Pharmacological Treatment of Mild Cognitive Impairment as a Prodromal Syndrome of Alzheimer´s Disease
Tarik Karakaya, Fabian Fußer, Johannes Schröder and Johannes Pantel
Affiliation: Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, J.W. Goethe-University, Heinrich- Hoffmann-Str. 10, 60528 Frankfurt, Germany
Keywords: Mild cognitive impairment, Alzheimer’s Dementia, Clinical Trials, Treatment
Mild cognitive impairment (MCI) is a syndrome which, depending on various neurobiological, psychological
and social factors, carries a high risk of developing into dementia. As far as diagnostic uncertainty and the heterogeneous
underlying pathophysiological mechanisms are concerned, only limited therapeutic options are currently available.
Clinical trials involving a wide range of substances have failed to show efficacy on primary and secondary outcome
parameters. Most results reflect not only a lack of effectiveness of drug therapy but also methodological constraints in true
prodromal Alzheimer´s disease (AD) based on clinical criteria. Biomarkers may help to identify MCI as a prodromal
phase of dementia, so it is important to use them to improve specificity of case selection in future studies. For MCI as a
prodromal syndrome of AD, clinical trials with disease modifying drugs that target underlying pathological mechanisms
such as amyloid-beta accumulation and neurofibrillary tangle formation may help develop effective treatment options in
the future. Alternative pharmacological approaches are currently being evaluated in ongoing phase 1 and phase 2 studies.
Nevertheless, a lack of approved pharmacotherapeutic options has led to specific interventions that focus on patient
education and life-style related factors receiving increasing attention.
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