How is mild cognitive impairment (MCI) diagnosed?

Updated: Apr 22, 2019
  • Author: Sonal Mehta, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Answer

Answer

No specific diagnostic studies exist for mild cognitive impairment. However, most clinicians perform a basic workup at minimum to exclude potential treatable causes (eg, thyroid disease, cobalamin deficiency). Research is ongoing in the search for biologic markers that may help differentiate between the large number of conditions that may progress from MCI to full dementia.

Brain imaging with magnetic resonance imaging (MRI) or computed tomography (CT) is often performed in patients with MCI. In general, MRI is preferred, as whole brain and hippocampal volume on MRI can predict progression from MCI to Alzheimer disease (AD). [2] However, there are no established parameters to integrate this finding into the routine diagnosis and management of MCI. In addition, there is also some preliminary evidence for the use of baseline FDG-PET of the brain in conjunction with episodic memory assessment to predict conversion to AD. [3]

There are no stipulated neuropsychological tests for patients with MCI, nor are there predetermined cutoff points (eg, 1.0, 1.5, or 2 standard deviations below the mean). However, clinicians use the results from standardized memory and cognitive tests to determine whether these data represent significant changes from a patient’s presumed baseline. In general, serial testing is required to establish whether the patient’s cognitive function is improving, staying stable, or progressing to full-blown clinical dementia.


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