S4‐04‐04: Clinical Practices Regarding Mild Cognitive Impairment (MCI) Among Neurology Service Providers
Year: 2009
Type: article
Study design: Observational Study
Abstract: MCI is a research categorization that is entering clinical practice, but little is known about how it is being used. To assess how neurologists are diagnosing and treating patients with mild cognitive symptoms and how they view MCI as a clinical diagnosis. Members of the Geriatric and Behavioral Neurology sections of the American Academy of Neurology (AAN) were surveyed by the AAN Survey Department via mail and Internet. Four hundred twenty providers (response rate = 48%) completed the survey. 88% reported at least monthly encounters with patients experiencing mild cognitive symptoms. Most respondents recognize MCI as a clinical diagnosis (90%) and use its diagnostic code for billing purposes (70%). When seeing this population, most respondents report routinely making recommendations for monitoring and follow-up (88%), counseling patients on physical (78%) and mental exercise (75%), and communicating about risk of dementia (63%). Relatively few respondents routinely provide information on support services (27%) or a written summary of findings (15%). Most (70%) prescribe cholinesterase inhibitors at least sometimes for this population, with memantine (39%) and “other” agents (e.g., vitamin E, gingko) prescribed less frequently. Respondents endorsed several benefits of making a clinical diagnosis of MCI: 1) labeling the problem is helpful (91%); 2) involving the patient in planning for the future (86%); 3) motivating the patient's risk reduction activities (85%); 4) helping the family with financial planning (72%); and 5) prescribing medications useful for treating MCI (65%). Some respondents noted potential drawbacks of MCI as a clinical diagnosis, including 1) it is too difficult to diagnose accurately or reliably (23%); 2) it is usually better described as early AD (21%); and 3) a diagnosis can cause unnecessary worry (20%). Patients with MCI are commonly seen by neurologists and prescribed various medications to address their symptoms. The MCI concept is generally viewed as a useful diagnostic category in clinical practice. Clinicians vary significantly in the education and support they provide or recommend for MCI patients, suggesting a need for practice guidelines in this area. Future research is needed to illuminate decision-making around MCI treatment. Funding source: Alzheimer's Association
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W1987978195