Cognitive Impairment Criteria Impact Alzheimer's Diagnosis

Vast majority of mild Alzheimer's dementia would be reclassified as mild cognitive impairment

TUESDAY, Feb. 7 (HealthDay News) -- Using revised criteria for mild cognitive impairment (MCI), the vast majority of patients with very mild or mild Alzheimer's disease (AD) would be reclassified as having MCI, according to a study published online Feb. 6 in the Archives of Neurology.

John C. Morris, M.D., of Washington University in St. Louis, conducted a retrospective review of ratings of functional impairment for 17,535 individuals with normal cognition, MCI, or AD dementia to investigate the potential impact of revised criteria for MCI on the diagnosis of very mild and mild AD dementia.

Morris found that, according to the revised criteria, based on the level of impairment in the Clinical Dementia Rating domains for performance of instrumental activities of daily living, 99.8 percent of individuals currently diagnosed with very mild AD, and 92.7 percent with mild AD, would be reclassified as having MCI. Many of these individuals with AD dementia would meet the revised criteria for "functional independence," as measured by the Functional Assessment Questionnaire.

"The revised criteria accept that MCI can be associated with impaired functional activities, such that the distinction of MCI from dementia now simply is a matter of an individual clinician's threshold for what represents one condition versus the other," the author writes. "It now is time to advance AD patient care and research by accepting that 'MCI due to AD' is more appropriately recognized as the earliest symptomatic stage of AD."

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