Mariani Elena, Monastero Roberto, Mecocci Patrizia
Section of Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, University of Perugia, Perugia, Italy.
J Alzheimers Dis. 2007 Aug;12(1):23-35. doi: 10.3233/jad-2007-12104.
MCI is a nosological entity proposed as an intermediate state between normal aging and dementia. The syndrome can be divided into two broad subtypes: amnestic MCI (aMCI) characterized by reduced memory, and non-amnestic MCI (naMCI) in which other cognitive functions rather than memory are mostly impaired. aMCI seems to represent an early stage of AD, while the outcomes of the naMCI subtypes appear more heterogeneous--including vascular dementia, frontotemporal dementia or dementia with Lewy bodies--but this aspect is still under debate. MCI in fact represents a condition with multiple sources of heterogeneity, including clinical presentation, etiology, and prognosis. To improve classification and prognosis, there is a need for more sensitive instruments specifically developed for MCI as well as for more reliable methods to determine its progression or improvement. Current clinical criteria for MCI should be updated to include restriction in complex ADL; also the diagnostic and prognostic role of behavioral symptoms and motor dysfunctions should be better defined. A multidisciplinary diagnostic approach including biological and neuroimaging techniques may probably represent the best option to predict the conversion from MCI to dementia. In this review we discuss the most recent aspects related to the epidemiological, clinical, neuropathological, neuroimaging, biochemical and therapeutic aspects of MCI, with specific attention to possible markers of conversion to dementia.
轻度认知障碍（MCI）是一种被提出的疾病实体，被视为正常衰老与痴呆之间的中间状态。该综合征可分为两大类亚型：以记忆力减退为特征的遗忘型MCI（aMCI），以及主要损害记忆以外其他认知功能的非遗忘型MCI（naMCI）。aMCI似乎代表了阿尔茨海默病（AD）的早期阶段，而naMCI亚型的转归似乎更为多样——包括血管性痴呆、额颞叶痴呆或路易体痴呆——但这方面仍存在争议。事实上，MCI代表了一种具有多种异质性来源的状况，包括临床表现、病因和预后。为了改善分类和预后，需要专门为MCI开发更敏感的检测工具，以及更可靠的方法来确定其进展或改善情况。MCI的现行临床标准应更新，以纳入复杂日常生活活动受限的情况；行为症状和运动功能障碍的诊断及预后作用也应得到更好地界定。包括生物学和神经影像学技术在内的多学科诊断方法可能是预测MCI向痴呆转化的最佳选择。在本综述中，我们讨论了与MCI的流行病学、临床、神经病理学、神经影像学、生物化学和治疗方面相关的最新内容，特别关注向痴呆转化的可能标志物。
