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Controversies in Neurology
July 2005

Treating Mild Cognitive ImpairmentThe Absence of Evidence

Author Affiliations

Author Affiliations: Wake Forest University School of Medicine, Winston-Salem, NC.



Arch Neurol. 2005;62(7):1167. doi:10.1001/archneur.62.7.1167

The absence of evidence does not constitute evidence of absence.

William Safire

Most people with Alzheimer disease (AD) develop mild cognitive impairment (MCI) as an initial step toward progressively severe dementia, but there are numerous other causes of MCI. If we define AD by its pathological changes rather than by the severity and variety of its signs and symptoms, then many, perhaps even most, individuals with MCI will eventually prove to have early AD. And if a medication improves cognitive function of a person with AD, even modestly, why not treat individuals with MCI? It seems reasonable to guess that a medication known to alleviate symptoms of AD could also be useful in the different conditions with overlapping clinical manifestations.

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