Fast Five Quiz: Memory Loss and Cognitive Impairment

Helmi L. Lutsep, MD


April 28, 2021

According to AAN guidelines, no biomarkers have been clearly proven to predict progression in patients with MCI. Clinicians should counsel patients as such. They may discuss the possibility of biomarker research or refer patients to centers or organizations that can connect patients to this research.

The AAN states that when screening or assessing for MCI, validated assessment tools should be used. They recommend that because brief cognitive assessment instruments are usually calibrated to maximize sensitivity rather than specificity, patients who test positive for MCI should then have further assessment to formally assess for this diagnosis. Diagnosis of MCI is ultimately based on a clinical evaluation that determines cognitive function and functional status and not solely on a specific test score.

The AAN states that at this time, no US Food and Drug Administration–approved medications are specifically indicated for the treatment of MCI. Moreover, no high-quality, long-term studies have identified pharmacologic or dietary agents that either improve cognitive symptoms or delay progression in patients with MCI.

The AAN guidelines explain that cholinesterase inhibitors have not shown clear benefit in terms of cognitive outcomes or reduction in progression from MCI to dementia. In addition, adverse effects of cholinesterase inhibitors are common. As such, clinicians may choose not to offer cholinesterase inhibitors. If they are offered, clinicians must first discuss with patients the fact that this is an off-label prescription not currently backed by empirical evidence.

Read more about the treatment of MCI.


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