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From the Department of Neurology (Dr. Petersen), Mayo Clinic, Rochester, MN; Lutheran Medical Office (Dr. Stevens), Fort Wayne, IN; Department of Psychiatry, University of Pittsburgh School of Medicine and Department of Epidemiology, University of Pittsburgh Graduate School of Public Health (Dr. Ganguli), Pittsburgh, PA; Department of Internal Medicine (Dr. Tangalos), Mayo Clinic, Rochester, MN; Departments of Neurology and Psychiatry & Biobehavioral Science (Dr. Cummings), University of California at Los Angeles; Departments of Neurology and Psychiatry (Dr. DeKosky), University of Pittsburgh, PA.
Address correspondence and reprint requests to the Quality Standards Subcommittee, American Academy of Neurology, 1080 Montreal Ave., St. Paul, MN 55116.
OBJECTIVE: The goal of this project was to determine whether screening different groups of elderly individuals in a general or specialty practice would be beneficial in detecting dementia.
BACKGROUND: Epidemiologic studies of aging and dementia have demonstrated that the use of research criteria for the classification of dementia has yielded three groups of subjects: those who are demented, those who are not demented, and a third group of individuals who cannot be classified as normal or demented but who are cognitively (usually memory) impaired.
METHODS: The authors conducted computerized literature searches and generated a set of abstracts based on text and index words selected to reflect the key issues to be addressed. Articles were abstracted to determine whether there were sufficient data to recommend the screening of asymptomatic individuals. Other research studies were evaluated to determine whether there was value in identifying individuals who were memory-impaired beyond what one would expect for age but who were not demented. Finally, screening instruments and evaluation techniques for the identification of cognitive impairment were reviewed.
RESULTS: There were insufficient data to make any recommendations regarding cognitive screening of asymptomatic individuals. Persons with memory impairment who were not demented were characterized in the literature as having mild cognitive impairment. These subjects were at increased risk for developing dementia or AD when compared with similarly aged individuals in the general population.
RECOMMENDATIONS: There were sufficient data to recommend the evaluation and clinical monitoring of persons with mild cognitive impairment due to their increased risk for developing dementia (Guideline). Screening instruments, e.g., Mini-Mental State Examination, were found to be useful to the clinician for assessing the degree of cognitive impairment (Guideline), as were neuropsychologic batteries (Guideline), brief focused cognitive instruments (Option), and certain structured informant interviews (Option). Increasing attention is being paid to persons with mild cognitive impairment for whom treatment options are being evaluated that may alter the rate of progression to dementia.
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A. Marcos, P. Gil, A. Barabash, R. Rodriguez, M. Encinas, C. Fernandez, and J. A. Cabranes Neuropsychological Markers of Progression From Mild Cognitive Impairment to Alzheimer's Disease American Journal of Alzheimer's Disease and Other Dementias, May 1, 2006; 21(3): 189 - 196. [Abstract] [PDF]
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R. C. Petersen, J. E. Parisi, D. W. Dickson, K. A. Johnson, D. S. Knopman, B. F. Boeve, G. A. Jicha, R. J. Ivnik, G. E. Smith, E. G. Tangalos, et al. Neuropathologic Features of Amnestic Mild Cognitive Impairment Arch Neurol, May 1, 2006; 63(5): 665 - 672. [Abstract] [Full Text] [PDF]
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G. A. Jicha, J. E. Parisi, D. W. Dickson, K. Johnson, R. Cha, R. J. Ivnik, E. G. Tangalos, B. F. Boeve, D. S. Knopman, H. Braak, et al. Neuropathologic outcome of mild cognitive impairment following progression to clinical dementia. Arch Neurol, May 1, 2006; 63(5): 674 - 681. [Abstract] [Full Text] [PDF]
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A. L. W. Bokde, P. Lopez-Bayo, T. Meindl, S. Pechler, C. Born, F. Faltraco, S. J. Teipel, H.-J. Moller, and H. Hampel Functional connectivity of the fusiform gyrus during a face-matching task in subjects with mild cognitive impairment Brain, May 1, 2006; 129(5): 1113 - 1124. [Abstract] [Full Text] [PDF]
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D. C. Steffens, E. Otey, G. S. Alexopoulos, M. A. Butters, B. Cuthbert, M. Ganguli, Y. E. Geda, H. C. Hendrie, R. R. Krishnan, A. Kumar, et al. Perspectives on Depression, Mild Cognitive Impairment, and Cognitive Decline Arch Gen Psychiatry, February 1, 2006; 63(2): 130 - 138. [Abstract] [Full Text] [PDF]
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M. E. Gurol, M. C. Irizarry, E. E. Smith, S. Raju, R. Diaz-Arrastia, T. Bottiglieri, J. Rosand, J. H. Growdon, and S. M. Greenberg Plasma {beta}-amyloid and white matter lesions in AD, MCI, and cerebral amyloid angiopathy Neurology, January 10, 2006; 66(1): 23 - 29. [Abstract] [Full Text] [PDF]
