Younkin, Steven G

Publication Detail

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Mild cognitive impairment in clinical care: a survey of American Academy of Neurology members.

J S Roberts; J H Karlawish; W R Uhlmann; R C Petersen; R C Green (Profiled Author: Petersen, Ronald C)

Department of Health Behavior & Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. jscottr@umich.edu
Neurology 2010;75(5):425-31.

OBJECTIVE: To assess how neurologists view mild cognitive impairment (MCI) as a clinical diagnosis and how they treat patients with mild cognitive symptoms. METHODS: Members of the American Academy of Neurology with an aging, dementia, or behavioral neurology practice focus were surveyed by self-administered questionnaire. RESULTS: Survey respondents were 420 providers (response rate 48%), and 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 these patients, most respondents routinely provide counseling on physical (78%) and mental exercise (75%) and communicate about dementia risk (63%); fewer 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) prescribed less frequently. Respondents endorsed several benefits of a diagnosis of MCI: 1) involving the patient in planning for the future (87%); 2) motivating risk reduction activities (85%); 3) helping with financial planning (72%); and 4) prescribing medications (65%). Some respondents noted drawbacks, including 1) too difficult to diagnose (23%); 2) better described as early Alzheimer disease (21%); and 3) diagnosis can cause unnecessary worry (20%). CONCLUSIONS: Patients with mild cognitive symptoms are commonly seen by neurologists, who view MCI as a useful diagnostic category. Information and treatments provided to patients with MCI vary significantly, suggesting a need for practice guidelines and further research on clinical decision-making with this population.

4 Originating Grant

• 1.

  PETERSEN, RONALD C

  Mayo Alzheimer's Disease Research Center

  1 May 1999 - 30 April 2014

  NATIONAL INSTITUTE ON AGING

  Total Funding: $ 25,743,859

• 2.

  TROJANOWSKI, JOHN Q.

  Alzheimer's Disease Core Center

  15 July 1997 - 30 June 2016

  NATIONAL INSTITUTE ON AGING

  Total Funding: $ 25,158,594

• 3.

  PETERSEN, RONALD C

  Alzheimers Disease Patient Registry

  30 September 1986 - 31 August 2014

  NATIONAL INSTITUTE ON AGING

  Total Funding: $ 17,300,028

• 4.

  Kokmen, Emre

  ALZHEIMERS DISEASE PATIENT REGISTRY

  Total Funding: $ 3,948,430

Scientific Context

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