Mild Cognitive Impairment: the Manchester Consensus
dc.contributor.author | Dunne, RA | |
dc.contributor.author | Aarsland, D | |
dc.contributor.author | O'Brien, JT | |
dc.contributor.author | Ballard, C | |
dc.contributor.author | Bannerjee, S | |
dc.contributor.author | Fox, NC | |
dc.contributor.author | Isaacs, JD | |
dc.contributor.author | Underwood, BR | |
dc.contributor.author | Perry, RJ | |
dc.contributor.author | Chan, D | |
dc.contributor.author | Dening, T | |
dc.contributor.author | Thomas, AJ | |
dc.contributor.author | Schryer, J | |
dc.contributor.author | Jones, A-M | |
dc.contributor.author | Evans, AR | |
dc.contributor.author | Alessi, C | |
dc.contributor.author | Coulthard, EJ | |
dc.contributor.author | Pickett, J | |
dc.contributor.author | Elton, P | |
dc.contributor.author | Jones, RW | |
dc.contributor.author | Mitchell, S | |
dc.contributor.author | Graham, S | |
dc.contributor.author | Hooper, N | |
dc.contributor.author | Kalafatis, C | |
dc.contributor.author | Rasmussen, JGC | |
dc.contributor.author | Martin, H | |
dc.contributor.author | Schott, JM | |
dc.contributor.author | Burns, A | |
dc.date.accessioned | 2020-09-03T10:38:06Z | |
dc.date.issued | 2020-11-17 | |
dc.description.abstract | Given considerable variation in diagnostic and therapeutic practice, there is a need for national guidance on the use of neuroimaging, fluid biomarkers, cognitive testing, follow-up and diagnostic terminology in Mild Cognitive Impairment (MCI). MCI is a heterogenous clinical syndrome reflecting a change in cognitive function and deficits on neuropsychological testing but relatively intact activities of daily living. MCI is a risk state for further cognitive and functional decline with 5-15% of people developing dementia per year. However, ~50% remain stable at 5 years and in a minority, symptoms resolve over time. There is considerable debate about whether MCI is a useful clinical diagnosis, or whether use of the term prevents proper inquiry (by history, examination and investigations) into underlying causes of cognitive symptoms, which can include prodromal neurodegenerative disease, other physical or psychiatric illness, or combinations thereof. Cognitive testing, neuroimaging and fluid biomarkers can improve the sensitivity and specificity of aetiological diagnosis, with growing evidence that these may also help guide prognosis. Diagnostic criteria allow for a diagnosis of Alzheimer’s disease to be made where MCI is accompanied by appropriate biomarker changes; but in practice such biomarkers are not available in routine clinical practice in the UK. This would change if disease-modifying therapies became available and required a definitive diagnosis but would present major challenges to the NHS and similar health systems. Significantly increased investment would be required in training, infrastructure and provision of fluid biomarkers and neuroimaging. Statistical techniques combining markers may provide greater sensitivity and specificity than any single disease marker but their practical usefulness will depend on large-scale studies to ensure ecological validity, and that multiple measures, e.g. both cognitive tests and biomarkers, are widely available for clinical use. To perform such large studies, we must increase research participation amongst those with MCI. | en_GB |
dc.identifier.citation | Published online 17 November 2020 | en_GB |
dc.identifier.doi | 10.1093/ageing/afaa228 | |
dc.identifier.uri | http://hdl.handle.net/10871/122693 | |
dc.language.iso | en | en_GB |
dc.publisher | Oxford University Press (OUP) / British Geriatrics Society | en_GB |
dc.rights | © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com | |
dc.subject | Mild cognitive impairment | en_GB |
dc.subject | dementia | en_GB |
dc.subject | biomarkers | en_GB |
dc.subject | amyloid | en_GB |
dc.subject | tau | en_GB |
dc.subject | CSF | en_GB |
dc.subject | clinical trials | en_GB |
dc.subject | risk reduction | en_GB |
dc.subject | cerebrovascular | en_GB |
dc.subject | neurodegeneration | en_GB |
dc.subject | Alzheimer’s | en_GB |
dc.subject | Lewy body | en_GB |
dc.subject | neuropsychology | en_GB |
dc.subject | neuroimaging | en_GB |
dc.title | Mild Cognitive Impairment: the Manchester Consensus | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2020-09-03T10:38:06Z | |
dc.identifier.issn | 0002-0729 | |
dc.description | This is the final version. Available on open access from Oxford University Press via the DOI in this record | en_GB |
dc.identifier.journal | Age and Ageing | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | en_GB |
dcterms.dateAccepted | 2020-09-02 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2020-09-02 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2020-09-03T09:37:13Z | |
refterms.versionFCD | AM | |
refterms.dateFOA | 2020-11-20T16:10:16Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as © The Author(s) 2020. Published by Oxford University Press on behalf of the British Geriatrics Society.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com