Need for an Update for the Guideline for the Management of Mild Cognitive Impairment
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Attention is being paid to diagnosis and treatment of mild cognitive impairment (MCI) because early diagnosis and preventive management can slow down the progression of Alzheimer’s disease. In particular, in the present era, the use of biomarkers for predicting conversion into dementia is permitted in medical practice. Therefore, authors aimed to propose additional considerations when updating guidelines for the management of MCI, including predictable biomarkers, revising treatment option after additional clinical trials for cholinesterase inhibitors, and detailed regimes for lifestyle interventions. After reviewing 3 patients with MCI by detailed evaluation, we realized that cholinesterase inhibitors were not recommended. In addition, regular exercise and cognitive training were only possible recommendations for patients according to current guidelines, although all 3 patients had evidence of β-amyloid accumulation and related neurodegeneration. Furthermore, caregivers for all 3 patients were worried whether patients could keep doing regular exercise and cognitive training by themselves and asked about the economic training system which monitors patients so that they can keep training. Therefore, we propose that guidelines for managing MCI need to be updated in the present era when the use of biomarkers for predicting conversion into dementia is permitted in medical practice.
Abstract
Attention is being paid to diagnosis and treatment of mild cognitive impairment (MCI) because early diagnosis and preventive management can slow down the progression of Alzheimer’s disease. In particular, in the present era, the use of biomarkers for predicting conversion into dementia is permitted in medical practice. Therefore, authors aimed to propose additional considerations when updating guidelines for the management of MCI, including predictable biomarkers, revising treatment option after additional clinical trials for cholinesterase inhibitors, and detailed regimes for lifestyle interventions. After reviewing 3 patients with MCI by detailed evaluation, we realized that cholinesterase inhibitors were not recommended. In addition, regular exercise and cognitive training were only possible recommendations for patients according to current guidelines, although all 3 patients had evidence of β-amyloid accumulation and related neurodegeneration. Furthermore, caregivers for all 3 patients were worried whether patients could keep doing regular exercise and cognitive training by themselves and asked about the economic training system which monitors patients so that they can keep training. Therefore, we propose that guidelines for managing MCI need to be updated in the present era when the use of biomarkers for predicting conversion into dementia is permitted in medical practice.
참고문헌 (29)
- Jack CR Jr, "NIA-AA Research Framework : toward a biological definition of Alzheimer’s disease", Alzheimers Dement, 14, pp.535~562 (2018)
- Jack CR Jr, "Hypothetical model of dynamic biomarkers of the Alzheimer’s pathological cascade", Lancet Neurol, 9, pp.119~128 (2010)
- Matthews FE, "A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England : results of the Cognitive Function and Ageing Study I and II", Lancet, 382, pp.1405~1412 (2013)
- Wu YT, "Dementia in western Europe : epidemiological evidence and implications for policy making", Lancet Neurol, 15, pp.116~124 (2016)
- Petersen RC, "Practice guideline update summary : mild cognitive impairment : report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology", Neurology, 90, pp.126~135 (2018)
- Winblad B, "Mild cognitive impairment--beyond controversies, towards a consensus : report of the International Working Group on Mild Cognitive Impairment", J Intern Med, 256, pp.240~246 (2004)
- Albert MS, "The diagnosis of mild cognitive impairment due to Alzheimer’s disease : recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.270~279 (2011)
- Jack CR Jr, "Introduction to the recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease", Alzheimers Dement, 7, pp.257~262 (2011)
- Petersen RC, "Practice guideline update summary : mild cognitive impairment : report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology", Neurology, 90, pp.126~135 (2018)
- 이진산, "Clinical Practice Guideline for Dementia (Diagnosis and Evaluation): 2021 Revised Edition", Dementia and Neurocognitive Disorders(대한치매학회지), 21(1), pp.42~44 (2022), 대한치매학회[DOI]
- Scheltens P, "Atrophy of medial temporal lobes on MRI in"probable"Alzheimer’s disease and normal ageing : diagnostic value and neuropsychological correlates", J Neurol Neurosurg Psychiatry, 55, pp.967~972 (1992)
- Fazekas F, "MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging", AJR Am J Roentgenol, 149, pp.351~356 (1987)
- 박선아, "Promising Blood Biomarkers for Clinical Use in Alzheimer’s Disease: A Focused Update", Journal of Clinical Neurology, 18(4), pp.401~409 (2022), 대한신경과학회
- 강수진, "한국판 Instrumental Activities of Dalily Living의 타당도와 신뢰도", 대한신경과학회지, 20(1), pp.8~14 (2002), 대한신경과학회
- Kasper S, "Management of mild cognitive impairment(MCI) : the need for national and international guidelines", World J Biol Psychiatry, 21, pp.579~594 (2020)
- Galluzzi S, "Supporting evidence for using biomarkers in the diagnosis of MCI due to AD", J Neurol, 260, pp.640~650 (2013)
- Sano M, "ICAD 2010: Detection may hold the key to treatment. International Conference on Alzheimer Disease (ICAD) 2010 Honolulu, HI, USA, 10–15 July 2010", Expert Rev Neurother, 10, pp.1659~1661 (2010)
- Petersen RC, "Vitamin E and donepezil for the treatment of mild cognitive impairment", N Engl J Med, 352, pp.2379~2388 (2005)
- Petersen RC, "Practice parameter: early detection of dementia: mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology", Neurology, 56, pp.1133~1142 (2001)
- Petersen RC, "Current concepts in mild cognitive impairment", Arch Neurol, 58, pp.1985~1992 (2001)
- Lopez OL, "Prevalence and classification of mild cognitive impairment in the Cardiovascular Health Study Cognition Study : part 1", Arch Neurol, 60, pp.1385~1389 (2003)
- Petersen RC, "Mild cognitive impairment as a diagnostic entity", J Intern Med, 256, pp.183~194 (2004)
- Ganguli M, "Mild cognitive impairment, amnestic type : an epidemiologic study", Neurology, 63, pp.115~121 (2004)
- Edmonds EC, "Unmasking the benefits of donepezil via psychometrically precise identification of mild cognitive impairment: a secondary analysis of the ADCS vitamin E and donepezil in MCI study", Alzheimers Dement(N Y), 4, pp.11~18 (2017)
- Edmonds EC, "Susceptibility of the conventional criteria for mild cognitive impairment to false-positive diagnostic errors", Alzheimers Dement, 11, pp.415~424 (2015)
- Bangen KJ, "Cortical amyloid burden differences across empirically-derived mild cognitive impairment subtypes and interaction with APOE varepsilon4 genotype", J Alzheimers Dis, 52, pp.849~861 (2016)
- Edmonds EC, "Heterogeneous cortical atrophy patterns in MCI not captured by conventional diagnostic criteria", Neurology, 87, pp.2108~2116 (2016)
- Kivipelto M, "World-Wide FINGERS Network : a global approach to risk reduction and prevention of dementia", Alzheimers Dement, 16, pp.1078~1094 (2020)
- Moon SY, "Facility-based and home-based multidomain interventions including cognitive training, exercise, diet, vascular risk management, and motivation for older adults: a randomized controlled feasibility trial", Aging(Albany NY), 13, pp.15898~15916 (2021)