Differential Diagnosis of Mild Cognitive Impairment
Report of difficulty with memory or another core cognitive domain, preferably corroborated by an informant. Deficits relative to norms for age and education are objectively evident on a mental status exam or neuropsychological testing.
Normal overall cognition.
Generally intact function in usual daily activities.
The most common type of mild cognitive impairment (MCI) is “amnestic MCI,” involving a primary memory complaint.
Older adults with MCI progress to dementia at a higher rate than those with no impairment, but progression is not inevitable. Rates of progression have varied considerably in different studies.
No treatments for MCI have been approved by the U.S. Food and Drug Administration (FDA).
Scientists have not completely characterized this disorder. Amnestic MCI may be a forerunner of Alzheimer’s disease. Yet mild memory impairments could also be associated with preclinical signs of any dementing illness.
Studies have found that individuals diagnosed with amnestic MCI had some type of abnormality affecting key memory regions, and most seemed to be on their way toward meeting standards for Alzheimer’s. Most also had evidence of other abnormalities in addition to the characteristic plaques and tangles of Alzheimer’s disease.
Four core cognitive domains
Recent memory - ability to learn and recall new information
Language - either comprehension or expression
Visuospatial ability - comprehension and effective manipulation of nonverbal, graphic or geographic information
Executive function - ability to plan, perform abstract reasoning, solve problems, focus despite distractions and shift focus when appropriate