What is the pathophysiology of mild cognitive impairment (MCI)?

Updated: Apr 22, 2019
  • Author: Sonal Mehta, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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In mild cognitive impairment (MCI), cognitive impairment exceeds the normal expected age-related changes, but functional activities are largely preserved; thus, MCI does not meet the criteria for dementia. [1] Different subtypes of MCI are recognized. One common classification distinguishes between amnestic and nonamnestic forms of MCI.

Amnestic MCI, in which memory impairment predominates, is often a precursor of clinical Alzheimer disease (AD). Nonamnestic forms of MCI are characterized by a variety of cognitive impairments, the most common of which is probably impaired executive function. A substantial number of patients with MCI may be judged to have normal cognition on follow-up visits.

The pathophysiology of MCI is multifactorial. Most cases of amnestic MCI result from pathologic changes of AD that have not yet become severe enough to cause clinical dementia. [16] At least in specialty research populations, autopsies done on amnestic MCI patients have found the neuropathology to be typical of AD. [17] Nonamnestic MCI may be associated with cerebrovascular disease, frontotemporal dementias (as a precursor), or no specific pathology.

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