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»What is Mild Cognitive Impairment?

Mild Cognitive Impairment Criteria

Mild Cognitive Impairment (MCI) is considered a transitional state preceding the development of dementia. Some experts use the term to describe patients who may have Alzheimer's Disease (AD) but do not yet have the dementia that is required to diagnosis AD. Others use the term to denote people who are "at risk" for dementia. In clinical studies, patients with MCI convert to AD at the rate of approximately 10 to 15% per year such that after 3 years approximately half will have AD. However, other studies observe that a proportion of people with MCI have in fact improved to a level that they no longer fulfill MCI criteria. These estimates vary considerably from clinic to clinic. Therefore, the implications of using MCI as a diagnosis must be carefully considered.

Inclusion Criteria

    1. Memory complaints and memory difficulties which are verified by an informant.
    2. Abnormal memory function documented by scoring below the education adjusted cutoff on the Logical Memory II subscale (delayed paragraph recall) from the Wechsler Memory Scale - Revised or on the NYU Paragraph Recall Test
    3. MMSE score, 24 to 30
    4. Clinical Dementia Rating = 0.5
    5. General cognitive and functional performance is sufficiently preserved such that a diagnosis of AD cannot be made
    6. No significant cerebrovascular disease: Modified Hachinski score = 4
    7. Age range 55 to 90
    8. Hamilton Depression rating scale score of 12 on the 17-item scale
    9. CT or MRI scans within 12 months prior to screening without evidence of focal lesions

Exclusion Criteria

    1. Any significant neurologic disease other than suspected incipient AD, such as Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurological defaults or known structural brain abnormalities.
    2. Major depression, other major psychiatric disorder, alcohol or substance abuse or dependence within the past 2 years.
    3. Significant systemic illness or unstable medical condition that could cause cognitive impairment.
    4. Use of CNS active medications that can cause cognitive impairment.


Reference:

Petersen, R. C., Stevens, J. C., Ganguli, M., Tangalos, E. G., Cummings, J. L., & DeKosky, S. T. (2001). 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. 56, 1133-42.



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