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dc.contributor.authorDunne, RAen
dc.contributor.authorAarsland, Den
dc.contributor.authorO’Brien, JTen
dc.contributor.authorBallard, Cen
dc.contributor.authorBanerjee, Sen
dc.contributor.authorFox, NCen
dc.contributor.authorIsaacs, JDen
dc.contributor.authorUnderwood, BRen
dc.contributor.authorPerry, RJen
dc.contributor.authorChan, Den
dc.contributor.authorDening, Ten
dc.contributor.authorThomas, AJen
dc.contributor.authorSchryer, Jen
dc.contributor.authorJones, A-Men
dc.contributor.authorEvans, ARen
dc.contributor.authorAlessi, Cen
dc.contributor.authorCoulthard, EJen
dc.contributor.authorPickett, Jen
dc.contributor.authorElton, Pen
dc.contributor.authorJones, RWen
dc.contributor.authorMitchell, Sen
dc.contributor.authorHooper, Nen
dc.contributor.authorKalafatis, Cen
dc.contributor.authorRasmussen, JGCen
dc.contributor.authorMartin, Hen
dc.contributor.authorSchott, JMen
dc.contributor.authorBurns, Aen

Given considerable variation in diagnostic and therapeutic practice, there is a need for national guidance on the use of neuroimaging, fluid biomarkers, cognitive testing, follow-up and diagnostic terminology in mild cognitive impairment (MCI). MCI is a heterogenous clinical syndrome reflecting a change in cognitive function and deficits on neuropsychological testing but relatively intact activities of daily living. MCI is a risk state for further cognitive and functional decline with 5–15% of people developing dementia per year. However, ~50% remain stable at 5 years and in a minority, symptoms resolve over time. There is considerable debate about whether MCI is a useful clinical diagnosis, or whether the use of the term prevents proper inquiry (by history, examination and investigations) into underlying causes of cognitive symptoms, which can include prodromal neurodegenerative disease, other physical or psychiatric illness, or combinations thereof. Cognitive testing, neuroimaging and fluid biomarkers can improve the sensitivity and specificity of aetiological diagnosis, with growing evidence that these may also help guide prognosis. Diagnostic criteria allow for a diagnosis of Alzheimer’s disease to be made where MCI is accompanied by appropriate biomarker changes, but in practice, such biomarkers are not available in routine clinical practice in the UK. This would change if disease-modifying therapies became available and required a definitive diagnosis but would present major challenges to the National Health Service and similar health systems. Significantly increased investment would be required in training, infrastructure and provision of fluid biomarkers and neuroimaging. Statistical techniques combining markers may provide greater sensitivity and specificity than any single disease marker but their practical usefulness will depend on large-scale studies to ensure ecological validity and that multiple measures, e.g. both cognitive tests and biomarkers, are widely available for clinical use. To perform such large studies, we must increase research participation amongst those with MCI.

dc.format.extent72 - 80en
dc.publisherBritish Geriatrics Societyen
dc.titleMild Cognitive Impairment: the Manchester consensusen
dc.typeJournal Article
plymouth.journalAge and Ageingen
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School/PMS - Manual
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.rights.embargoperiodNot knownen
rioxxterms.typeJournal Article/Reviewen

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