Detection and Prevention of Mild Cognitive Impairment and Dementia

Dear Colleagues,

Mild cognitive impairment (MCI) is characterized by cognitive deficits but essentially preserved competence in activities of daily living. It is a risk factor for the development of dementia and can reflect a prodromal predementia state of Alzheimer's disease (AD), vascular dementia (VD), Parkinson’s disease dementia (PDD), and other degenerative dementias. Early symptoms of MCI and dementia may not be apparent in routine clinical examinations and are sometimes even concealed during short office visits initiated for other complaints. Although current methods of detecting moderate dementia in community-based clinical practices are reasonably accurate, they do not sensitively detect MCI and often do not detect mild dementia. The difficulty of detecting MCI and, in many cases, mild dementia is largely due to the insensitivity of the most commonly used screening tests in clinical practice, e.g., the Mini Mental Status Examination (MMSE). This insensitivity is due to a person with MCI or very mild dementia experiencing subtle memory problems only slightly greater than those normally expected with aging without showing any other symptoms of dementia such as impaired judgment or reasoning. Given that early detection is critical for treatment, effective methods of screening for MCI and dementia are a high research priority and more sensitive screening tests or brief neuropsychological batteries that can be practically applied in community healthcare settings are therefore needed. Furthermore, due to advances in the field of biomarker-based early detection of MCI and dementia, it is now possible to differentiate between MCI patients with and without an underlying pathological condition and therefore between patients with a low and those with a high risk of the development of dementia. However, at present specific guideline recommendations in many European and other countries for the diagnostic use of biomarkers in predementia detection are limited and unspecific. As the population ages, there is a growing need for early, proactive programs that can delay the consequences of dementia and improve the quality of life of people with MCI and their caregivers. Various intervention approaches for older people with MCI have been suggested to delay cognitive deterioration. Pharmacological as well as non-pharmacological approaches (cognitive stimulation—rehabilitation, nutritional supplementation, physical exercise, electric/magnetic stimulation) and multicomponent interventions have been proposed.

This Special Issue of Healthcare, aims to address various issues related to the detection and prevention of mild cognitive impairment and dementia in community-dwelling older adults and primary care patients. Therefore, we kindly invite you to submit manuscripts (original research, empirical, clinical, basic research, and review papers or meta-analyses) that address any of the issues mentioned previously or the following questions:

(1) Which screening instruments or brief neuropsychological batteries best detect dementia or mild cognitive impairment (MCI) in community-dwelling older primary care patients?

(2) Does the combined use of screening tests, brief neuropsychological batteries, and diagnostic biomarkers improve the accuracy of detecting MCI and mild dementia in outpatient and other clinical settings compared with test use alone?

(3) Do early interventions for cognitive impairment in community-dwelling older adults improve decision making and patient/family/caregiver outcomes?

Dr. Lambros Messinis
Dr. Grigorios Nasios
Dr. Panagiotis Ioannidis
Dr. Panayiots Patrikelis
Guest Editors

Manuscript Submission Information

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