In this discussion, the status of mild cognitive impairment (MCI) will be addressed from several perspectives. While some investigators maintain that MCI or its equivalent states actually represent fully developed Alzheimer’s disease (AD), others suggest that there must be an intermediate stage between the cognitive changes of aging and the very earliest manifestations of AD. Since AD is a degenerative disorder, by definition, it likely evolves over a period of months to years, or perhaps even longer. As such, there must be a prodromal state during which some of the clinical features of the disease are manifested but the fully developed syndrome is not present. Even if these mild features turn out to be related to neuritic plaques and neurofibrillary tangles, by current definitions, these persons do not yet meet accepted criteria for AD. We will address this topic from several different perspectives: clinical, neuroimaging, biomarkers, and neuropathology. We contend that this transitional state exists and the several lines of evidence demonstrated in the literature are consistent with this position.
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Petersen et al. (2005) studied this question.