Alzheimer's disease is by far the most common dementing disorder in later life, but discriminating the initial manifestations of Alzheimer's from the cognitive changes that accompany usual aging is, in many instances, a difficult task. The term "mild cognitive impairment" (MCI) has been proposed to represent the border zone between aging–related changes and frank dementia.
The purpose of this book is to describe the cognitive changes associated with age, the earliest detectable stages of Alzheimer's, and the relationship of these conditions to MCI. The authors review the latest advances in our understanding of MCI, its prevalence, evaluation, management, and outcomes. In so–doing they provide practising physicians with a useful resource that will assist them in identifying those MCI patients who will progress to recognized Alzheimer's Disease. The ability to identify these individuals, as opposed to those with MCI who do not have an underlying dementing illness, will allow the earliest symptomatic stages of true dementia to more easily recognized and treated.
What is mild cognitive impairment?
Epidemiological studies of MCI.
The border zone between aging and dementia: cognitive and neuropathological changes.
Aging and cognitive performance.
2. Neuropathology of Alzheimer s disease, non–demented aging and MCI.
Topography of neuropathological changes.
Neuropathological AD diagnosis.
Neuropathology of aging.
Neuropathology of MCI.
Does a subset of MCI patients actually have early Alzheimer s disease?
3. Detecting and diagnosing MCI and early AD.
Recognition of MCI and early AD.
Laboratory and radiological evaluation.
Psychometric/mental status testing.
Mini–mental state examination.
Dementia staging instruments.
Global deterioration scale.
4. Etiology of MCI: differential diagnosis.
Dementia with Lewy bodies.
Frontotemporal lobar dementias.
Identifying the subset of MCI that is AD.
5. Treatment of MCI and dementia.
The case for early treatment.
Agents under investigation for AD treatment and prevention.
Vitamin E and selegiline.
6. Future therapeutic and diagnostic strategies.
CSF amyloid beta (A ).
CSF markers of inflammation.
CSF markers of oxidative stress.
PET and SPECT.
Functional MRI (fMRI).
Early–onset familial AD.
Amyloid precursor protein.
7. Case studies.
Case report 1: MCI as early–stage Alzheimer s disease.
Case report 2: Diagnosis of dementia prior to impairment sufficient for MCI.
Case report 3: Memory complaints associated with non–demented aging.
Dr Burns is an Assistant Professor in the Department of Neurology at the University of Kansas Medical Center. He is the Director of the Alzheimer and Memory Center and the Alzheimer s Disease Clinical Research Program and serves as the Principal Investigator of the Brain Aging Program.