Mild cognitive impairment: Conceptual, assessment, ethical, and social issues

Abstract

Mild cognitive impairment (MCI) is defi ned as a condition characterized by newly acquired cognitive decline to an extent that is beyond that expected for age or educational background, yet not causing signifi cant functional impairment. The concept of MCI has received considerable attention in the literature over the past few years, and aspects related to its defi nition, prevalence, and evolution have been extensively studied and reviewed. Here we attempt to synthesize the implications of the current status of this entity, focusing on the conceptual, methodological, and, in particular, the social and ethical aspects of MCI which have attracted less attention. We discuss the weaknesses of the concept of MCI, which is heterogeneous in etiology, manifestations, and outcomes, and suggest that the emergence of the syndrome at this stage refl ects industrial interests related to possible development of drugs for this disorder. On the other hand, the formal diagnosis of MCI, with its implications that the person may develop dementia, may have a grave impact on the psychological state of the individual, at a stage when prediction of outcome is tenuous and possibilities of useful interventions are meager. We present suggestions for the direction of future research in these areas.

Mild Cognitive Impairment and Caregiver Burden: A Critical Review and Research Agenda

“…However, considerable debate has emerged regarding its definition and assessment criteria. 3,25,26 Moreover, there is substantial variety in the assessment of its incidence and prevalence. 27 The present consensus states that MCI is characterized by clinical heterogeneity and that it includes amnestic (consisting of memory problems) and non-amnestic (consisting of impairment in other cognitive domains) phenotypes accompanied by subtypes of single and multiple domain classifications.…”

“…However, the outcome of MCI is mixed, with some individuals remaining stable, deteriorating slowly, or even improving, while others deteriorate into a state of dementia. [1][2][3] Studies assessing the course of cognitive deterioration over time show that the annual rate of conversion from MCI to dementia is ten percent to 15 percent, 4 although it is estimated that between 20 percent and 50 percent of MCI patients remain stable or improve. 5 Although there are substantial limitations in the ability to predict the transition from MCI to dementia or the rate of deterioration, 3,5 it is clear today that MCI is associated with consequences at the societal, individual and familial levels.…”

“…[1][2][3] Studies assessing the course of cognitive deterioration over time show that the annual rate of conversion from MCI to dementia is ten percent to 15 percent, 4 although it is estimated that between 20 percent and 50 percent of MCI patients remain stable or improve. 5 Although there are substantial limitations in the ability to predict the transition from MCI to dementia or the rate of deterioration, 3,5 it is clear today that MCI is associated with consequences at the societal, individual and familial levels. At the societal level, it has been estimated that the direct costs associated with MCI are now only slightly higher than the costs for persons without MCI, 6 most probably because the topic has not been examined yet in detailed studies.…”

Macular Thickness in Subjective Memory Complaints and Mild Cognitive Impairment: A Non-Invasive Biomarker

“…At present, there are numerous publications that deal with MCI, considering MCI as a risk factor for AD 6 or as an early manifestation of AD. 7 On the other hand, in the last few years, a progressive increase in the neurologist consultations due to memory problems has been observed. 8 Only 61% of these memory issues are corroborated by trustworthy informers.…”

Cognición y autonomía en personas mayores dependientes

“…Werner y Korczyn (2008) lo definen como una condición caracterizada por el declive cognitivo adquirido recientemente en una medida que está más allá de lo esperado para su edad o nivel educativo, sin embargo, no causan un deterioro funcional importante.…”