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Attitudes of UK psychiatrists to the diagnosis of MCI in clinical practice

Published online by Cambridge University Press:  03 October 2012

Joanne Rodda ,
Santhosh Dontham Gandhi ,
Naaheed Mukadam  and
Zuzana Walker
Joanne Rodda*
Affiliation:
University College London, London, UK North East London NHS Foundation Trust, London, UK
Santhosh Dontham Gandhi
Affiliation:
North Essex Partnership NHS Foundation Trust, Chelmsford, UK
Naaheed Mukadam
Affiliation:
University College London, London, UK Camden and Islington NHS Foundation Trust, London, UK
Zuzana Walker
Affiliation:
University College London, London, UK North Essex Partnership NHS Foundation Trust, Chelmsford, UK
*
Correspondence should be addressed to: Joanne Rodda, Havering Older People's Services, 135-147 Church Road, Romford RM3 0SH, UK. Phone: +0844-6001282; Fax: +0844 4930230. Email: joanne.rodda@nelft.nhs.uk.
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Abstract

Background: Mild cognitive impairment (MCI) may represent a transitional stage between normal functioning and dementia. Following the initial criteria developed by Petersen et al. in 1999, which focused on memory deficit in the context of otherwise normal cognition and general functioning, the concept has evolved with the introduction of subtypes of MCI and improved understanding of etiology. Our aim was to investigate current practice as well as familiarity with and attitudes toward the concept of MCI amongst UK old age psychiatrists.

Method: We sent an anonymized postal survey to all clinicians on the Royal College of Psychiatrists Old Age Psychiatry register. Questions covered attitudes toward the concept of MCI in addition to diagnostic criteria and assessment tools used.

Results: The response rate was 39% (453 of 1,154 questionnaires returned completed). The majority of respondents were consultants (83%) and 91% diagnosed MCI. Only 4.4% of the respondents thought that the concept of MCI was not useful and 79% of them required a memory complaint from either the patient or an informant for a diagnosis, but the majority did not have a specific cut-off on cognitive testing. Eighty-two percent reported that they required no or minimal impairment in activities of daily living for a diagnosis of MCI. The two most frequently used tools for assessment were the Mini-Mental State Examination and the Addenbrooke's Cognitive Examination–Revised.

Conclusions: Our survey shows that in the United Kingdom, the term MCI has become part of everyday clinical practice in psychiatry, suggesting that clinicians find it a useful term to conceptualize the transitional stage between normal aging and dementia. However, there is variability in diagnostic practice.

Keywords

mild cognitive impairmentmemory clinicAlzheimer's diseasedementia
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 2 , February 2013 , pp. 286 - 291
Copyright
Copyright © International Psychogeriatric Association 2012

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