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What explains variations in the clinical use of mild cognitive impairment (MCI) as a diagnostic category?

Published online by Cambridge University Press:  01 August 2008

Tiago Moreira ,
Julian C. Hughes ,
Thomas Kirkwood ,
Carl May ,
Ian McKeith  and
John Bond
Tiago Moreira*
Affiliation:
School of Applied Social Sciences, University of Durham, U.K.
Julian C. Hughes
Affiliation:
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, U.K. Northumbria Healthcare NHS Foundation Trust, U.K.
Thomas Kirkwood
Affiliation:
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, U.K.
Carl May
Affiliation:
Institute for Health and Society, Newcastle University, Newcastle upon Tyne, U.K.
Ian McKeith
Affiliation:
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, U.K.
John Bond
Affiliation:
Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, U.K. Institute for Health and Society, Newcastle University, Newcastle upon Tyne, U.K.
*
Correspondence should be addressed to: Tiago Moreira, School of Applied Social Sciences, University of Durham, 32 Old Elvet, Durham, DH1 3HN, U.K. Phone: +44 191 3346843. Fax: +44 191 3346821. Email: tiago.moreira@durham.ac.uk.
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Abstract

Background: Mild cognitive impairment (MCI) is proposed to describe the transitional stage between normal cognitive aging and dementia. It has had significant impact in the field of dementia research, but it remains controversial whether or not it should be used as a diagnostic category in clinical practice.

Methods: Semi-structured interviews were carried out with international experts (N = 37) in the field of dementia research and practice. These interviews explored the advantages and difficulties of using MCI as a clinical diagnosis.

Results: There is wide variation in the clinical use of MCI. This variation depends on institutional factors and two types of cultural factors: (a) clinical culture, and (b) the “evidential culture” – how research and guidelines figure in clinical practice.

Conclusion: The study shows the importance of combining values-based practice with evidence-based practice in the early diagnosis of dementia.

Keywords

mild cognitive impairmentclinical diagnosisclinical practiceinstitutional factorsvalues-based practice
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 4 , August 2008 , pp. 697 - 709
Copyright
© International Psychogeriatric Association 2008

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