Abstract
Current research is aiming to push the boundaries of the point at which a diagnosis of Alzheimer Disease (AD) can be made. Clinical syndromes such as Mild Cognitive Impairment (MCI) and various clinical and biological markers of AD may help to identify people in the early stage of AD, before a full dementia syndrome is present. In the first part of this paper, we discuss whether MCI represents incipient AD, and examine some of the methods currently used in research to identify AD patients in the preclinical phase. In the second part, we discuss whether specific guidelines are needed for the diagnosis and management of MCI and incipient AD, and consider the potential impact of this on clinical practice and public health from the perspective of patients, caregivers, and healthcare providers.
Highlights
IntroductionDementia of the Alzheimer type is diagnosed clinically according to diagnostic criteria [1]
The Concept of Mild Cognitive Impairment (MCI) and Incipient Alzheimer disease (AD)Currently, dementia of the Alzheimer type is diagnosed clinically according to diagnostic criteria [1]
There are currently no clinical trials investigating the effect of treating behavioral and psychological symptoms of dementia (BPSD) and psychiatric disorders in MCI patients, and it is not known whether pharmacological treatments are effective either in slowing the progression from MCI to AD or in reducing the severity of neuropsychiatric symptoms in these patients
Summary
Dementia of the Alzheimer type is diagnosed clinically according to diagnostic criteria [1] These criteria include deficits in memory and other cognitive functions, and the symptoms have a gradual onset and progressive deterioration. The MCI paradigm is based on the assumption that patients with AD develop symptoms, memory impairment, gradually and, there may be an intermittent stage between normal aging and dementia characterized primarily by episodic memory deficits. These MCI patients have a high risk of progressing to a full dementia syndrome within a few years [8], as discussed later, the evolution is heterogeneous. The differential diagnostic capacity of using CSF markers between the preliminary states of various dementia disorders has not yet been thoroughly studied, the discoveries regarding AD are pushing the boundaries as to when AD can be identified and diagnosed in individuals
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