中国科学院心理研究所机构知识库

Mild cognitive impairment （MCI）, as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer＇s Disease Consortium （EADC） may better reflect the heterogeneity of MCI syndrome. Beiling United Study Group on MCI funded by the Capital Foundation of Medical Developments （CFMD） proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to： （1） cognitive complaints coming from the patients or their families; （2） reporting of a relative decline in cognitive functioning during the past year by the patient or informant; （3） cognitive disorders evidenced by clinical evaluation; （4） activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and （5） absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI （aMCI）, single non-memory MCI （snmMCI） and multiple-domainsMCI （mdMCI）. Finally, the subtype causes could be identified commonly as Alzheimer disease （AD）, vascular dementia （VaD）, and other degenerative diseases such as frontaltemporal dementia （FTD）, Lewy body disease （LBD）, semantic dementia （SM）, as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin Bβ2 and folic acid, plasma insulin, insulin-degrading enzyme, Aβ40, Aβ42, inflammatory factors. Computed tomography （or preferentially magnetic resonance imaging, when available） is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE ε4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.

首都医学发展基金联合攻关项目(No2005-SF-1-007) 国家自然科学基金资助项目(No30672693) 北京市自然科学基金重大项目(No7071005) 高等学校创新引智计划(NoB08006) 华北制药集团制剂有限公司资助项目 国家973项目(No2003CB517104)