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Review of Mild Cognitive Impairment

James M. Ellison, MD, MPH, Discussant

JAMA. 2008;300(13):1566-1574.

Many older individuals experience or demonstrate cognitive impairment that is significantly abnormal for their age and education yet beneath the threshold for a diagnosis of dementia. This mild cognitive impairment causes minimal functional impairment and is often overlooked in clinical settings, yet affected individuals are at heightened risk for a range of adverse outcomes including conversion to dementia. The case of Ms E, a 60-year-old woman with mild memory impairment and white matter lesions on magnetic resonance imaging, provides an opportunity to consider the questions that face patient, family, and clinicians when mild cognitive symptoms prompt a search for diagnosis and management options. Discussion of her case reviews mild cognitive impairment with emphasis on an evidence-based approach to evaluation and treatment, including management of comorbid medical conditions, lifestyle changes, and pharmacotherapy.

Author Affiliations: Dr Ellison is Associate Professor of Psychiatry, Harvard Medical School; Clinical Director, Geriatric Psychiatry Program, and Director, Memory Diagnostic Clinic, McLean Hospital, Belmont, Massachusetts.

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