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.