[di meliora]

The paper is concerned with the onset of dementia. Dr Helen Dr Lavretsky, the author, is Professor of Psychiatry in the department of psychiatry and biobehavioral sciences of the David Geffen School of Medicine at UCLA. She also directs the Late-life Mood, Stress, and Wellness Research Program at the Semel Institute for Neuroscience and Human Behavior at UCLA.

She begins:

The topic of appropriate diagnosis of mild cognitive impairment (MCI), which is the focus of the November 2011 issue of the American Journal of Geriatric Psychiatry, is timely given the recently proposed DSM-5 criteria for minor neurocognitive disorders that were tested in the Large Academic Sites Field trials performed by the American Psychiatric Association.1

This is the first time a cognitive diagnosis previously restricted to “pre-dementia populations” will be applied broadly to a variety of neuropsychiatric disorders.

It will be increasingly important to strengthen the definitions of what is “normal” to avoid the “pathologizing” of aging or of any individuals who experience temporary or continuous cognitive impairment.

Defining “normal” memory is becoming increasingly important as the field understands the trajectory for individuals who progress beyond the expected age-associated memory loss and as effective treatments are developed to interrupt the neurodegenerative or cerebrovascular process and thereby improve outcomes. In the 1980s, “normal cognitive decline” had several names, including age-associated memory impairment, age-consistent memory impairment, and late-life forgetfulness. Many potential cognitive problems were dismissed as “senior moments.”1 http://www.psychiatrictimes.com/disp.../10168/2029551

She points out:

Our understanding of what is “normal” cognition in the elderly has recently been refined. Considerable data support the validity of MCI, first described 20 years ago. MCI is of interest because subtypes have been shown to predict subsequent development of Alzheimer disease (AD) and other dementing illnesses. In fact, the probability of conversion from MCI to dementia is estimated to be approximately 15%. Estimates of the prevalence of MCI currently range from 5% to 29% and are climbing as the population ages.1

Dr Lavretsky goes on to expand on her thesis. As the populations age, her work becomes more important in identifying proper treatments. As one with symptoms of dementia, I appreciate her work.

[Fresia]

Caring for friends and family, and knowing it will be me one day too with the family history, while knowing the impact that that this has had and will have for many, I appreciate that the researchers are evaluating this as well and not dismissing them as "senior moments". It was hard to get some the docs to listen when certain family and friends ventured into dementia, and not just the decline of aging. Thanks for this, it is hopeful.