Mild cognitive impairment (MCI) twenty years on

Abstract

Cognitive decline has commonly been considered an inevitable result of brain aging and has been of clinical interest principally because of related difficulties with everyday functioning. Since the 1990s the “normality” of age-related cognitive decline has been called into question, being commonly attributed to a number of underlying disorders. Numerous concepts have been proposed which link subclinical cognitive change to pathological states (mild cognitive disorder, mild neurocognitive disorder, mild cognitive impairment). Of these, mild cognitive impairment (MCI) has become the most popular, driven on the one hand by industrial interests seeking to extend new dementia treatments for a more prevalent subclinical syndrome, and on the other by researchers attempting to identify at-risk populations. MCI has been both criticized for “medicalizing” behavior still within normal limits (Stephan et al., 2008; Moreira et al., 2008) and welcomed in that it suggests cognitive decline with aging may not be inevitable, but rather due to abnormalities which could ultimately be treated. Recently, in both Europe (DuBois et al., 2007) and the USA (Albert et al., 2011), panels of experts have scrutinized the concept of MCI and more broadly the pre-dementia stages of neurodegenerative diseases and offered new research diagnostic criteria. These proposed criteria have highlighted the (potential) value of biomarkers in assisting diagnosis, although some have considered the elevation of biomarkers to this level of importance in diagnosing disease before dementia develops to be premature given both the extent and quality of diagnostic biomarker data currently available (McShane et al., 2011a; 2011b).

Increased Risk of Cognitive Impairment in Patients With Diabetes Is Associated With Metformin

“…Alternatively, metformin also impairs absorption of vitamin B 12 via a drug interaction that occurs at the distal ileum. Low serum vitamin B 12 levels are associated with AD and other neurodegenerative diseases (38). …”

Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments

“…Thus, current evidence strongly suggests older adults with impaired mobility are at significant risk for decline in both HRQoL and QoL [9]. Further, QoL is associated with cognitive status in older adults [10]. …”

What is the Relationship between Health, Mood, and Mild Cognitive Impairment?

“…Therefore, the present study will also examine differences across the measures of health in participants with MCI who report SMC and those who do not report SMC, to explore whether such processes extend beyond appraisals of cognitive functioning and are instead part of a global appraisal of health. Research into the role of SMC and their relevance in the MCI diagnosis is growing [19], but as yet no study has considered the effects of subjective appraisal in other domains.…”