ABSTRACT

There are two main objectives of this chapter. The first is to provide an overview of the different treatment interventions that have been tested in, or might be potentially useful in treating, individuals with mild cognitive impairment (MCI). The second objective is to advocate for an approach to intervention for MCI that combines traditional pharmacological therapies with cognitive/behavioral techniques that emphasize the use of strategic processing abilities. To accomplish these objectives, the chapter is divided into five sections. We begin by describing the important conceptual and general methodological issues related to designing and implementing MCI treatment programs. One of the important themes developed in this section is the heterogeneity of MCI. Development of successful treatment programs for MCI will require consideration of the variability of cognitive profiles, etiology, and prognosis that characterizes this condition. We also emphasize the importance of recognizing and targeting noncognitive domains (e.g., psychosocial functioning) when developing treatment interventions for MCI. In the second section we summarize the major pharmacological therapies that have been tested in individuals with MCI and Alzheimer's disease (AD). The majority of this section focuses on the role and efficacy of the Cholinesterase inhibitors (ChEIs) in treating AD and MCI. The third section is an overview of the different cognitive interventions that have been tested in individuals with normal cognitive functioning, MCI, AD, as well as individuals with memory impairment due to acquired brain damage. In this section we also describe a new cognitive rehabilitation program that is comprehensive in its approach and shown to be effective in improving cognitive performance in older adults who have experienced significant cognitive decline. Although not yet tested in individuals diagnosed with MCI, we think this program has potential to be usefully applied to this population. In the fourth section, we review the results of studies that have combined pharmacological and cognitive treatment interventions in individuals with mild AD and MCI. Despite the relatively few studies to date, the evidence favors combined approaches that include cognitive interventions that target more than just memory function. Finally, we end the chapter by summarizing the key points and highlighting areas for future research.