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Mild Cognitive Impairment

Mild Cognitive Impairment is a topic covered in the 5-Minute Clinical Consult.

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Basics

Description

  • Mild cognitive impairment (MCI) is defined as significant cognitive impairment in the absence of dementia, as measured by standard memory tests:
    • Concern regarding change in cognition
    • Preservation of independence in functional activities (ADLs)
    • Impairment in ≥1 cognitive domains (attention, executive dysfunction, memory, visuospatial, language)
    • Other terms used in the literature relating to MCI: isolated memory impairment; cognitive impairment not dementia (CIND); predementia; mild cognitive disorder; age-associated memory impairment; age-related cognitive decline; benign senescent forgetfulness. Some of these conditions do not progress to dementia (i.e., benign senescent forgetfulness, age-associated memory impairment, age-related cognitive decline). DSM-5 mentions “mild neurocognitive disorder” (mNCD), which may be a precursor to Alzheimer disease and has many of the same features as MCI.
  • Older adults with MCI are 3 times more likely to progress to dementia in 2 to 5 years than age matched cohorts (1)[A].

Epidemiology

Incidence
  • Predominant sex: male > female
  • Predominant age:
    • Higher in older persons and in those with less education
    • 12 to 15/1,000 person-years in those age ≥65 years
    • 54/1,000 person-years in those age ≥75 years

Prevalence
  • MCI is more prevalent than dementia in the United States.
  • 12–18% for those age ≥60 years (2)

Etiology and Pathophysiology

  • Subtypes of MCI:
    • Single-domain amnestic
    • Multiple-domain amnestic
    • Nonamnestic single-domain
    • Nonamnestic multiple-domain
  • The amnestic subtype is higher risk for progression to Alzheimer disease.
  • Vascular, degenerative, traumatic, metabolic, psychiatric, or a combination

Genetics
Apolipoprotein (APO) E4 genotype: Various pathways exist leading to amyloid accumulation and deposition thought to be associated with dementia.

Risk Factors

  • Age
  • Diabetes
  • Hypertension
  • Hyperlipidemia
  • Cerebrovascular disease
  • Smoking
  • Sleep apnea
  • APO E4 genotype

Commonly Associated Conditions

See “Risk Factors.”

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Citation

Stephens, Mark B., et al., editors. "Mild Cognitive Impairment." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2019. 5minute, www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116980/all/Mild_Cognitive_Impairment.
Mild Cognitive Impairment. In: Stephens MB, Golding J, Baldor RA, et al, eds. 5-Minute Clinical Consult. 27th ed. Wolters Kluwer; 2019. https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116980/all/Mild_Cognitive_Impairment. Accessed June 20, 2019.
Mild Cognitive Impairment. (2019). In Stephens, M. B., Golding, J., Baldor, R. A., & Domino, F. J. (Eds.), 5-Minute Clinical Consult. Available from https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116980/all/Mild_Cognitive_Impairment
Mild Cognitive Impairment [Internet]. In: Stephens MB, Golding J, Baldor RA, Domino FJ, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2019. [cited 2019 June 20]. Available from: https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116980/all/Mild_Cognitive_Impairment.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Mild Cognitive Impairment ID - 116980 ED - Stephens,Mark B, ED - Golding,Jeremy, ED - Baldor,Robert A, ED - Domino,Frank J, BT - 5-Minute Clinical Consult, Updating UR - https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/116980/all/Mild_Cognitive_Impairment PB - Wolters Kluwer ET - 27 DB - 5minute DP - Unbound Medicine ER -