See the 2,456 pharmacies on the National E-Pharmacy Platform
Mild cognitive impairment
1. Click to Add Title
Click to Add Subtitle
Mild Cognitive
Impairment Spectrum
Monica K. Crane, MD
Director of Clinical Research
Associate Director, Cole Neuroscience Center
Clinical Assistant Professor of Medicine
Dept. of Medicine
11. Who has MCI?
Dickerson. Advances in quantitative magnetic resonance imaging-based biomarkers for Alzheimer disease. Alzheimer's Research & Therapy 2010; 2:21
Meyer et al. Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People. Arch Neurol 2010;67:949-956.
10-20% of those aged 65+ older may
have MCI.
13. • Clinically “normal” range but may
have patterns or positive biomarker
for AD.
• Treated as “worried well” depressed,
anxious, etc.
Dickerson. Advances in quantitative magnetic resonance imaging-based biomarkers for Alzheimer disease. Alzheimer's Research & Therapy 2010; 2:21
Meyer et al. Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People. Arch Neurol 2010;67:949-956.
What is preclinical or pre-MCI?
15. Dickerson. Advances in quantitative magnetic resonance imaging-based biomarkers for Alzheimer disease. Alzheimer's Research & Therapy 2010; 2:21
Meyer et al. Diagnosis-Independent Alzheimer Disease Biomarker Signature in Cognitively Normal Elderly People. Arch Neurol 2010;67:949-956.
21. Biomarkers for MCI due to AD
• Anatomy
• Functional or
metabolic change
(downstream)
• Pathology
– CSF Aβ-42
– CSF tau / phospho-
tau
– PET amyloid imaging
– Tau imaging
Additional IMAGING American Academy of Neurology guidelines. Arora A, Bhagat N.
Insight into the Molecular Imaging of Alzheimer's Disease. Int J Biomed Imaging. 2016
22. Foster DJ, Wilson MA. Nature 2006;440:680-683.
Foster DJ, Knierim JJ. Curr Opinion Neurobiol 2012;22:294-300.
Biomarker: Hippocampus
• Working memory
• Planning and
imagination
• Must be intact to
imagine the
“what ifs”…
31. • Lack of exercise
• Midlife obesity
• Low education
• Smoking
• Hypertension
• Diabetes
• Depression
• New risk factors
7+ risk factors for Alzheimer’s
that you can modify
1/3 of
current AD
cases are
from these
7 factors
PAR, population attributable risk. Courtesy of Lancet Neurol. 2011 Sep; 10(9): 819–828.
33. • Lack of exercise
• Midlife obesity
• Low education
• Smoking
• Hypertension
• Diabetes
• Depression
• New risk factors
7+ risk factors for Alzheimer’s
that you can modify
1/3 of
current AD
cases are
from these
7 factors
PAR, population attributable risk. Courtesy of Lancet Neurol. 2011 Sep; 10(9): 819–828.
35. Mediterranean diet
• Nuts, complex grains, olive oil
• Fruits and vegetables
• Coffee and Tea
• Omega-3 fats.
– Salmon, tuna, trout, sardines, seafoods.
• Avoid refined sugars, red meat and processed
foods
– Sugary desserts, baked goods
– Red meat, fast food, “diet” food
www.rand.org Meta-analysis 1.5 million people, 35 studies: Mediterranean diet
decreased risk of dementia death by 13%
36. • Lack of exercise
• Midlife obesity
• Low education
• Smoking
• Hypertension
• Diabetes
• Depression
• New risk factors
7+ risk factors for Alzheimer’s
that you can modify
1/3 of
current AD
cases are
from these
7 factors
PAR, population attributable risk. Courtesy of Lancet Neurol. 2011 Sep; 10(9): 819–828.