About MCI – Dementia

The progressive increase in the human lifespan, the rising costs of global healthcare services and the rising number of elderly citizens in the developed countries are turning care and assistance of the elderly into a cost-sensitive topic with a rising importance. A relevant condition for the elderly is mild to moderate Cognitive Impairment, today affecting more than 30 million people worldwide, with an expected growth of up to 100% every 20 years. 

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Cognitive Impairment reduces people’s ability to take care of themselves, and increases risks of social isolation and deterioration, translating into risks of falling, malnutrition, bad hygiene, depression and, in the worst case, mortality.

The challenge is now to spread feasible and sustainable innovation across National Healthcare Systems, enabling independent living solutions for Cognitive Impairment-affected people in their homes and sustainable ways for delivering integrated care and social care services.

As described by many researchers and stated in the “Remember Me” paper, by Eibhlín Ní Ógáin and Katie Mountain and edited by Nesta, dementia is one of the single greatest challenges that our society will face in the next fifty years, and a lot of effort and funding is rightly directed towards both finding a cure and drug treatment that can offset the effects of illness. Great focus has been given to the early identification of Cognitive Impairment symptoms, so as to lower the speed of patients’ decay and reduce the costs necessary for dementia and Cognitive Impairment treatment.

Mild Cognitive Impairment (MCI) is the intermediate stage from normal cognitive function to dementia. This concept is important because people with MCI have a high rate of progression to dementia over a relatively short period. [1]

In 2015, a review about prevalence of Mild Cognitive Impairment (MCI) in different geographical regions was made [2]. The published range of MCI prevalence estimates was 5.0%–36.7%. This was reduced with all cognitive impairment definitions: performance in the bottom 6.681% (3.2%–10.8%); Clinical Dementia Rating of 0.5 (1.8%–14.9%); Mini-Mental State Examination score of 24–27 (2.1%–20.7%). Prevalence using the first definition were 5.9% overall, and increased with age (P < .001) but were unaffected by sex or the main races/ethnicities investigated (Whites and Chinese). Not completing high school increased the likelihood of MCI (P 0 .01).

Alzheimer’s disease (AD) is the most common type of dementia. As the elderly population grows worldwide, the number of patients with AD also increases rapidly.
In a recent review [3], in 2015, about prevalence and incidence of Alzheimer’s disease the results were that the prevalence of Alzheimer’s disease in Europe was estimated at 5.05% (95% CI, 4.73-5.39). The prevalence in men was 3.31% (95% CI, 2.85-3.80) and in women, 7.13% (95% CI, 6.56-7.72), and increased with age.
The incidence of Alzheimer’s disease in Europe was 11.08 per 1000 person-years (95% CI, 10.30-11.89). Broken down by sex, it was 7.02 per 1000 person-years (95% CI, 6.06-8.05) in men and 13.25 per 1000 person-years (95% CI, 12.05-14.51) in women; again these rates increased with age.

 

AGE-RELATED COGNITIVE DECLINE
Age-Related Cognitive Decline (ARCD) is a label for the general modification of cognition which results from ageing. Physiological ageing is not responsible for causing cognitive disorders as such, but it’s associated to a general cognitive modification with respect to young age.
For the DECI project the DSM – IV ARCD definition will be used [4]: This category can be used when the focus of clinical attention is an objectively identified decline in cognitive functioning consequent to the aging process that is within normal limits given the person’s age. Individuals with this condition may report problems remembering names or appointments or may experience difficulty in solving complex problems. This category should be considered only after it has been determined that the cognitive impairment is not attributable to a specific mental disorder or neurological condition.

 

BIBLIOGRAPHY:
[1] Bischkopf J, Busse A, Mc A. Mild cognitive impairment 1 – a review of prevalence , incidence and outcome according to current approaches. 2002;403–14.
[2] Sachdev PS, Lipnicki DM, Kochan NA, Crawford JD, Thalamuthu A, Andrews G, et al. The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration. 2015;1–19.
[3] Niu H. ARTICLE IN PRESS. Neurología [Internet]. SEGO; 2016; Available from: http://dx.doi.org/10.1016/j.nrl.2016.02.016
[4] American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition Text Revision (DSM-IV-TR). American Psychiatry Association, Washington DC.