Early diagnosis of Alzheimer's disease: is MCI too late?

The field of aging and dementia research is advancing rapidly toward the stage of earlier identification of clinical symptoms. Ultimately, clinicians would like to be able to identify individuals who are asymptomatic but at risk for developing dementia. In the interim, the construct of mild cognitive impairment (MCI) has come to represent an intermediate clinical state between the cognitive changes of aging and the very earliest features of Alzheimer's disease. A great deal of research has been generated in the past several years on MCI, and epidemiologic studies are characterizing its frequency in the general population. There are predictors of a more rapid progression from MCI to Alzheimer's disease, and these studies are suggesting techniques for altering future clinical trials. The neuropathology of MCI is intermediate between the neuropathologic changes of aging and fully developed Alzheimer's disease. The breadth of research in MCI is expanding and will be reviewed.