Dipartimento di Medicina e Riabilitazione, Istituto Clinico S. Anna-Gruppo San Donato, Brescia, Italy.
Italian Society of Gerontology and Geriatrics (SIGG), Florence, Italy.
J Alzheimers Dis. 2019;68(4):1401-1414. doi: 10.3233/JAD-181253.
Mild cognitive impairment (MCI) generally evolves in a gradually progressive decline in memory and non-memory cognitive domains that may eventually decay to dementia. This process might be preventable by improving early detection of the MCI syndrome followed by proper and timely interventions. The aim of this work was providing helpful indications for a standardized early diagnosis of MCI, mainly focusing on the Italian elderly population. We reviewed here MCI epidemiology and classification, as well as the most recent advancements in early detection of the patient with MCI in the Italian scenario. Specialist centers in connection with general practitioners (GPs) have been established across the country and designated as Centers for Cognitive Disorders and Dementia (CDCD). CDCDs are dedicated to the diagnosis and management of patients for all forms of dementia across all the complex staging spectrum. New tools were made available by the advancements of imaging techniques and of the research on biomarkers, leading to novel approaches based on the combination of imaging and biomarker detection, to improve accuracy and effectiveness in the early diagnosis of MCI. Moreover, patient genotyping, alone or in combination with other techniques, was also revealed as a promising method in evaluating and preventing MCI progression. We recommend the introduction of all these novel tools in the diagnostic practice of the specialist centers and that further efforts and resources are spent into the research of the most effective techniques and biomarkers to be introduced as first-level tests into the practice of early diagnosis of MCI.
轻度认知障碍 (MCI) 通常表现为记忆和非记忆认知领域的逐渐进行性下降,最终可能发展为痴呆。通过改善对 MCI 综合征的早期检测,并随后进行适当和及时的干预,可能可以预防这种情况。这项工作的目的是为 MCI 的标准化早期诊断提供有用的指示,主要关注意大利老年人群。我们在这里回顾了 MCI 的流行病学和分类,以及在意大利背景下 MCI 患者早期检测的最新进展。全国各地都建立了与全科医生 (GP) 相关的专家中心,并指定为认知障碍和痴呆症中心 (CDCD)。CDCD 致力于诊断和管理所有形式的痴呆症患者,涵盖所有复杂的分期谱。影像学技术的进步和生物标志物研究提供了新的工具,导致了基于影像学和生物标志物检测相结合的新方法,以提高 MCI 早期诊断的准确性和有效性。此外,患者基因分型,单独或与其他技术结合,也被证明是评估和预防 MCI 进展的一种有前途的方法。我们建议在专家中心的诊断实践中引入所有这些新工具,并投入更多的努力和资源来研究最有效的技术和生物标志物,将其作为一线测试引入 MCI 的早期诊断实践中。