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Mild cognitive impairment: the Manchester consensus
Dunne RA, Aarsland D, O'Brien JT, Ballard C, Banerjee S, Fox NC, Isaacs JD, Underwood BR et al.. Age and ageing, 2021-01-01
Topic: Risk, prevention and care in population studies
Given considerable variation in diagnostic and therapeutic practice, there is a need for national guidance on the use of neuroimaging, fluid biomarkers, cognitive testing, follow-up and diagnostic terminology in mild cognitive impairment (MCI). MCI is a heterogenous clinical syndrome reflecting a change in cognitive function and deficits on neuropsychological testing but relatively intact activities of daily living. MCI is a risk state for further cognitive and functional decline with 5-15% of people developing dementia per year. However, ~50% remain stable at 5 years and in a minority, symptoms resolve over time. There is considerable debate about whether MCI is a useful clinical diagnosis, or whether the use of the term prevents proper inquiry (by history, examination and investigations) into underlying causes of cognitive symptoms, which can include prodromal neurodegenerative disease, other physical or psychiatric illness, or combinations thereof. Cognitive testing, neuroimaging and fluid biomarkers can improve the sensitivity and specificity of aetiological diagnosis, with growing evidence that these may also help guide prognosis. Diagnostic criteria allow for a diagnosis of Alzheimer's disease to be made where MCI is accompanied by appropriate biomarker changes, but in practice, such biomarkers are not available in routine clinical practice in the UK. This would change if disease-modifying therapies became available and required a definitive diagnosis but would present major challenges to the National Health Service and similar health systems. Significantly increased investment would be required in training, infrastructure and provision of fluid biomarkers and neuroimaging. Statistical techniques combining markers may provide greater sensitivity and specificity than any single disease marker but their practical usefulness will depend on large-scale studies to ensure ecological validity and that multiple measures, e.g. both cognitive tests and biomarkers, are widely available for clinical use. To perform such large studies, we must increase research participation amongst those with MCI.
Key findings
- Significantly increased investment would be required in training, infrastructure and provision of fluid biomarkers and neuroimaging.
Why it matters
This consensus report describes mild cognitive impairment as a risk state in which 5-15% of people develop dementia per year, but about 50% remain stable at 5 years and some improve. It discusses diagnosis and terminology, and notes that biomarkers to identify underlying Alzheimer's disease are not available in routine UK clinical practice.
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Study details
- Evidence strengthLow
How this study scored 54/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2021 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 215 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 30.7 citations a year over 7 year(s) since 2021 |
| Impact for its field and year | 4 / 6 | Cited 11.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 19 other studies in this library |
| Still being cited | 3 / 4 | Cited 144 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Alistair S. Burns: h-index 96 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 27 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 33197937) |
| Free to read | 2 / 2 | Free to read |
| Total | 54 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Dunne, R. A., Aarsland, D., O'Brien, J. T., Ballard, C., Banerjee, S., Fox, N. C., et al. (2021). Mild cognitive impairment: the Manchester consensus. Age and ageing. https://doi.org/10.1093/ageing/afaa228
Vancouver
Dunne RA, Aarsland D, O'Brien JT, Ballard C, Banerjee S, Fox NC, et al. Mild cognitive impairment: the Manchester consensus. Age and ageing. 2021. doi:10.1093/ageing/afaa228. PMID: 33197937.
BibTeX
@article{dunne2021-33197937,
author = {Dunne, R. A. and Aarsland, D. and O'Brien, J. T. and Ballard, C. and Banerjee, S. and Fox, N. C. and Isaacs, J. D. and Underwood, B. R. and others},
title = {{Mild cognitive impairment: the Manchester consensus}},
journal = {Age and ageing},
year = {2021},
doi = {10.1093/ageing/afaa228},
pmid = {33197937},
url = {https://doi.org/10.1093/ageing/afaa228}
}
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