Eva Svoboda, PhD,^1,2 Gillian Rowe, PhD,^1,2 Kelly Murphy, PhD,^1,2
1Neuropsychology and Cognitive Health Program, Baycrest Centre, Toronto, ON.
²Department of Psychology, University of Toronto, Toronto, ON.

Abstract
Memory problems can be devastating as they limit independent functioning and disrupt social, family, and occupational roles. One form of remembering, prospective memory - remembering to attend to a task or event in the future—is particularly vulnerable to disruption. Fortunately memory is not a singular ability and patients can learn to compensate for memory difficulties by using preserved memory systems. Combining smartphone technology with appropriate training techniques has been shown to be effective in supporting prospective memory function even in individuals with amnesia. We have evidence that such technology may be used in a similar fashion to promote memory in mild cognitive impairment with the aim of delaying or preventing dementia onset. Even in dementia, memory training or support in forming new habits and routines which tap into preserved memory systems can be effectively used to help patients learn new names, reduce repetitive questions and remain oriented to the present. The best prevention is early intervention. Older adults presenting with memory complaints, no matter how mild, should be directed to maintain, reestablish, or institute habits of organization and written reminders, both to support current memory functioning and to preserve functional independence into the future should their concerns turn out to be the early manifestations of a neurodegenerative condition.
Keywords: amnesia, technology, dementia, mild cognitive impairment, memory intervention.

Lesley J. Ritchie, MSc, Department of Psychology, Centre on Aging, University of Victoria, Victoria, BC.
Holly Tuokko, PhD, Department of Psychology, Centre on Aging, University of Victoria, Victoria, BC.

Mild cognitive impairment (MCI) is an intermediary stage in the cognitive continuum from normal aging to dementia. Six to 48% of individuals with MCI are estimated to develop dementia.1 As such, the conceptualization and operationalization of MCI present unique opportunities for the development and implementation of strategies to prevent or delay the conversion to dementia. Despite the lack of a “gold standard” case definition for MCI, information gathered from neuropsychological assessment may inform a diagnosis of MCI based on clinical judgment, as impaired performance on several neuropsychological measures is predictive of conversion to dementia for persons exhibiting cognitive decline but who are not demented.
Key words: mild cognitive impairment, dementia, conversion, neuropsychology, predictors of dementia.

Angela K. Troyer, PhD, CPsych, Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, ON.
Kelly J. Murphy, PhD, CPsych, Department of Psychology, Baycrest Centre for Geriatric Care, Toronto, ON.

Functional decline in dementia causes increased dependence on others and negatively impacts quality of life. Emerging evidence indicates that functional debility can be delayed or minimized by promoting an active lifestyle and using memory strategies. Older adults with active lifestyles maintain higher cognitive abilities and have reduced risks of developing dementia. Furthermore, individuals with dementia show improved cognitive and functional abilities following participation in physically and mentally stimulating activities. Memory strategy application can improve situation-specific memory performance in individuals with mild cognitive impairment and dementia, and has been shown to positively impact perceptions of well-being and functional ability in these individuals.
Key words: active lifestyle, dementia, memory intervention, mild cognitive impairment, rehabilitation.

Holly A. Tuokko, PhD, RPsych, CIHR Institute of Aging Senior Investigator; Professor, University of Victoria, Victoria, BC.

Impairments in cognition and everyday activities are primary risk factors for increases in need for care. Even before cognitive impairment is of sufficient severity to be considered dementia, complex, high-level, everyday activities may be notably impaired. As cognitive impairment increases, so too does the type and magnitude of difficulties in performing everyday tasks. When the severity of cognitive impairment and level of dependency for everyday tasks exceeds that which can be provided at home in the community, long-term care facility admission may need to be considered.
Key words: mild cognitive impairment, dementia, everyday functioning, long-term care facility admission.

Andrew R. Frank, MD, Alzheimer’s Disease Center, Mayo Clinic College of Medicine, Rochester, MN, U.S.A.
Ronald C. Petersen, MD, PhD, Alzheimer’s Disease Center, Mayo Clinic College of Medicine, Rochester, MN, U.S.A.

Mild Cognitive Impairment (MCI) describes a state of abnormal cognitive functioning that is insufficient to warrant a diagnosis of dementia. While dementia requires that activities of daily functioning be compromised due to cognitive symptomology, the diagnosis of MCI can be made earlier, in the absence of such functional impairment. In MCI, the patient must present with cognitive complaints (or someone who knows the patient well must present them on the patient's behalf), and these complaints must be corroborated by abnormalities on standardized cognitive testing. The diagnosis of MCI alerts the clinician to a higher risk of future development of dementia and provides an ideal target population that may benefit the most from “disease-modifying” cognitive therapies currently in development.
Key words: mild cognitive impairment, MCI, Alzheimer’s disease, dementia, early diagnosis, treatment.

Raj C. Shah, MD, Rush Alzheimer’s Disease Center; Department of Family Medicine, Rush University Medical Center, Chicago, IL, USA.
David A. Bennett, MD, Rush Alzheimer’s Disease Center; Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.

Mild cognitive impairment (MCI), the presence of cognitive difficulties without having dementia, is viewed as a preclinical state for Alzheimer’s disease (AD) or another dementing illness. With the burden of AD expected to increase, research efforts have focused on interventions to delay the progression of MCI to AD. In this review, we first discuss the current conceptual understanding of MCI. Then, we outline a simplified approach to help clinicians diagnose MCI. Finally, we provide an overview of how to address the clinical needs of individuals with MCI.
Key words: mild cognitive impairment, Alzheimer’s disease, diagnosis, prognosis, treatment.