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I. Prohovnik, D. P. Perl, K. L. Davis, L. Libow, G. Lesser, and V. Haroutunian Dissociation of neuropathology from severity of dementia in late-onset Alzheimer disease Neurology, January 10, 2006; 66(1): 49 - 55. [Abstract] [Full Text] [PDF]
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G. M. Doniger, T. Dwolatzky, D. M. Zucker, H. Chertkow, H. Crystal, A. Schweiger, and E. S. Simon Computerized cognitive testing battery identifies mild cognitive impairment and mild dementia even in the presence of depressive symptoms American Journal of Alzheimer's Disease and Other Dementias, January 1, 2006; 21(1): 28 - 36. [Abstract] [PDF]
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P. A. Boyle, R. S. Wilson, N. T. Aggarwal, Z. Arvanitakis, J. Kelly, J. L. Bienias, and D. A. Bennett Parkinsonian signs in subjects with mild cognitive impairment Neurology, December 27, 2005; 65(12): 1901 - 1906. [Abstract] [Full Text] [PDF]
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M. C. Irizarry, M. E. Gurol, S. Raju, R. Diaz-Arrastia, J. J. Locascio, M. Tennis, B. T. Hyman, J. H. Growdon, S. M. Greenberg, and T. Bottiglieri Association of homocysteine with plasma amyloid {beta} protein in aging and neurodegenerative disease Neurology, November 8, 2005; 65(9): 1402 - 1408. [Abstract] [Full Text] [PDF]
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C. T. Gualtieri and L. G. Johnson Neurocognitive testing supports a broader concept of mild cognitive impairment American Journal of Alzheimer's Disease and Other Dementias, November 1, 2005; 20(6): 359 - 366. [Abstract] [PDF]
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E van den Berg, R P C Kessels, E H F de Haan, L J Kappelle, and G J Biessels Mild impairments in cognition in patients with type 2 diabetes mellitus: the use of the concepts MCI and CIND J. Neurol. Neurosurg. Psychiatry, October 1, 2005; 76(10): 1466 - 1467. [Full Text] [PDF]
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D. A. Fleischman, R. S. Wilson, J. D. E. Gabrieli, J. A. Schneider, J. L. Bienias, and D. A. Bennett Implicit memory and Alzheimer's disease neuropathology Brain, September 1, 2005; 128(9): 2006 - 2015. [Abstract] [Full Text] [PDF]
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J D Fisk and K Rockwood Outcomes of incident mild cognitive impairment in relation to case definition J. Neurol. Neurosurg. Psychiatry, August 1, 2005; 76(8): 1175 - 1177. [Abstract] [Full Text] [PDF]
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S. Gauthier and J. Touchon Mild Cognitive Impairment Is Not a Clinical Entity and Should Not Be Treated Arch Neurol, July 1, 2005; 62(7): 1164 - 1166. [Full Text] [PDF]
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R. C. Petersen, R. G. Thomas, M. Grundman, D. Bennett, R. Doody, S. Ferris, D. Galasko, S. Jin, J. Kaye, A. Levey, et al. Vitamin E and Donepezil for the Treatment of Mild Cognitive Impairment N. Engl. J. Med., June 9, 2005; 352(23): 2379 - 2388. [Abstract] [Full Text] [PDF]
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T. R. Stoub, M. Bulgakova, S. Leurgans, D. A. Bennett, D. Fleischman, D. A. Turner, and L. deToledo-Morrell MRI predictors of risk of incident Alzheimer disease: A longitudinal study Neurology, May 10, 2005; 64(9): 1520 - 1524. [Abstract] [Full Text] [PDF]
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J. N. Keller, F. A. Schmitt, S. W. Scheff, Q. Ding, Q. Chen, D. A. Butterfield, and W. R. Markesbery Evidence of increased oxidative damage in subjects with mild cognitive impairment Neurology, April 12, 2005; 64(7): 1152 - 1156. [Abstract] [Full Text] [PDF]
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D. A. Bennett, J. A. Schneider, J. L. Bienias, D. A. Evans, and R. S. Wilson Mild cognitive impairment is related to Alzheimer disease pathology and cerebral infarctions Neurology, March 8, 2005; 64(5): 834 - 841. [Abstract] [Full Text] [PDF]
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T. A. Ala, A. M. Popovich, and L. G. Berck Knowledge of personal information and caregiver awareness in Alzheimer's disease American Journal of Alzheimer's Disease and Other Dementias, March 1, 2005; 20(2): 119 - 125. [Abstract] [PDF]
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M. W. Bondi, W. S. Houston, L. T. Eyler, and G. G. Brown fMRI evidence of compensatory mechanisms in older adults at genetic risk for Alzheimer disease Neurology, February 8, 2005; 64(3): 501 - 508. [Abstract] [Full Text] [PDF]
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Y Nagahama, T Okina, N Suzuki, H Nabatame, and M Matsuda The cerebral correlates of different types of perseveration in the Wisconsin Card Sorting Test J. Neurol. Neurosurg. Psychiatry, February 1, 2005; 76(2): 169 - 175. [Abstract] [Full Text] [PDF]
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J. B. Tornatore, E. Hill, J. A. Laboff, and M. E. McGann Self-Administered Screening for Mild Cognitive Impairment: Initial Validation of a Computerized Test Battery J Neuropsychiatry Clin Neurosci, February 1, 2005; 17(1): 98 - 105. [Abstract] [Full Text] [PDF]
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