Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
- PMID: 29282327
- PMCID: PMC5772157
- DOI: 10.1212/WNL.0000000000004826
Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
Abstract
Objective: To update the 2001 American Academy of Neurology (AAN) guideline on mild cognitive impairment (MCI).
Methods: The guideline panel systematically reviewed MCI prevalence, prognosis, and treatment articles according to AAN evidence classification criteria, and based recommendations on evidence and modified Delphi consensus.
Results: MCI prevalence was 6.7% for ages 60-64, 8.4% for 65-69, 10.1% for 70-74, 14.8% for 75-79, and 25.2% for 80-84. Cumulative dementia incidence was 14.9% in individuals with MCI older than age 65 years followed for 2 years. No high-quality evidence exists to support pharmacologic treatments for MCI. In patients with MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may improve cognitive measures.
Major recommendations: Clinicians should assess for MCI with validated tools in appropriate scenarios (Level B). Clinicians should evaluate patients with MCI for modifiable risk factors, assess for functional impairment, and assess for and treat behavioral/neuropsychiatric symptoms (Level B). Clinicians should monitor cognitive status of patients with MCI over time (Level B). Cognitively impairing medications should be discontinued where possible and behavioral symptoms treated (Level B). Clinicians may choose not to offer cholinesterase inhibitors (Level B); if offering, they must first discuss lack of evidence (Level A). Clinicians should recommend regular exercise (Level B). Clinicians may recommend cognitive training (Level C). Clinicians should discuss diagnosis, prognosis, long-term planning, and the lack of effective medicine options (Level B), and may discuss biomarker research with patients with MCI and families (Level C).
Copyright © 2017 American Academy of Neurology.
Comment in
-
Guideline: In patients with mild cognitive impairment, the AAN recommends regular exercise and no drugs or supplements.Ann Intern Med. 2018 Apr 17;168(8):JC38. doi: 10.7326/ACPJC-2018-168-8-038. Ann Intern Med. 2018. PMID: 29677245 No abstract available.
-
Reader response: Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2018 Aug 21;91(8):371-372. doi: 10.1212/WNL.0000000000006041. Neurology. 2018. PMID: 30126882 No abstract available.
-
Reader response: Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2018 Aug 21;91(8):372. doi: 10.1212/WNL.0000000000006039. Neurology. 2018. PMID: 30126883 No abstract available.
-
Reader response: Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2018 Aug 21;91(8):373. doi: 10.1212/WNL.0000000000006038. Neurology. 2018. PMID: 30126884 No abstract available.
-
Author response: Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2018 Aug 21;91(8):373-374. doi: 10.1212/WNL.0000000000006042. Neurology. 2018. PMID: 30126885 No abstract available.
Similar articles
-
Practice Guideline Update Recommendations Summary: Disorders of Consciousness: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research.Arch Phys Med Rehabil. 2018 Sep;99(9):1699-1709. doi: 10.1016/j.apmr.2018.07.001. Epub 2018 Aug 8. Arch Phys Med Rehabil. 2018. PMID: 30098791
-
Screening for Cognitive Impairment in Older Adults: An Evidence Update for the U.S. Preventive Services Task Force [Internet].Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Nov. Report No.: 14-05198-EF-1. PMID: 24354019 Free Books & Documents. Review.
-
Practice guideline update summary: Vaccine-preventable infections and immunization in multiple sclerosis: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.Neurology. 2019 Sep 24;93(13):584-594. doi: 10.1212/WNL.0000000000008157. Epub 2019 Aug 28. Neurology. 2019. PMID: 31462584
-
The diagnosis and management of mild cognitive impairment: a clinical review.JAMA. 2014 Dec 17;312(23):2551-61. doi: 10.1001/jama.2014.13806. JAMA. 2014. PMID: 25514304 Free PMC article. Review.
-
Practice guideline update recommendations summary: Disorders of consciousness: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology; the American Congress of Rehabilitation Medicine; and the National Institute on Disability, Independent Living, and Rehabilitation Research.Neurology. 2018 Sep 4;91(10):450-460. doi: 10.1212/WNL.0000000000005926. Epub 2018 Aug 8. Neurology. 2018. PMID: 30089618 Free PMC article. Review.
Cited by
-
Monoclonal anti-amyloid antibody treatment: the epidemiological profile of the target patients in Austria and the status of treatment-eligible patients registered at an outpatient memory clinic.Wien Klin Wochenschr. 2024 Oct 23. doi: 10.1007/s00508-024-02465-8. Online ahead of print. Wien Klin Wochenschr. 2024. PMID: 39441361
-
Association of trimethylamine oxide and its precursors with cognitive impairment: a systematic review and meta-analysis.Front Aging Neurosci. 2024 Oct 4;16:1465457. doi: 10.3389/fnagi.2024.1465457. eCollection 2024. Front Aging Neurosci. 2024. PMID: 39430973 Free PMC article.
-
Development of a digital multidomain lifestyle intervention for mild cognitive impairment: A pilot study on the feasibility and efficacy of cognitive training.Digit Health. 2024 Oct 10;10:20552076241284810. doi: 10.1177/20552076241284810. eCollection 2024 Jan-Dec. Digit Health. 2024. PMID: 39430697 Free PMC article.
-
Transcutaneous Electrical Acupoint Stimulation for Elders with Amnestic Mild Cognitive Impairment: A Randomized Controlled Pilot and Feasibility Trial.Healthcare (Basel). 2024 Sep 28;12(19):1945. doi: 10.3390/healthcare12191945. Healthcare (Basel). 2024. PMID: 39408125 Free PMC article.
-
Individualised computerised cognitive training (iCCT) for community-dwelling people with mild cognitive impairment (MCI): results on cognition in the 6-month intervention period of a randomised controlled trial (MCI-CCT study).BMC Med. 2024 Oct 15;22(1):472. doi: 10.1186/s12916-024-03647-x. BMC Med. 2024. PMID: 39407328 Free PMC article. Clinical Trial.
References
-
- Winblad B, Palmer K, Kivipelto M, et al. . Mild cognitive impairment: beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. J Intern Med 2004;256:240–246. - PubMed
-
- Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med 2004;256:183–194. - PubMed
-
- Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol 1999;56:303–308. - PubMed
-
- Petersen RC, Stevens JC, Ganguli M, Tangalos EG, Cummings JL, DeKosky ST. Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology 2001;56:1133–1142. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources