Mild Cognitive Impairment: Clinical Characterization and Outcome

Department of Neurology, Mayo Clinic, Rochester, Minn 55905, USA.
JAMA Neurology (Impact Factor: 7.42). 04/1999; 56(3):303-8. DOI: 10.1001/archneur.56.6.760
Source: PubMed


Subjects with a mild cognitive impairment (MCI) have a memory impairment beyond that expected for age and education yet are not demented. These subjects are becoming the focus of many prediction studies and early intervention trials.
To characterize clinically subjects with MCI cross-sectionally and longitudinally.
A prospective, longitudinal inception cohort.
General community clinic.
A sample of 76 consecutively evaluated subjects with MCI were compared with 234 healthy control subjects and 106 patients with mild Alzheimer disease (AD), all from a community setting as part of the Mayo Clinic Alzheimer's Disease Center/Alzheimer's Disease Patient Registry, Rochester, Minn.
The 3 groups of individuals were compared on demographic factors and measures of cognitive function including the Mini-Mental State Examination, Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale-Revised, Dementia Rating Scale, Free and Cued Selective Reminding Test, and Auditory Verbal Learning Test. Clinical classifications of dementia and AD were determined according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition and the National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria, respectively.
The primary distinction between control subjects and subjects with MCI was in the area of memory, while other cognitive functions were comparable. However, when the subjects with MCI were compared with the patients with very mild AD, memory performance was similar, but patients with AD were more impaired in other cognitive domains as well. Longitudinal performance demonstrated that the subjects with MCI declined at a rate greater than that of the controls but less rapidly than the patients with mild AD.
Patients who meet the criteria for MCI can be differentiated from healthy control subjects and those with very mild AD. They appear to constitute a clinical entity that can be characterized for treatment interventions.

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Available from: Steve Waring, Oct 13, 2015
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    • ". MCI was diagnosed on the basis of the Mayo Clinic criteria [18] as described previously [19] [20]. In total, blood samples from 302 subjects were included, and the distribution of control, MCI, AD subjects are shown in Table 1. "
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    ABSTRACT: Alzheimer's disease (AD) is the most common type of dementia in the elderly. The accumulation of amyloid-β peptides and tau proteins is the major pathogenic event of AD. There is accumulating evidence that both tau and amyloid-β linked to the small ubiquitin-like modifier (SUMO), which is increased in the brain of AD model mouse. The present study focused on the determination of SUMO1 protein level in AD blood plasma by the ELISA methods. We compared plasma from 80 dementia patients (average age 75.3 y), 89 persons with amnestic mild cognitive impairment (MCI) (average age 73.71 y),and 133 cognitively normal controls (average age 71.97 y). The plasma level of SUMO1 was significantly increased in dementia patients, as compared to control groups. The levels of SUMO1 correlated to decreased Mini-Mental State Examination (r =-0.123, p = 0.029). These results suggest that elevated plasma SUMO1 levels may be associated with AD.
    Journal of Alzheimer's disease: JAD 09/2015; 47(3):639-643. DOI:10.3233/JAD-150103 · 4.15 Impact Factor
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    • "revised (DSM-III-R) criteria for dementia syndrome [38], the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for possible and probable AD [39], the International statistical classification of diseases and related health problems, 10th revision (ICD-10) criteria for vascular dementia, and other dementing diseases [40]. We generally adhered to the diagnostic criteria for MCI as defined by Petersen and colleagues [1], we did not require subjective memory impairment, and we allowed for the presence of non-cognitive disabilities and comorbid illnesses. In particular, the MCI criteria required for diagnosis: 1) no dementia; 2) normal general cognitive functioning as assessed by MMSE using age and education based norms (this cutoff was calculated by subtracting 1.5 standard deviation (SD) from the mean ageand education-adjusted MMSE scores after excluding subjects with prevalent dementia). "
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    ABSTRACT: Coffee, tea, or caffeine consumption may be protective against cognitive impairment and dementia. We estimated the association between change or constant habits in coffee consumption and the incidence of mild cognitive impairment (MCI). We evaluated 1,445 individuals recruited from 5,632 subjects, aged 65-84 year old, from the Italian Longitudinal Study on Aging, a population-based sample from eight Italian municipalities with a 3.5-year median follow-up. Cognitively normal older individuals who habitually consumed moderate amount of coffee (from 1 to 2 cups of coffee/day) had a lower rate of the incidence of MCI than those who never or rarely consumed coffee [1 cup/day: hazard ratio (HR): 0.47, 95% confidence interval (CI): 0.211 to 1.02 or 1-2 cups/day: HR: 0.31 95% CI: 0.13 to 0.75]. For cognitively normal older subjects who changed their coffee consumption habits, those increasing coffee consumption (>1 cup of coffee/day) had higher rate of the incidence of MCI compared to those with constant habits (up to±1 cup of coffee/day) (HR: 1.80, 95% CI: 1.11 to 2.92) or those with reduced consumption (<1 cup of coffee/day) (HR: 2.17, 95% CI: 1.16 to 4.08). Finally, there was no significant association between subjects with higher levels of coffee consumption (>2 cups of coffee/day) and the incidence of MCI in comparison with those who never or rarely consumed coffee (HR: 0.26, 95% CI: 0.03 to 2.11). In conclusion, cognitively normal older individuals who increased their coffee consumption had a higher rate of developing MCI, while a constant in time moderate coffee consumption was associated to a reduced rate of the incidence of MCI.
    Journal of Alzheimer's disease: JAD 09/2015; 47(4):889-899. DOI:10.3233/JAD-150333 · 4.15 Impact Factor
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    • "Tel.: +44 0115 82 31519; Fax: +44 0115 82 30231; E-mail: or severity to constitute dementia [1]. The broader MCI definition encompasses the following criteria: an objective impairment in memory or other cognitive domains such as language, a subjective memory complaint , absence of dementia, intact general cognition, and intact activities of daily living [2] [3] [4] [5]. Currently, several variants of this definition exist, and such variations differ in the extent to which they endorse the criteria above [6]. "
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    ABSTRACT: Subjective memory complaints (SMC) are a criterion in many definitions of mild cognitive impairment (MCI). However, there is controversy over whether this is useful and appropriate, as previous research has suggested that SMC may be a function of mood problems such as anxiety and depression. This paper aimed to establish the relationship between MCI and mood in older people and to investigate the role that SMC play in the relationship. Structured interviews were conducted with community dwelling older people in Wales to collect information regarding cognitive functioning, mood, and well-being. A widely-used algorithm was used to categorize 3,173 participants into three groups: not cognitively impaired, MCI including SMC (MCI), and MCI without SMC (MCIW). The odds of experiencing anxiety or depression were calculated for each cognitive group. Participants with MCI had increased odds of experiencing symptoms of both anxiety and depression, but the odds were not changed for participants in the not cognitively impaired or MCIW categories. A mediation analysis was performed on the whole sample using cognition as a dichotomous variable, grouped using an age-, education-, and gender-adjusted median cut off point. This showed that SMC partially mediated the relationship between anxiety and cognition, and depression and cognition. Mood problems may be related to SMC rather than objective cognitive impairment, as only participants with MCI that included SMC showed increased odds of experiencing anxiety and depression. SMC are likely to play a mediating role in the relationship between mood and cognitive functioning.
    Journal of Alzheimer's disease: JAD 09/2015; 48(1). DOI:10.3233/JAD-150371 · 4.15 Impact Factor
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