ABSTRACT
Mild cognitive impairment (MCI) has been considered to be associated with a 10-fold risk for developing dementia, most commonly Alzheimer’s disease (AD). Different kinds of tests have been put forward as predictors for AD, such as neuropsychological tests, neuroimaging findings, genetic profile and biological markers. Neuropsychological tests, in particular tests of delayed recall, are sensitive at predicting who will suffer dementia. Promising results have also been obtained from magnetic resonance imaging (MRI) studies. Atrophy of the hippocampus and the entorhinal cortex is a sensitive indicator of early AD. A volume loss in the entorhinal cortex, in particular, has been suggested to predict AD in its preclinical stage. The apolipoprotein E ε4 allele is a significant contributor in predicting AD, especially when combined with neuropsychological and MRI volumetric data. With respect to biological markers, high cerebrospinal fluid (CSF) tau and low amyloid β (Aβ)1-42 levels have been reported in MCI, but the data are by no means unequivocal. The major problem encountered in MCI studies is the diversity of the criteria used to define the disorder. In a population-based setting the MCI category is heterogeneous. However, as will be shown in this
chapter, it seems to be possible to identify among the MCI subjects those individuals who are at high risk for developing AD. In particular, amnestic MCI has been considered as a prodromal state for AD. This group represents a valid target for preventive measures as well as for pharmaceutical interventions.
