Diagnosing early Alzheimer’s and Mild Cognitive Impairment: Emerging Challenges and Implications

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Blur­ry line in diag­nos­ing ear­ly Alzheimer’s: study (Reuters):

  • “The revised def­i­n­i­tion of a brain con­di­tion called mild cog­ni­tive impair­ment means that many peo­ple now con­sid­ered to have mild or ear­ly Alzheimer’s dis­ease could eas­i­ly be giv­en that diag­no­sis instead, sug­gests a new study.”
  • “Creighton Phelps, head of the Alzheimer’s Dis­ease Cen­ters Pro­gram at the Nation­al Insti­tute on Aging, said that to a cer­tain extent, the line between mild cog­ni­tive impair­ment and ear­ly Alzheimer’s is indeed “fuzzy” and depends on a doc­tor’s indi­vid­ual judg­ment. But he added that many researchers still think there’s a point in between nor­mal think­ing and func­tion­ing and Alzheimer’s demen­tia that deserves its own category.”
  • “White­house said that all of the divi­sions between nor­mal and mild cog­ni­tive impair­ment and Alzheimer’s miss the most impor­tant point: that every­one, as they age, should be tak­ing steps to main­tain their brain health. That includes keep­ing your mind and body active, eat­ing a healthy, Mediter­ranean-style diet and keep­ing engaged social­ly, he added.”

Study: Revised Cri­te­ria for Mild Cog­ni­tive Impair­ment May Com­pro­mise the Diag­no­sis of Alzheimer Dis­ease Demen­tia (Arch Neu­rol). From the abstract:

  • Results  Almost all (99.8%) indi­vid­u­als cur­rent­ly diag­nosed with very mild AD demen­tia and the large major­i­ty (92.7%) of those diag­nosed with mild AD demen­tia could be reclas­si­fied as hav­ing MCI with the revised cri­te­ria, based on their lev­el of impair­ment in the Clin­i­cal Demen­tia Rat­ing domains for per­for­mance of instru­men­tal activ­i­ties of dai­ly liv­ing in the com­mu­ni­ty and at home. Large per­cent­ages of these indi­vid­u­als with AD demen­tia also meet the revised “func­tion­al inde­pen­dence” cri­te­ri­on for MCI as mea­sured by the Func­tion­al Assess­ment Questionnaire.
  • Con­clu­sions  The cat­e­gor­i­cal dis­tinc­tion between MCI and milder stages of AD demen­tia has been com­pro­mised by the revised cri­te­ria. The result­ing diag­nos­tic over­lap sup­ports the premise that “MCI due to AD” rep­re­sents the ear­li­est symp­to­matic stage of AD.

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