment of daily behavioral changes in patients with MCI and AD using digital technologies (e.g., wearable and nonwearable sensor-based assessment) has been noted in recent years. In addition, more objective, quantitative, and realistic evidence of altered daily behavioral patterns in patients with MCI and AD has been provided by digital technologies rather than traditional assessments. Therefore, this study hypothesized that the assessment of daily behavioral changes with digital technologies can replace or assist traditional assessment methods for early MCI and AD detection. In this review, we focused on research using nonwearable sensor-based in-home assessment. Previous studies on the assessment of behavioral changes in MCI and AD using traditional performance- or questionnaire-based assessments are first described. Next, an overview of previous studies on the assessment of behavioral changes in MCI and AD using nonwearable sensor-based in-home assessment is provided. Finally, the usefulness and problems of nonwearable sensor-based in-home assessment for early MCI and AD detection are discussed. In conclusion, this review stresses that subtle changes in daily behavioral patterns detected by nonwearable sensor-based in-home assessment can be early MCI and AD biomarkers.


2012 ◽  
pp. 145-159
Author(s):  
Catherine Coveney ◽  
Jonathan Gabe ◽  
Simon Williams

Sociological engagement with debates around the promise, problems and prospects of pharmaceutical cognitive enhancment is still at an early stage. In this paper we attempt to explore how the prospect of cognitive enhancement can be understood using existing sociological concepts of medicalisation, biomedicalisation and pharmaceuticalisation. Drawing on two case studies, that of Mild Cognitive Impairment (MCI) and the use of modafinil to enhance alertness, we discuss the idea of enhancement medicine and the use of cognitive enhancers outside of medical authority. We suggest that whilst all three of the above concepts shed important light on these developments, overlapping and converging as they do in various ways, pharmaceuticalisation provides a more precise sociological term of reference. We end with some suggestions for a research agenda for tracing and tracking trends in pharmaceutical cognitive enhancement over time.


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