Mild Cognitive Impairment

What Is MCI?

Mild cognitive impairment (MCI), though recognized for its association with dementia and Alzheimer’s disease, can be underappreciated as an early diagnostic marker.1

How MCI is different from the normal aging process

MCI is often mistaken for typical cognitive decline associated with aging, but with MCI, symptoms are more severe, particularly compared to age-matched peers.2,3 This condition can be an early sign of Alzheimer’s disease,4 and has been correlated with aggregating proteins associated with Alzheimer’s disease, as well as biomarkers associated with neuronal damage,5,6 which is why attentiveness in diagnosing MCI is critical.

MCI as an Indicator for Action

Alzheimer’s disease is widely appreciated as a progressive and debilitating neurodegenerative condition.4 Over the past decade, there has been additional research conducted to develop treatments that target protein aggregates in the brain, which may potentially slow progression of Alzheimer’s disease if utilized early in the disease’s pathology. However, this outlook relies entirely on early diagnosis.7

MCI by itself is not entirely correlative with Alzheimer’s disease; in fact, MCI often self-resolves.3 However, MCI has a 10%-15% chance of progressing to dementia within one year,3 which is 5x greater than the risk factor associated with aging (2% per year over the age of 65).8 This makes MCI one of the strongest predictors for dementia and Alzheimer’s disease and should thus be strongly considered as a basis for diagnostic testing.

Engage Patients and Carers About MCI

Early diagnosis in Alzheimer’s disease is important. Identifying Alzheimer’s disease pathology early via recognition of MCI symptoms can give patients time to adjust to their life with cognitive decline2 and presents the only opportunity for early intervention as emerging treatments become available to slow Alzheimer’s disease progression.

Patients may not recognize the symptoms of MCI, which is why it is important to ask the right questions and engage with them to gain a thorough understanding of their cognitive state. Through thorough evaluations, we can get to early diagnosis and begin early interventions.


References:

1. Dunne RA, Aarsland D, O’Brien JT, et al. Mild Cognitive Impairment: the Manchester consensus. Age Ageing. 2020;50(1):72-80. doi:10.1093/ageing/afaa228

2. What Is Mild Cognitive Impairment? | Alzheimers.gov. Accessed September 13, 2023. http://www.nia.nih.gov/alzheim...

3. Mild Cognitive Impairment (MCI). Alzheimer’s Disease and Dementia. Accessed September 13, 2023. https://alz.org/alzheimers-dem...

4. Mofrad SA, Lundervold AJ, Vik A, Lundervold AS. Cognitive and MRI trajectories for prediction of Alzheimer’s disease. Sci Rep. 2021;11:2122. doi:10.1038/s41598-020-78095-7

5. Zhang J, Cheng H, Liu W, Li H, Song Y, Jia L. Neurofilament light chain in cerebrospinal fluid or blood as a biomarker for mild cognitive impairment: A systematic review and meta-analysis. Medicine (Baltimore). 2022;101(9):e28932. doi:10.1097/MD.0000000000028932

6. Giacomucci G, Mazzeo S, Bagnoli S, et al. Plasma neurofilament light chain as a biomarker of Alzheimer’s disease in Subjective Cognitive Decline and Mild Cognitive Impairment. J Neurol. 2022;269(8):4270-4280. doi:10.1007/s00415-022-11055-5

7. Ramanan VK, Armstrong MJ, Choudhury P, et al. Antiamyloid Monoclonal Antibody Therapy for Alzheimer Disease: Emerging Issues in Neurology. Neurology. Published online July 26, 2023:10.1212/WNL.0000000000207757. doi:10.1212/WNL.0000000000207757

8. Mayo Clinic Staff. Mild cognitive impairment - Symptoms and causes. Mayo Clinic. Published January 18, 2023. Accessed October 27, 2023. https://www.mayoclinic.org/dis...