Skip to main content

Research Repository

Advanced Search

Mild cognitive impairment in the older population: Who is missed and does it matter?

Stephan, Blossom C.M.; Brayne, Carol; McKeith, Ian G.; Bond, John; Matthews, Fiona E.

Authors

Blossom C.M. Stephan

Carol Brayne

Ian G. McKeith

John Bond



Abstract

Objectives: Classifications of mild cognitive impairment (MCI) vary in the precision of the defining criteria. Their value in clinical settings is different from population settings. This difference depending on setting is to be expected, but must be well understood if population screening for dementia and pre-dementia states is to be considered. Of importance is the impact of missed diagnosis. The magnitude of missed 'at-risk' cases in the application of different MCI criteria in the population is unknown. Methods: Data were from the Medical Research Council Cognitive Function and Ageing Study, a large population based study of older aged individuals in the UK. Prevalence and two-year progression to dementia in individuals whose impairment failed to fulfil published criteria for MCI was evaluated. Results: Prevalence estimates of individuals not classified from current MCI definitions were extremely variable (range 2.5-41.0%). Rates of progression to dementia in these non-classified groups were also very variable (3.7-30.0%), reflecting heterogeneity in MCI classification requirements. Conclusions: Narrow definitions of MCI developed for clinical settings when applied in the population result in a large proportion of individuals who progress to dementia being excluded from MCI classifications. More broadly defined criteria would be better for selection of individuals at risk of dementia in population settings, but at the possibility of high false positive rates. While exclusion may be a good thing in the population since most people are presumably 'normal', over-inclusion is more likely to be harmful. Further work needs to investigate the best classification system for application in the population. Copyright © 2008 John Wiley & Sons, Ltd.

Citation

Stephan, B. C., Brayne, C., McKeith, I. G., Bond, J., & Matthews, F. E. (2008). Mild cognitive impairment in the older population: Who is missed and does it matter?. International journal of geriatric psychiatry, 23(8), 863-871. https://doi.org/10.1002/gps.2013

Journal Article Type Article
Publication Date Aug 1, 2008
Deposit Date Dec 8, 2023
Journal International Journal of Geriatric Psychiatry
Print ISSN 0885-6230
Electronic ISSN 1099-1166
Publisher Wiley
Volume 23
Issue 8
Pages 863-871
DOI https://doi.org/10.1002/gps.2013
Public URL https://hull-repository.worktribe.com/output/4455291