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


CONCLUSIONS
The study shows the importance of combining values-based practice with evidence-based practice in the early diagnosis of dementia.
Moreira
Tiago
T
School of Applied Social Sciences, University of Durham, UK. tiago.moreira@durham.ac.uk
Hughes
Julian C
JC
Kirkwood
Thomas
T
May
Carl
C
McKeith
Ian
I
Bond
John
J
D000368:Aged; D000544:Alzheimer Disease / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D002170:Canada; D003072:Cognition Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D003431:Cross-Cultural Comparison; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D005852:Geriatric Psychiatry; D005853:Geriatrics; D006801:Humans; D009426:Netherlands; D011320:Primary Health Care; D009626:Terminology as Topic; D006113:United Kingdom; D014481:United States