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Journal of Chinese Integrative Medicine ›› 2008, Vol. 6 ›› Issue (1): 9-14.doi: 10.3736/jcim20080103

• Editorial • Previous Articles     Next Articles

Guiding principles of clinical research on mild cognitive impairment (protocol)

Jin-zhou Tian1,2(), Jing Shi1, Xin-qing Zhang3, Qi Bi4, Xin Ma5, Zhi-liang Wang6, Xiao-bin Li6, Shu-li Shen3, Lin Li3, Zhen-yun Wu7, Li-yan Fang1, Xiao-dong Zhao1, Ying-chun Miao1, Peng-wen Wang1, Ying Ren1, Jun-xiang Yin1, Yong-yan Wang8, Beijing United Study Group on MCI of the Capital Foundation of Medical Developments   

  1. 1. Department of Care of the Elderly, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
    2. Department of Preclinical Medicine, Hubei College of Chinese Medicine, Wuhan, Hubei Province 430061, China
    3. Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053, China
    4. Department of Neurology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China
    5. Department of Geriatrics, Beijing Anding Hospital, Capital University of Medical Sciences, Beijing 100088, China
    6. North China Pharmaceutical Group Formulation Company Limited, Shijiazhuang, Hebei Province 050015, China
    7. Research Centre of Elderly Psychology, Institute of Psychology, China Academy of Sciences, Beijing 100101, China
    8. Institute of Clinical Basics, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2007-09-03 Online:2008-01-20 Published:2008-01-15
  • Contact: TIAN Jin-zhou E-mail:johnsontian@hotmail.com

Mild cognitive impairment (MCI), as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer's Disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Beijing United Study Group on MCI funded by the Capital Foundation of Medical Developments (CFMD) proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to: (1) cognitive complaints conning from the patients or their families; (2) reporting of a relative decline in cognitive functioning during the past year by the patient or informant; (3) cognitive disorders evidenced by clinical evaluation; (4) activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and (5) absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI (aMCI),single non-memory MCI (snmMCI) and multiple-domains MCI (mdMCI). Finally, the subtype causes could be identified commonly as Alzheimer disease (AD), vascular dementia (VaD),and other degenerative diseases such as frontal- temporal dementia (FTD),Lewy body disease (LBD),semantic dementia (SM), as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin B12 and folic acid, plasma insulin, insulin-degrading enzyme, A(340, A(342, inflammatory factors. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE e4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.

Key words: cognition disorders, diagnostic techniques and procedures, programmed instruction

CLC Number: 

  • R-62
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