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Diagnostic transitions in mild cognitive impairment subtypes
International Psychogeriatrics, 11/04/09

Forlenza OV et al. – The clinical diagnosis of MCI and its subtypes yields groups of patients with heterogeneous patterns of transitions between one given cognitive state to another. The presence of more severe and widespread cognitive deficits, as indicated by the group of multiple–domain amnestic MCI may be a better predictor of AD than single–domain amnestic or non–amnestic deficits. These higher–risk individuals could probably be the best candidates for the development of preventive strategies and early treatment for the disease.

Exclusive Author Commentary
Orestes Vicente Forlenza, 11/04/09

We understand that biomarker technologies (e.g., amyloid imaging with PET, or the quantification of AD-like molecules in the CSF) will add important insights into the clinical and neuropsychological heterogeneity of MCI. But it is reasonable to assume that these resources are highly specialized, and may not be available in most clinical settings. The identification of subtle changes in the cognition and the functional status, compatible with the expected pattern of transitions in the MCI-AD continuum, may add accuracy to the diagnosis of Alzheimer’s disease at pre-dementia stages.

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