Mild Cognitive Impairment

Mild Cognitive Impairment (MCI) beschreibt einen Zustand beobachtbarer und objektivierbarer kognitiver Einschränkungen am Übergang zwischen altersbedingten kognitiven Veränderungen und Demenz. Primär anhand kognitiver Leistungsprofile definiert, bezieht das Syndrom auch die Alltagsrelevanz der kognitiven Einschränkung mit ein. In Gedächtnisambulanzen erhält jede 5. Person die Diagnose MCI [1].

Kernaussagen

• MCI ist eine syndromale Diagnose. Es gibt verschiedene MCI-Definitionen, was zu Unsicherheiten im Umgang mit dem Konstrukt führen kann.

• Über alle Definitionen hinweg ist MCI definiert als Kombination erworbener, beobachtbarer und objektivierbarer Defizite kognitiver Leistungsfähigkeit, die nicht zu deutlichen Einschränkungen in der Bewältigung der Alltagsaktivitäten führen.

• Das Konstrukt sollte vor allem dann verwendet werden, wenn die kognitiven Einschränkungen das klinisch führende Symptom sind.

• Die Diagnose MCI sollte nicht unter alleiniger Nutzung kognitiver Kurztests gestellt werden, sondern i.d.R. nach Durchführung einer ausführlichen neuropsychologischen Untersuchung, die alle relevanten kognitiven Domänen prüft.

• Die diagnostische Abklärung umfasst die Erhebung der Eigen- und Fremdanamnese zu Verlauf und Alltagskompetenz, die klinische Untersuchung und eine vertiefte neuropsychologische Testung.

• Die klinische Relevanz und Aussagekraft des Konstrukts MCI steigt, wenn eine ätiologische Abklärung inkl. der Bestimmung von Biomarkern erfolgt. Hieraus ergeben sich eine Verbesserung der diagnostischen Sicherheit, der prognostischen Wertigkeit und die Grundlage für die Entwicklung effektiver Interventionen.

• Neurodegenerative Erkrankungen, insbesondere auch die Alzheimer-Krankheit, werden aktuell als klinisches Kontinuum verstanden. MCI bezeichnet hier ein Krankheitsstadium, das zwischen subjektiven kognitiven Defiziten und der manifesten Demenz infolge neuropathologischer Veränderungen anzusiedeln ist.

• Die Diagnose MCI hat erhebliche klinische Relevanz, da sich hieraus therapeutische Konsequenzen ableiten.

• Bei MCI treten neben den kognitiven Einschränkungen häufig psychische sowie Verhaltenssymptome auf (z.B. depressive Symptome, Schlafstörungen, Angstzustände).

Schlüsselwörter

Mild Cognitive Impairment - subjektive kognitive Störung - Demenz - Alltagsrelevanz - Biomarker

Publication History

Article published online:
26 September 2025

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