1. Concern regarding a change in cognition
There should be evidence of concern about a change in cognition, in comparison to the
person‟s prior level. This concern can be obtained from the patient, from an informant
who knows the patient well, or from a skilled clinician observing the patient.
2. Impairment in one or more cognitive domains
There should be evidence of lower performance in one or more cognitive domains that is
greater than would be expected for the patient‟s age and educational background. If
repeated assessments are available, then a decline in performance should be evident
over time. This change can occur in a variety of cognitive domains, including: memory,
executive function, attention, language and visuospatial skills. An impairment in episodic
memory (i.e., the ability to learn and retain new information) is seen most commonly in
MCI patients who subsequently progress to a diagnosis of AD. (See the section on the
cognitive characteristics, below, for further details).
3. Preservation of independence in functional abilities
Persons with MCI commonly have mild problems performing complex functional tasks
they used to be able to perform, such as paying bills, preparing a meal, shopping at the
store. They may take more time, be less efficient, and make more errors at performing
such activities than in the past. Nevertheless, they generally maintain their
independence of function in daily life, with minimal aids or assistance.
4. Not demented
These cognitive changes should be sufficiently mild that there is no evidence of a
significant impairment in social or occupational functioning. It should be emphasized that
the diagnosis of MCI requires evidence of intra-individual change. If an individual has
only been evaluated once, change will need to be inferred from the history and/or
evidence that cognitive performance is impaired beyond what would have been
expected for that individual. Serial evaluations are of course optimal, but may not be
feasible in a particular circumstance.