Cognitive Enhancement at the Mild Cognitive Impairment Stage of Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common cause of dementia in aging. Currently, therapeutic interventions are being initiated earlier in the disease course. The rationale of this strategy is to take advantage of the still healthy neuronal systems to optimize function, slow cognitive decline, and facilitate adaptive compensation in deficient brain networks. This chapter provides an overview and critique of the evidence supporting the enhancement of cognitive function at the early symptomatic stage of AD, so-called mild cognitive impairment due to AD (MCI-AD). It reviews the clinical diagnosis of MCI-AD, underscoring the differences between this condition and healthy brain aging and highlighting the importance of fluid and imaging biomarkers in ensuring reliable diagnosis and providing targets for therapeutic modification. Next, it discusses techniques to enhance cognition in MCI, with an emphasis on nonpharmacological interventional approaches. It concludes with a discussion of future challenges and opportunities in the treatment of MCI-AD.