Revised Criteria for Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) is a common condition in the elderly. It is characterized by deterioration of memory, attention, and cognitive function that is beyond what is expected based on age and educational level. MCI does not interfere significantly with individuals’ daily activities.

A workgroup on diagnostic guidelines from the National Institute on Aging and the Alzheimer’s Association (NIA-AA) identified the following core clinical features that indicate MCI due to Alzheimer disease (AD). It should be noted that these criteria only refer to the subset of all MCI that is thought be due to AD, and not to MCI due to other etiologies, eg, vascular disease, other neurodegenerative conditions, or psychiatric conditions.

  • Cognitive concern reflecting a change in cognition reported by patient or informant or observed by clinician
  • Objective evidence of impairment in one or more cognitive domains, typically including memory
  • Preservation of independence in functional abilities
  • Not demented

The etiology of MCI should be evaluated to identify the cause as most likely to be AD:

  • Rule out vascular, traumatic, medical causes of cognitive decline, where possible
  • Provide evidence of longitudinal decline in cognition, when feasible
  • Report history consistent with AD genetic factors, where relevant

As part of the MCI due to AD criteria, biomarkers are used to augment clinical suspicions that the clinical syndrome of MCI is due to AD.

 

References:

  1. Gillis C, Mirzaei F, Potashman M, Ikram MA, Maserejian N. The incidence of mild cognitive impairment: A systematic review and data synthesis. Alzheimers Dement (Amst). 2019 Mar 8;11:248-256. [Medline]
  2. Sanford AM. Mild Cognitive Impairment. Clin Geriatr Med. 2017 Aug;33(3):325-337. [Medline]
  3. Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, Gamst A, Holtzman DM, Jagust WJ, Petersen RC, Snyder PJ, Carrillo MC, Thies B, Phelps CH. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011 May;7(3):270-9. [Medline]
  4. McKhann GM, Knopman DS, Chertkow H, Hyman BT, Jack CR Jr, Kawas CH, Klunk WE, Koroshetz WJ, Manly JJ, Mayeux R, Mohs RC, Morris JC, Rossor MN, Scheltens P, Carrillo MC, Thies B, Weintraub S, Phelps CH. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011 May;7(3):263-9. [Medline]

 

Created Oct 25, 2019.