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.
Jane McCusker, MD, DrPH, Professor, Epidemiology and Biostatistics, McGill University; Head, Clinical Epidemiology and Community Studies, St. Mary's Hospital, Montreal, QC.
Nine published studies of the outcomes of delirium with at least six months of follow-up were reviewed. The results indicate that: 1) the symptoms of delirium are more persistent than previously thought; up to 15% of those without dementia and 49% of those with dementia continued to have core symptoms of delirium 12 months after the initial diagnosis; 2) a diagnosis of delirium is an independent predictor of increased mortality for up to three years after diagnosis and; 3) a diagnosis of delirium predicts continued poorer cognitive and physical functioning for up to 12 months after diagnosis.
Key words: delirium, prognosis, dementia, functioning, cognitive status.
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