Mild Cognitive Impairment

This article reviews the diagnosis of mild cognitive impairment, its implications for the subsequent development of dementia, and potential management strategies. The possible use of imaging and biomarkers to identify persons at high risk is discussed. Foreword This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations. Stage A 70-year-old woman has been noticing increasing forgetfulness over the past 6 to 12 months. Although she has always had some difficulty recalling the names of acquaintances, she is now finding it difficult to keep track of appointments and recent telephone calls, but the process has been insidious. She lives independently in the community; she drives a car, pays her bills, and is normal in appearance. A mental status examination revealed slight difficulty on delayed recall of four words, but the results were otherwise normal. Does the patient have mild cognitive impairment? How should her case be managed? The . . .