A survey of attitudes of clinicians towards the diagnosis and treatment of mild cognitive impairment in Australia and New Zealand.
OBJECTIVE
The aim of the study was to assess the attitudes of clinicians to the diagnostic construct of mild cognitive impairment (MCI), their approach to relaying the diagnosis to patients and families, and recommended treatment and follow-up.


METHODS
An anonymous questionnaire was sent out to 503 members of the Australian Society for Geriatric Medicine (ASGM) and New Zealand Geriatrics Society (NZGS), of whom 163 replied.


RESULTS
Most responders (83%) had diagnosed MCI. About 70% rated the importance of separating MCI from dementia, or MCI from normal cognition, as 4 or 5 on a scale from 1 (not very important) to 5 (very important). Most responders reported that they would inform their patients and families of a diagnosis of MCI, and used that term. A minority used the term "early Alzheimer's disease," but 44% of NZGS members used other terms to relay the diagnosis compared to 13% of ASGM members. Follow-up was most often recommended at 6-12 months. Non-pharmacological treatment (such as mental stimulation strategies) was recommended most often, followed by no treatment.


CONCLUSIONS
The diagnostic entity of MCI appears to have a general acceptance among those who responded to the survey, and the term has gained use in clinical practice. Most clinicians are recommending follow-up, recognizing the high risk for progression. Treatment recommendations do not favor pharmaceuticals, reflecting the current evidence for lack of effect.
Mitchell
Terry
T
Older People's Health, Auckland City Hospital, New Zealand. terrym@adhb.govt.nz
Woodward
Michael
M
Hirose
Yuichi
Y
D000367:Age Factors; D000544:Alzheimer Disease / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D001291:Attitude of Health Personnel; D001315:Australia; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D003625:Data Collection / Q000706:statistics & numerical data; D003936:Diagnosis, Computer-Assisted; D018450:Disease Progression; D005500:Follow-Up Studies; D005853:Geriatrics / Q000706:statistics & numerical data*; D006801:Humans; D008569:Memory Disorders / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D009483:Neuropsychological Tests; D009520:New Zealand; D005791:Patient Care; D010346:Patient Care Management / Q000379:methods; D010818:Practice Patterns, Physicians'; D011368:Professional-Family Relations; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D009626:Terminology as Topic