By Gila Reckess
March 23, 2001
School of Medicine research- ers have found that most people diagnosed with mild cognitive impairment (MCI) by the school's Memory and Aging Project (MAP) develop Alzheimer's disease in the following years.
The results suggest that MCI, characterized by minor memory loss, is an early stage of Alzheimer's disease rather than a separate disorder.
"We were surprised to find that an unexplained memory deficit currently called MCI almost always turns out to be early Alzheimer's," John C. Morris, M.D., said.
Morris is the Harvey A. and Dorismae Hacker Friedman Professor of Neurology, director of MAP and co-director of the Alzheimer's Disease Research Center. He is first author of the paper, which appears in the March issue of Archives of Neurology.
The researchers examined 404 people aged 45 and older who had either mild memory loss or no memory problems and who volunteered for annual memory assessments at MAP between July 1990 and June 1997.
The 227 individuals with MCI were placed into one of three categories: uncertain, suspicious and fairly confident. The categories reflected the researchers' degree of confidence that the subtle signs of memory loss might indicate the onset of Alzheimer's disease.
The volunteers were reassessed annually for up to 9.5 years. After five years, Alzheimer's disease symptoms had developed in 6.8 percent of the healthy volunteers, 19.9 percent of the individuals in the uncertain MCI group, 35.7 percent of those in the suspicious group and 60.5 percent of those in the fairly confident group. By 9.5 years, all volunteers with the most severe form of MCI had developed the clinical symptoms of Alzheimer's.
Forty-two participants died before the end of the study and donated their brains for postmortem analysis, the only way to diagnose Alzheimer's disease with 100 percent accuracy. Autopsy results from 25 volunteers who originally were diagnosed with MCI confirmed that 21 had Alzheimer's disease.
Morris pointed out that these results are based on a select group of individuals who volunteered for memory research. "Even with that caveat, the findings are impressive," he said. "Any change from normal is, apparently, suspicious. Once physicians recognize this, they will begin to diagnose Alzheimer's disease much earlier than they do now."
Earlier diagnosis, Morris said, will reveal that more people suffer from the disease than the current estimate of 4 million Americans. It also will help scientists develop more effective therapies for early intervention.
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