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Dementia > Mild Cognitive Impairment (MCI)
What is Mild Cognitive Impairment (MCI)?
Mild cognitive impairment (MCI) a condition in which a person has problems with memory, language, or another mental function severe enough to be noticeable to other people and to show up on tests, but not serious enough to interfere with daily life.
Because the problems do not interfere with daily activities, the person does not meet criteria for being diagnosed with dementia. The best-studied type of MCI involves a memory problem and is called “amnestic MCI.”
Symptoms of Mild Cognitive Impairment (MCI)
In 2001, the American Academy of Neurology (AAN) published practice guidelines for the early detection of memory problems. The AAN workgroup of specialists identified the following criteria for an MCI diagnosis:
- an individual’s report of his or her own memory problems, preferably confirmed by another person
- measurable, greater-than-normal memory impairment detected with standard memory assessment tests
- normal general thinking and reasoning skills
- ability to perform normal daily activities
These criteria do not settle all debate about MCI. Key questions that researchers continue to investigate include the following:
1. How much memory impairment is too much to be considered more than normal?
2. How much memory impairment is significant enough to be considered a symptom of mild dementia?
3. How hard should one look for subtle abnormalities in other areas of thinking?
4. How do we know if these other changes are normal aging or worse?
Because researchers are still investigating these questions, other details about MCI remain unclear. For example, some research suggests that essentially all cases of MCI progress to Alzheimer’s disease or another form of dementia. This would mean that MCI is simply a very early sign of dementia. Other studies suggest that some people with MCI may not develop dementia, but that many are at a very high risk of developing the disorder. Still other studies indicate that a significant number of people diagnosed with MCI may “revert” to normal.
Treatment of Mild Cognitive Impairment (MCI)
- There is currently no treatment for MCI approved by the FDA
- Results of a large, federally funded trial showed that 10 milligrams of donepezil (Aricept) daily can reduce the risk of progressing from amnestic MCI to Alzheimer’s disease for about a year, but the benefit disappears within three years. The trial also showed that 2,000 international units of vitamin E daily do not reduce the risk of progressing
- The study authors say the results were not strong enough to support a clear recommendation to treat amnestic MCI with donepezil, but it might be reasonable for patients and their physicians to talk about the possible benefits and risks of treatment on an individual basis
- Two other studies have tested galantamine (Razadyne) as a treatment for MCI. These studies found no benefit, but the data showed an increased number of deaths in participants taking galantamine compared with those receiving the placebo
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