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State of the science on mild cognitive impairment (MCI)

机译：轻度认知障碍科学状态（MCI）

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Mild cognitive impairment (MCI) represents a transitional stage between healthy aging and dementia, and affects 10–15% of the population over the age of 65. The failure of drug trials in Alzheimer’s disease (AD) treatment has shifted researchers’ focus toward delaying progression from MCI to dementia, which would reduce the prevalence and costs of dementia profoundly. Diagnostic criteria for MCI increasingly emphasize the need for positive biomarkers to detect preclinical AD. The phenomenology of MCI comprises lower quality-of-life, greater symptoms of depression, and avoidant coping strategies including withdrawal from social engagement. Neurobiological features of MCI are hypoperfusion and hypometabolism in temporoparietal cortices, medial temporal lobe atrophy particularly in rhinal cortices, elevated tau and phosphorylated tau and decreased Aβ42 in cerebrospinal fluid, and brain Aβ42 deposition. Elevated tau can be identified in MCI, particularly in the entorhinal cortex, using positron emission tomography, and analysis of signal complexity using electroencephalography or magnetoencephalography holds promise as a biomarker. Assessment of MCI also relies on cognitive screening and neuropsychological assessment, but there is an urgent need for standardized cognitive tests to capitalize on recent discoveries in cognitive neuroscience that may lead to more sensitive measures of MCI. Cholinesterase inhibitors are frequently prescribed for MCI, despite the lack of evidence for their efficacy. Exercise and diet interventions hold promise for increasing reserve in MCI, and group psychoeducational programs teaching practical memory strategies appear effective. More work is needed to better understand the phenomenology and neurobiology of MCI, and how best to assess it and delay progression to dementia.
机译：轻度认知障碍（MCI）代表健康老化和痴呆之间的过渡阶段，和65的药物试验的阿尔茨海默氏病的失败岁以上影响人口的10-15％（AD）的治疗已经转移的研究人员们对拖延焦点级数从MCI痴呆，这将减少老年痴呆症的发病率和成本深刻。 MCI的诊断标准日益强调需要积极的生物标志物检测的临床前AD。 MCI的现象包括低质量的生活，抑郁的症状更大，和回避的应对策略，包括从社会参与撤离。 MCI的神经生物学特征是在颞皮质血流灌注不足和代谢减退，内侧颞叶萎缩特别是在鼻腔皮质，升高的tau和磷酸化tau和脑脊液中减少Aβ42和Aβ42脑沉积。升高的tau在MCI被识别，特别是在内嗅皮质，使用正电子发射断层摄影术，以及信号使用脑电图或脑磁图复杂度分析有希望作为生物标志物。 MCI的评价也依赖于认知筛查和神经心理学评估，但有一个迫切需要标准化的认知测试在认知神经科学的最新发现可能导致MCI的更加敏感的措施把握。胆碱酯酶抑制剂经常处方MCI，尽管缺乏证据的效力。运动和饮食干预有希望在MCI增加储备，以及组教学实践记忆策略心理教育方案似乎有效。需要更多的工作，以更好地了解MCI的现象学和神经生物学，以及如何最好地并延缓进程评估痴呆。

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