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Clinical Manifestations.

Beili Shao1,2, Abigail Rebecca Lee2, Elizabeta Mukaetova-Ladinska3

  • 1School of Medicine, University of Nottingham, Nottingham, Nottinghamshire, United Kingdom.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
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Summary
This summary is machine-generated.

This study highlights the diverse causes of mild cognitive impairment (MCI) in young-onset dementia clinics, emphasizing the importance of accurate diagnosis for effective treatment. Alzheimer's disease was the most frequent diagnosis among participants.

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Area of Science:

  • Neurology
  • Neuroscience
  • Gerontology

Background:

  • Mild cognitive impairment (MCI) represents a critical transitional phase between normal aging and dementia, posing diagnostic challenges due to its varied origins and progression.
  • Accurate early diagnosis and subtyping of MCI are essential for implementing targeted therapies and providing adequate patient and family support.

Purpose of the Study:

  • To investigate the heterogeneous causes and co-pathologies of mild cognitive impairment (MCI) in individuals referred to a regional tertiary memory clinic specializing in young-onset dementia.
  • To analyze demographic, clinical, cognitive, cerebrospinal fluid (CSF) biomarker, and neuroimaging data from a prospective longitudinal cohort.

Main Methods:

  • A six-year observational study (December 2018 - November 2024) at Queen's Medical Centre, Nottingham, involving patients referred to the Young-Onset Dementia Clinic.
  • Data collection included demographic, clinical assessments, cognitive testing (ACE-III), CSF biomarkers, and neuroimaging (MRI, FDG-PET) as part of the Cognition and NeuroImaging in Neurodegenerative Disorders (CogNID) study.
  • Analysis of 429 participants (68.10% of 630 referrals) with a mean age of 60.08 years.

Main Results:

  • Alzheimer's disease (AD) was the most common diagnosis (24.94%), followed by functional cognitive decline (12.59%), frontotemporal dementia (6.99%), and COVID-related cognitive impairment (6.06%).
  • Mixed pathologies were identified in 12.82% of participants, with AD and frontotemporal dementia (FTD) being the most frequent co-occurrence.
  • Participants exhibited cognitive deficits, particularly in attention, memory, and fluency, with brain MRI being the primary investigation method.

Conclusions:

  • The study underscores the complex and diverse etiologies underlying MCI in the context of young-onset dementia.
  • Findings emphasize the need for comprehensive diagnostic approaches, including biomarker and neuroimaging analysis, to identify co-pathologies and guide treatment strategies.
  • Real-world data from memory clinics provide crucial insights into the heterogeneous nature of MCI and its management.