MCI-AD · Natural history of Mild Cognitive Impairment and Alzheimer’s Disease: factors influencing early detection, clinical course, and prognosis

Background: There has been great interest in identifying persons at high risk of developing Alzheimer disease (AD) and dementia, as they should constitute a target group for possible prevention or early treatment of dementia in the future. Mild Cognitive Impairment (MCI) is a transitional zone between normal cognitive function and clinical AD. The MCI syndrome is characterized by subjective memory problems and memory deficits. Persons with MCI have an increased risk of developing dementia but some are stable or even recover, while others have an increased risk of death. As not all subjects with MCI progress to dementia, there is a need to examine factors that determine which MCI subjects will develop dementia. Aims/implementation: The main aims include to: 1) identify predictors of AD in the early, prediagnostic phase of the disease; 2) evaluate prognostic factors in patients with MCI; 3) explore the natural history of AD and other dementias and; 4) assess the occurrence of behavioral and psychological symptoms in dementia. The two-year Fellowship will be conducted at the Santa Lucia Foundation, Rome, and the Italian National Research Council, Institute of Biomedical Technologies, Milan. Three Italian, multi-center, clinical cohort studies on patients with AD and MCI will be investigated: 1) Behavioral and Psychological Symptoms of Dementia (BPSD) multi-center Italian study, including 1015 patients with AD; 2) The Italian Dementia Study, a multi-center clinical study of 1550 patients with MCI, AD and other dementias and; 3) The Italian Network on AD, MCI study, including 270 subjects with MCI, who were referred to 21 neurological centers around Italy in 2000-1. Relevance: The current project might have considerable implications n public health and understanding the natural history of degenerative diseases. Detecting syndromes associated with an early AD phase will enable earlier treatment, healthcare planning, and the postponement of institutionalization.