What is the approach to treatment of mild cognitive impairment (MCI)?

Updated: Apr 22, 2019
  • Author: Sonal Mehta, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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At present, no established treatment exists for mild cognitive impairment (MCI). Cholinesterase inhibitors have not been found to delay the onset of Alzheimer disease (AD) or dementia in individuals with MCI; however, donepezil has been found to delay the progression to AD in MCI patients with depression without affecting their symptoms of depression. [5] There is some evidence to suggest that cognitive interventions may have a positive effect. [4]

A practice parameter recommendation by the American Academy of Neurology states that patients with MCI should be identified and monitored because of their increased risk for AD and, to a lesser extent, other dementing conditions. Obviously, correcting (to the extent possible) any sensory and motor manifestations compounding the cognitive symptoms is important for minimizing their impact on MCI.

Particular attention should be given to the need to make a legal statement about the competency of patients to handle their own affairs. Because patients with MCI are by definition not demented, they usually do not need to assign power of attorney to anyone else—unlike patients with AD, who eventually will need such help.

The results of a study that included 361 subjects with AD, vascular dementia, or mixed dementias suggested that centrally acting angiotensin-converting enzyme inhibitors (CACE-Is) may reduce the rate of cognitive decline in patients with dementia, regardless of blood pressure levels at the time of their hypertension diagnosis. [31, 32] The rate of cognitive change was slowed in the first 6 months after dementia patients started taking these drugs.

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