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

J. S. Roberts, J. H. Karlawish, W. R. Uhlmann, Ronald Carl Petersen, R. C. Green

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)425-431
Number of pages7
JournalNeurology
Volume75
Issue number5
DOIs
StatePublished - Aug 3 2010

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Neurobehavioral Manifestations
Dementia
Memantine
Cholinesterase Inhibitors
Risk Reduction Behavior
Neurology
Surveys and Questionnaires
Cognitive Dysfunction
Vitamin E
Practice Guidelines
Population
Counseling
Alzheimer Disease
Exercise
Research
Neurologists
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Mild cognitive impairment in clinical care : A survey of American Academy of Neurology members. / Roberts, J. S.; Karlawish, J. H.; Uhlmann, W. R.; Petersen, Ronald Carl; Green, R. C.

In: Neurology, Vol. 75, No. 5, 03.08.2010, p. 425-431.

Research output: Contribution to journalArticle

Roberts, J. S. ; Karlawish, J. H. ; Uhlmann, W. R. ; Petersen, Ronald Carl ; Green, R. C. / Mild cognitive impairment in clinical care : A survey of American Academy of Neurology members. In: Neurology. 2010 ; Vol. 75, No. 5. pp. 425-431.
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