THE IMPORTANCE OF MCI DUE TO AD

The first symptomatic stage of Alzheimer’s disease (AD) may provide only a limited timeframe before dementia.1

A critical stage of the AD continuum1

During the mild cognitive impairment (MCI) stage, clinicians may be able to detect very early features of AD that
are distinct from other causes of memory loss or other forms of cognitive impairment.2,3 

These features can be detected using validated tools such as Mini-Cog, General Practitioner Assessment of
Cognition (GPCOG), Memory Impairment Screen (MIS), and Montreal Cognitive Assessment (MoCA).3,4

A history of MCI due to AD3,5

The AD continuum has evolved over time to include not only dementia, but also MCI and preclinical Alzheimer’s disease. In fact, the concept of MCI as a stage of AD has been around for nearly 30 years. Today, multiple sets of criteria refer to MCI due to AD based on the same defining elements. And in 2018, the FDA issued guidance on the development of drugs focused on early AD treatment.

Tap the to learn about some important MCI due to AD events.

Click the to learn about some important MCI due to AD events.

NYU

Mayo
Clinic

Key
Symposium

NIA-AA

DSM-5 &
IWG

NIA-AA
& FDA

1991

1999

2003

2011

2013

2018

NYU=New York University; NIA-AA=National Institute on Aging–Alzheimer's Association; DSM-5=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; IWG=International Working Group; FDA=Food and Drug Administration.

1991

NYU

NYU conceives of MCI, including it among the six disease stages of the global deterioration scale defining cognitive impairment and dementia.5

1999

Mayo Clinic

The Mayo Clinic creates diagnostic criteria to describe patients with early cognitive dysfunction, focused on memory disturbance that did not meet the definition of dementia.3,5

2003

Key Symposium

Key Symposium of opinion leaders held in Stockholm, Sweden broadened the classification and recognized the possibility of other etiologies for MCI.3

2011

NIA-AA

The National Institute on Aging and the Alzheimer’s Association (NIA-AA) develop criteria for the AD continuum, adopting the Key Symposium definition while adding rules for the use of AD biomarkers.3

2013

DSM-5 & IWG

2018

NIA-AA & FDA

NYU=New York University; NIA-AA=National Institute on Aging–Alzheimer's Association; DSM-5=Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; IWG=International Working Group; FDA=Food and Drug Administration.

The time between MCI due to AD and AD dementia is limited1,6,7

The rate of cognitive decline increases sharply in the years before dementia. Since MCI due to AD is the earliest
stage of Alzheimer’s disease with observable symptoms, this leaves limited time between diagnosis and
dementia—with estimates ranging from 2 to 6 years
.

Patients with MCI due to AD have been shown to convert to AD dementia at an annual rate of 31%.8

The critical role of biomarker assessment2,9-12

Biomarkers provide early indications of abnormal pathophysiological changes related to Alzheimer's disease. While biomarker testing is not currently recommended for routine clinical practice, it may be a useful tool when deemed appropriate by the clinician. In the future, it is anticipated that positron emission tomography (PET) imaging or cerebrospinal fluid (CSF) biomarkers will play a greater role and be used to detect amyloid burden and help support the early detection of Alzheimer's disease at the MCI due to AD stage.

The IDEAS Study recently showed how AD biomarkers changed the management of patients with MCI or dementia of uncertain etiology. In this longitudinal study published by the Journal of the American Medical Association, the primary endpoint was change in patient management, including AD therapy, other drug therapy, or safety counseling/future planning (target: 30% composite change in each group) after amyloid PET scanning.13

N=11,409; P<0.001.

Should disease-modifying interventions become available in the future, an early and accurate diagnosis of Alzheimer’s disease will be important for initiation of treatment. Identifying biomarkers may serve as the mechanism to improve early and accurate diagnosis.14,15

icon-book Journal Feature

Learn more about how amyloid PET influenced changes in the management of MCI or dementia.

Read: Rabinovici GD, Gatsonis C, Apgar C, et al. Association of amyloid positron emission tomography with
subsequent change in clinical management among Medicare beneficiaries with mild cognitive impairment or
dementia. 𝘑𝘈𝘔𝘈. 2019;321(13):1286-1294.

Read: Rabinovici GD, Gatsonis C, Apgar C, et al. Association of amyloid positron emission tomography with subsequent change in clinical management among Medicare beneficiaries with mild cognitive impairment or dementia. 𝘑𝘈𝘔𝘈. 2019;321(13):1286-1294.

Request more information

Receive updated news and perspectives about Alzheimer’s disease

Enter a valid email address