Mild cognitive impairment (MCI) is a transitional stage between normal and dementia that refers to the presence of cognitive impairment but not to the extent of a diagnosis of dementia. Mild cognitive impairment is a clinical syndrome that is most commonly characterized by memory loss, such as frequent misplacement of objects, difficulty remembering the names of acquaintances, forgetting the content of a conversation, difficulty remembering telephone numbers, forgetting the storyline of a movie you have seen, or inability to recall a complete event; or confusion about orientation in familiar environments, difficulty remembering time, decreased ability to learn and accept new knowledge, poor concentration, cycling or personality changes such as emotional indifference, depression or impatience, anxiety, irritability, etc., or slow speech, incomprehension, frequent misspoken words, etc.; or decreased executive function, such as inability to complete instructions, etc. Thirty-one percent of people over 60 years of age suffer from mild cognitive impairment and develop dementia at a rate of 15% per year, 10 times that of normal elderly people. 40% develop dementia after 2 years and 57% after 3 years. Of these, more than 80% develop Alzheimer’s disease (AD) and 20% develop vascular dementia (VaD) and other types of dementia. Alzheimer’s disease is the most predominant type of dementia, accounting for 60 to 80% of dementia in old age. Approximately 6-8% of people over 65 years of age have Alzheimer’s disease or other types of dementia, and about half of people with Alzheimer’s disease are in the early or mild cognitive impairment stage, and the other half are in the moderate to severe stage. For this reason, mild cognitive impairment is internationally recognized as an early stage of dementia and is a target for secondary prevention of dementia. Actively treating mild cognitive impairment to prevent the development of dementia is the second line of defense for holding on to dementia. Therefore, the stage of mild cognitive impairment is the best time for dementia treatment. If a middle-aged or older person over 55 years of age develops mild cognitive impairment, he or she should rush to the hospital for specialist consultation and treatment, and should not delay treatment. Since 1999, the majority of Alzheimer’s disease clinical trials approved by the U.S. Food and Drug Administration (FDA) have been for mild cognitive impairment, and these include several clinical trials of donepezil, galantamine, rivastigmine, vitamin E, niacin, and rosiglitazone.
In 2006, the European Alzheimer’s Association Working Group on Mild Cognitive Impairment proposed a diagnostic procedure for the mild cognitive impairment syndrome, making it possible to identify patients at high risk for dementia and to establish more specific and appropriate early treatment strategies. Although, only one of these clinical trials confirmed that donepezil could delay the progression of mild cognitive impairment to Alzheimer’s disease for one year, and the others failed to achieve the primary efficacy endpoint (reduction of dementia conversion rate), some clinical trials achieved the secondary efficacy endpoint (improvement of cognition and life skills). The geriatric neurology team led by Tian Jinzhou, after more than 10 years of research, proved that the herbal compound of tonifying kidney and phlegm method has the effect of improving memory and cognitive function in patients with mild cognitive impairment, and can delay the deterioration of cognitive function at one-year follow-up. The results not only won the First Prize of Science and Technology Progress of the Ministry of Education of China, but were also recommended by the First International Conference on Dementia Prevention as one of the five innovative therapies that “bring hope to Alzheimer’s disease” and reported by more than 170 international media. Recently, at the invitation of Harvard University Magazine, Tian Jinzhou, Shi Jing and Wang Yongyan co-authored “Chinese herbal medicine therapy – a new way to treat Alzheimer’s disease”, which was one of the 44 most popular articles of 2010 (ranked 28) and gained international attention and recognition.