Neurológia pre prax 6/2010

The concept of mild cognitive impairment in Alzheimer’s disease and Parkinson’s disease

Cognitive impairment exists in Parkinson’s disease (PD) as a transitional state between cognitively intact and demented PD patients. It seems to be a risk factor for development of dementia in PD, but the precise criteria and “malignant” cognitive profile of mild cognitive impairment in PD (MCI in PD) have not yet been established. The concept may turn to be different from that in Alzheimer’s disease (AD) since we search for those already diagnosed PD patients who are at risk of developing dementia. In addition, clinical variables specific for PD also play role. Importantly, MCI possesses a metabolic basis in PD. Various biomarkers including particularly neuropsychological testing, brain imaging, and analysis of specific proteins in cerebrospinal fluid hold promise in identification of MCI in PD patients with unfavourable prognoses. Well-designed longitudinal studies in MCI-PD cohorts are needed to assess the sensitivity and specificity of the PD-MCI designation as far as dementia development is concerned.

Keywords: mild cognitive impairment, dementia, Alzheimer’s disease, Parkinson’s disease, executive functions, memory, biomarkers.