Quality improvement in neurology

Mild cognitive impairment (MCI) is a syndrome increasingly recognized in older adults and has become a major focus of clinical care and research. MCI is used to describe acquired objective cognitive deficits that are insufficiently severe to affect most usual daily activities. A report of cognitive difficulty or change is insufficient to recognize MCI; objective measures documenting deficits are required. Maintenance of daily function distinguishes MCI from the dementia syndrome, yet it is particularly important because of its high risk for subsequent development of progressive dementia, particularly Alzheimer disease (AD) dementia. Patients with MCI may or may not recognize their impairments; consequently, concerns raised by friends or family and periodic cognitive health screening may be required to identify its presence. The syndrome can be further delineated as impairing a single or multiple cognitive domains and is often classified as either amnestic or nonamnestic.1 Amnestic MCI in particular often represents a prodromal form of AD dementia, although it is important to acknowledge that reversion to cognitive normalcy also occurs with some frequency.2