Early Diagnosis and Treatment of Mild Cognitive Impairment

Abstract

Due to the increasing number of Americans affected by Alzheimer's disease (AD), there is continual interest in understanding the pathology of the disease and its progression. A fairly novel diagnosis relating to AD, mild cognitive impairment (MCI), has furthered this understanding and also holds promise for a better diagnosis and treatment of the disease in the future. MCI is a transition state that exists between normal aging and Alzheimer's disease. Many studies have proven that some of the known degenerative changes that exist in AD patients are able to be seen in the beginning stages in MCI patients. There are three categories of MCI including amnestic MCI, multiple domain MCI, and single domain non-memory MCI. The amnestic form of MCI has the most information known and the most research being conducted on it. For AD and MCI early diagnosis is crucial because there is not yet a treatment method that is able to reverse the effects of the disease, only to slow the progression. Therefore, the goal is to achieve early diagnosis at which point the individual still has a fairly high cognitive level. An important component in the diagnosis of MCI is diagnostic tests. They examine multiple cognitive domains in an effort to increase specificity in the diagnosis. Biomarkers also play an integral role in the process as they can help the clinician understand more about how the disease is progressing and how to treat the individual most efficiently. Imaging is currently the most accurate tool in detecting MCI. There are a multitude of types of imaging and each one allows the clinician to get a clearer picture of the disease progression. Each of these diagnostic categories are constantly changing and developing as more scientific innovations are proven effective. Currently there are no approved treatments for MCI specifically. However, with a diagnosis of MCI it is common practice to prescribe treatments approved for AD. These include acetylcholinesterase inhibitors or N-methyl-D-aspartate (NMDA) receptor antagonists. Again, these treatments have only been shown to slow the progression and relieve some of the behavioral symptoms of AD, however, very promising research is being conducted on other treatment options that could treat AD, and eventually MCI, from a different angle.