The conceptual development of MCI

amilies, caregivers, and physicians of persons with

Alzheimer’s disease (AD) generally find it difficult to

pinpoint,  even  in  retrospect,  the  precise  onset  of  a

patient’s  cognitive  impairment. The  development  of

dementia due to a degenerative neurological illness typ-

ically proceeds insidiously over several years from a

state  of  cognitive  normalcy  to  progressively  severe

stages of global intellectual dysfunction. While consen-

sus criteria for diagnosing dementia and AD have been

published and widely adopted (Diagnostic and Statistical

Manual of Mental Disorders [DSM],¹ National Institute

of  Neurological  and  Communicative  Diseases  and

Stroke/Alzheimer’s  Disease  and  Related  Disorders

Association [NINCDS-ADRDA]²), guidelines for dis-

tinguishing   between   normal   age-related   cognitive

decline (ARCD) and the transitional levels of intellec-

tual performance that precede the onset of dementia

have been slow to emerge. In fact, clinical investigators

have grappled with the problem of defining the bound-

aries of normal cognitive aging for over 40 years. In

1962, Kral³ coined the term “benign senescent forget-

fulness” (BSF)  to  describe  a  population  of  nursing-

S t a t e   o f   t h e   a r t

3 5 1

Mild cognitive impairment: historical

development and summary of research

James Golomb, MD; Alan Kluger, PhD; Steven H. Ferris, PhD

F

Copyright © 2004 LLS SAS.  All rights reserved

www.dialogues-cns.org

This review article broadly traces the historical develop-

ment, diagnostic criteria, clinical and neuropathological

characteristics, and treatment strategies related to mild

cognitive impairment (MCI). The concept of MCI is con-

sidered in the context of other terms that have been

developed  to  characterize  the  elderly  with  varying

degrees of cognitive impairment. Criteria based on clin-

ical global scale ratings, cognitive test performance, and

performance on other domains of functioning are dis-

cussed. Approaches employing clinical, neuropsycholog-

ical, neuroimaging, biological, and molecular genetic

methodology used in the validation of MCI are consid-

ered, including results from cross-sectional, longitudinal,

and postmortem investigations. Results of recent drug

treatment studies of MCI and related methodological

issues are also addressed.   

© 2004, LLS SAS

Dialogues Clin Neurosci . 2004;6:351-367.

Keywords:   mild  cognitive  impairment;  diagnostic  criteria;  treatment;
prevalence, prediction; pathology; neuroimaging

Author  affiliations:  Department  of  Neurology,  William  &  Sylvia
Silberstein

Institute for Aging and Dementia, New York University Medical Center, New

York, NY  (James  Golomb); Department of Psychiatry, William & Sylvia

Silberstein Institute for Aging and Dementia, New York University  Medical

Center, New York, NY (Alan Kluger;  Steven  H. Ferris);  Department of

Psychology, Lehman College, Bronx, NY, USA (Alan Kluger)

Address for correspondence: Dr Steven H. Ferris, PhD, Department
of Psychiatry, William   &   Sylvia   Silberstein   Institute   for   Aging   
and   Dementia,   New   York University Medical Center, New York,
NY 10016, USA

(e-mail: steven.ferris@med.nyu.edu)