More than 7 million people in the United States may have mild cognitive impairment (MCI) and not know it. Even worse, very few doctors can diagnose this cognitive condition correctly, which could perpetuate the problem, according to two new studies.
In the first study, the researchers evaluated 40 million people who used Medicare and were over the age of 65. The team found that fewer than 8% of MCI cases were diagnosed properly over a four-year span before the pandemic. In other words, out of the 8 million people expected to develop MCI, 7.4 weren’t diagnosed with it.
The authors also found that detecting MCI was worse in people who had less education, as well as Black and Hispanic Americans.
“So, they’re hit twice: They have higher risk and yet lower detection rates,” Soeren Mattke, MD director of the Brain Health Observatory at USC Dornsife’s Center for Economic and Social Research, who led the investigations.
“This study is meant to raise awareness of the problem,” he said in a statement. “We want to say, ‘Pay attention to early changes in cognition, and tell your doctor about them. Ask for an evaluation.’”
People with diabetes, cardiovascular disease, hypertension and other health ailments have a higher risk for cognitive decline including dementia. Those health issues are more common in disadvantaged groups, the authors said.
In the second study, the team evaluated 200,000 individual primary care clinicians and found that 99% of them underdiagnosed MCI.
“There’s really just a tiny fraction of physicians in a position to diagnose MCI who would find these cases early enough for maximum therapeutic potential,” Mattke explains.
MCI can show up as forgetfulness, issues with executive function, and behavior. These challenges can exist at the same time. Some people may not bring these things up to their doctors, and the doctor may not accurately diagnose it.
