Prospective and retrospective studies of mild cognitive impairment : Alzheimer disease and senile tauopathy

点击翻译按钮获取中文摘要

Mild cognitive impairment (MCI) is defined as the intermediate state between normal cognition and dementia and highlighted as the main target for preventive scheme against cognitive decline in the elderly.We screened clinical records of 1,120 serial autopsy cases from Tokyo Metropolitan Brain Bank for Aging Research in these five years. The cases equivalent to MCI were retrospectively selected by two professional neurologists independently, on the following criteria: 1.the description of memory impairment incurring problems for medical care,2.no definite description of dementia, and 3.Clinical Dementia Rating 0.5.One hundred and seventy one cases were pulled out as MCI equivalents. The background pathology of these cases consisted of 25 cases mainly presenting with Alzheimer disease (AD)-type pathology,23 cases of senile tauopathy, comprising dementia with grain or neuforibrillary tangle-predominant form of dementia-type changes and others.With this result, we have established the crit … More ical path for MCI. The initial screening consists of neurological examination, Mini-Mental State Examination and CTscan. The secondary screening includes volumetric MRI, statistical SPECT, the Rivermead Behavioral Memory Test (RBMT) and electroencephalography (EEG). Those patients who fulfill the criteria of MCI are recruited to the prospective study with informed consent. The advanced examination includes biological marker of cerebrospinal fluid (tau, phosphorylated tau and Abeta), apoE phenotyping, WAIS-R, WMS-R and PET scans. MCI cases with possible early AD or senile tauopathy are recruited to medical control by acetylcholine esterase inhibitor.We have run this critical path this year. Tentative summaries are as follows: 1.MCI includes many cases in addition to AD. 2.Appropriate medical intervention could prevent and, in some cases, reverse the progression of cognitive decline. 3.Early intervention is quite useful for the preservation of the quality of life.Further accumulation of the cases are now on going. Less