Affiliations: [a] Section of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy | [b] Laboratory of Epidemiology and Psychology of Aging and Dementia, Department of Clinical Neuroscience, University of Palermo, Palermo, Italy | Section of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Italy
Correspondence:
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Corresponding author: Patrizia Mecocci, MD, PhD, Institute of Gerontology and Geriatrics, University of Perugia, Policlinico Monteluce-Padiglione E, Via Brunamonti 51, 06122 Perugia, Italy. Tel.: +39 075 578 3270; Fax: +39 075 573 0259; E-mail: mecocci@unipg.it.
Note: [1] Equal contribution.
Abstract: MCI is a nosological entity proposed as an intermediate state between normal aging and dementia. The syndrome can be divided into two broad subtypes: amnestic MCI (aMCI) characterized by reduced memory, and non-amnestic MCI (naMCI) in which other cognitive functions rather than memory are mostly impaired. aMCI seems to represent an early stage of AD, while the outcomes of the naMCI subtypes appear more heterogeneous -including vascular dementia, frontotemporal dementia or dementia with Lewy bodies- but this aspect is still under debate. MCI in fact represents a condition with multiple sources of heterogeneity, including clinical presentation, etiology, and prognosis. To improve classification and prognosis, there is a need for more sensitive instruments specifically developed for MCI as well as for more reliable methods to determine its progression or improvement. Current clinical criteria for MCI should be updated to include restriction in complex ADL; also the diagnostic and prognostic role of behavioral symptoms and motor dysfunctions should be better defined. A multidisciplinary diagnostic approach including biological and neuroimaging techniques may probably represent the best option to predict the conversion from MCI to dementia. In this review we discuss the most recent aspects related to the epidemiological, clinical, neuropathological, neuroimaging, biochemical and therapeutic aspects of MCI, with specific attention to possible markers of conversion to dementia.
Keywords: Alzheimer disease, apolipoprotein E, biomarkers, diagnosis, mild congnitive impairment
