• dementia
• neuropsychological assessment
• neuropsychological markers

Dementia is a highly debilitating disease that is growing in the world because of the progressive aging of the population. Dementia affects more than 25 million people in the world, with around 5 million new cases occurring every year (Brookmeyer et al., 2007). It has been estimated that 26% of women and 21% of men over 85 years of age suffer from several types of dementia, of which approximately 70% are of Alzheimer’s type (Qui et al., 2009). The prevalence of dementia worldwide was estimated to be 3.9 in the elderly population over 65 years of age (Ferri et al., 2005). The pooled data of population-based studies in Europe suggests that the prevalence of Alzheimer’s Disease (AD) in people over 65 years of age is 6.4% (Lobo et al., 2000) for dementia and 4.4% while the pooled incidence rate for AD is 19.4 per 1000 person-years (Fratiglioni et al., 2000).

Dementia currently represents a social and health emergency because of clinical features of the disease (progressive disability, severe cognitive impairment, and behavioural disturbances), economic implications (impact on the Welfare State), and human costs of patients and caregivers. Thus, the boundary state between normal aging and early insanity is an area of research interest for both clinical-diagnostic and therapeutic-rehabilitative reasons.

Literature presents many attempts to classify slight cognitive impairment in order to distinguish between physiological and pathological aging. The concept of slight cognitive impairment in aging appears confused with dementia until Kral (1962), who described senescent forgetfulness by distinguishing a physiological cognitive decline due to aging (“Benign Senescent Forgetfulness”) from a pathological cognitive decline (“Malignant Senescent Forgetfulness” or “Amnestic Syndrome”) apt to convert into dementia. After Kral, several studies provided different classifications of slight cognitive impairment but they did not completely describe its clinical features. In 1995, Petersen et al. defined the primary diagnostic criteria for Mild Cognitive Impairment (MCI) that were subsequently reviewed (Petersen et al., 1999). In order to specify MCI subtypes, Petersen (2004) proposed a new classification model.

Mild Cognitive Impairment refers to the clinical condition in which individuals show a slight cognitive impairment not severe enough to satisfy dementia diagnostic criteria but greater than expected for age and schooling, without notable interference in daily life activities. It represents the most valuable nosological entity currently adopted by clinicians to diagnose a specific form of slight cognitive impairment, believed to be a high-risk condition for developing dementia (especially Alzheimer’s Disease) (AD). However, researchers have severely criticized MCI for its marked inaccuracy for both theoretical and clinical reasons (Chertkow et al., 2008). Clinical research did not completely describe the neuropsychological features of MCI and its subtypes, and it did not provide characteristic markers to predict dementia, except those related to memory decline (Perri et al., 2005; 2007).

Starting from this assumption, the research project aims at:
1. describing the historical and conceptual course of mild cognitive impairment and its associated clinical entities;
2. critically analyzing psychodiagnostic procedures and psychometric rules commonly used for diagnosis;
3. pointing out the potential role of cognitive Activation Therapy (AT) for MCI subjects in delaying dementia onset;
4. estimating the proportion and defining the different neuropsychological profiles of each MCI subtype;
5. investigating the possibility to find neuropsychological markers apt to predict dementia.