MCI

Question 1

Rate of dementia in elderly? MCI?

Answer 1

8%, 16%

Question 2

rate of progression from MCI to dementia

Answer 2

10% per yr= 50% in 5 rs

higher risk if also has depression

Question 3

Best tests, and their metrics?

Answer 3

Not sure of this
MOCA: sens 90%, spec: 80%
MMSE: sens 80%, spec 90%
Dem Tect: sens: 80%, spec: 90%

Question 4

What to NOT do in MCI?

Answer 4

do not: 
say early dementia
treat with CEI
give vit E
give ginko
give estrogen
give NSAIDS

Question 5

What to DO in MCI?

Answer 5

close FU
refer to neuropsych testing if need confirmation (fair evidence)
control systolic BP <140
control other vascular RF
take meds for those RF
advise to do cognitive, physical and leisure activities as general recommendation to be healthy

Question 6

investigational markers (labs) to predict MCI progression

Answer 6

beta amyloid in CSF
tau protein in CSF
APOE gene
homocysteine
high LDL or LDL: HDL ration
interleukin
olfactory dysfunction
heme oxygenase-1

Question 7

investigational markers (imaging) to predict MCI progression

Answer 7

hippocampal volume
hippocampal volume loss
PET or SPECT to show focal decrease function
PET amyloid scan