There are of course several important obstacles to use of patient self-report in cognitive impairment. Disease-related disruptions to memory and cognition may interfere with the ability to complete may a questionnaire accurately, as might loss of insight with progressive disease [16], leading to reliance on informant and clinician report [15]. However, accuracy of informants, especially family caregivers, can also be suboptimal for multiple reasons, including the distortions introduced by caregiver depression and lack of caregiver awareness of some symptoms (for example, [17]). The focus of this overview is on the value of patient report for evaluating disease course and treatments in MCI and in prodromal, or ‘early’ AD [18].

The emphasis is on early disease, corresponding to newer terminology referencing prodromal AD, as well as to the less specific ‘mild cognitive impairment’ referenced by Petersen and colleagues [9]. Methods and findings Domains important for patient report in cognition were identified based on literature reviews completed for the Cognition Initiative, now the Cognition Working Group of the Critical Path Institute, between August 2009 and January 2011. Initial searches were limited to the period from January 2004 to June 2009 with subsequent updates through March 2011. Functioning, variously defined, emerged as an important area for self-report in early disease. There has been recent PRO measure development and empirical studies in the areas of complex ADL functioning and neuropsychological aspects of functioning (for example, executive functioning); additional work in self-reported neuropsychiatric symptoms and health-related quality of life was also identified.

Entinostat Each of these areas is considered briefly below, followed by a discussion of the role of insight in patient self-report. Details of the search this explanation and literature review are available below. A summary of selected measures is presented in Table ?Table11. Table 1 Summary of select measures relevant to patient-reported outcomes in mild cognitive impairment Search methods The initial literature search strategy targeted publications on AD and MCI (specifically ‘AD, moderate to severe’ and ‘MCI or very early AD’), crossing this literature with specific domain terms (functioning, functional status, executive functioning, HRQL, affect/mood/behavior). The search was limited to English language publications from 2004 to 2009 in MedLine and Embase. To ensure that relevant measures used in clinical trials for currently marketed AD drugs were included, separate searches were conducted for MCI and AD in each domain of interest, limited to 1999 to 2009, with the main focus on ‘Alzheimer’s disease’ OR ‘mild cognitive impairment’ OR ‘cognitive impairment no dementia.