Mild cognitive impairment and prevention

Professor Dennis Selkoe discusses mild cognitive impaitment, a precursor to Alzheimer's disease. Early identification may be critical to treatment.

In Alzheimer’s disease it’s not a simple, single syndrome; you just have Alzheimer’s [disease] or you don’t have it. There are gradations, and the fact is that long before one has Alzheimer’s [disease] such as I would diagnose in my patients in my clinic in Boston, one would have very mild impairment of memory. We refer to that now with the term MCI; not the company MCI but Mild Cognitive Impairment. That is a harbinger of Alzheimer’s [disease]; it’s not Alzheimer’s [disease] yet. And now we begin to think in the last couple of years of pre-MCI, something that happens even before MCI, and the concept is that when do you start getting worried about a trajectory towards Alzheimer’s [disease]? Is it when you once forget where you parked your car in the parking lot and you can’t quite find it at the airport? No, that wouldn’t be enough to say ‘uh oh, you may have pre-MCI or MCI’. But if you do that kind of thing repetitively over the course of months or a year or so, and three or four times during the year your wife has had to rescue you when you’ve not remembered where you’ve parked your car at the airport, then of course it’s time to see a specialist and see if that’s the case. If you forget important things in your life; the names of a child or a brother or a sister or a grandchild, and you do that repetitively, assuming you have less than a dozen grandchildren, then maybe that’s a problem and you should see someone. The whole thing is incredibly subtle, and Alzheimer’s [disease] I’m afraid for better or worse develops over the course of decades, not even years or months. We believe that the process starts maybe 10, 15 or even 20 years before a doctor can diagnose you as having unequivocal Alzheimer’s [disease]. Now that sounds frightening, but it’s also an opportunity. The whole Alzheimer’s [disease] field is going towards prevention. We’d like to treat people, lets say the children of an Alzheimer’s [disease] patient, when they’re in their 50’s and 60’s working and doing quite well, and not forgetting where they parked their car or only once a year or two which is allowed. So, that’s where the entire field of neurodegeneration is going – identify the process really early, and that’s why we use terms like MCI or Mild Cognitive Impairment, that’s when we like to treat.

mild cognitive impairment, mci, alzheimer, memory, prevention, treatment, dennis, selkoe

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