Treatment Practices of Mild Cognitive Impairment in California Alzheimer’s Disease Centersadministration
Mild cognitive impairment (MCI) is a cognitive syndrome that lies on the continuum between
normal aging and dementia. MCI is very common and affects approximately 19% of elders
over 65 years of age1. Compared to elders with normal cognition, MCI patients are at a 3-5
times increased risk for developing Alzheimer’s Disease (AD) and have a greater rate of
mortality2, 3. With the aging of many countries’ populations and subsequent expansion of MCI
prevalence and incidence, finding treatments that improve MCI symptoms and delay the
possible progression of MCI to dementia is essential.
While there are several FDA-approved medications for AD, there are no approved medications
for patients with MCI. For AD treatment, clinical practice guidelines suggest a trial of a
cholinesterase inhibitor (ChI) for mild to moderate severity and memantine for moderate to
severe disease4. While controversial, some studies have suggested that statins or antioxidants
may be beneficial for prevention of cognitive impairment5-10. High levels of homocysteine
and low levels of folic acid have been associated with cognitive impairment, suggesting that
homocysteine-reducing vitamins, such as folic acid, may prevent cognitive decline11.
In the absence of specific guidelines or FDA approved medications, it is valuable to know the
treatment patterns currently employed by health care professionals for patients with MCI. This
study investigates current “real world” treatment practices for MCI patients evaluated at the
California Department of Public Health Alzheimer’s Disease Research Centers of California.
In addition, this study explores which patient characteristics are associated with medication