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Issue: Issue 3 (2016) – Supplement 1


Debate

Mild cognitive impairment in Parkinson's disease

Author(s):
Amos D. Korczyn
Abstract:
Point of view: No
The mild cognitive impairment (MCI) concept was developed to identify the earliest stages of cognitive impairment. MCI and, more specifically, amnestic MCI were initially proposed as pathological transitional states that ultimately progress to full blown AD. However, it has been found that MCI subjects do not uniformly progress to dementia (either AD or another) and may revert back to normal cognitive state. The MCI is concept has been borrowed to other neurodegenerative diseases, particularly Parkinson's disease (PD). However the operational definition of MCI may not adequately convey the intended concept. Additional modifications to the concept and its operationalization are needed in order to better identify patients with incipient cognitive impairment and to guide clinical and research practices. Patients with PD have a very high likelihood of developing dementia, which develops insidiously. Cognitive impairment may start even before other symptoms, although this is not in accordance with Braak's sequence. There is no available data to support the concept that a certain constellation of cognitive symptoms in an otherwise healthy individual will herald development of PD or indeed will progress to dementia. Therefore, at present, identification of subtle cognitive dysfunction even in a person with diagnosed PD does not benefit the patient and should be avoided, except for research purposes.

Special Issue on Controversies in Neurology. From the 10th World Congress on Controversies in Neurology (CONy), Lisbon, Portugal. 17–20 March 2016.

International Journal of Clinical Neurosciences and Mental Health 2016; 3(Suppl. 1):D36
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