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A survey of attitudes of clinicians towards the diagnosis and treatment of mild cognitive impairment in Australia and New Zealand

Published online by Cambridge University Press:  01 February 2008

Terry Mitchell ,
Michael Woodward  and
Yuichi Hirose
Terry Mitchell*
Affiliation:
Older People's Health, Auckland City Hospital, New Zealand
Michael Woodward
Affiliation:
Aged and Residential Care, Heidelberg Repatriation Hospital, Victoria, Australia
Yuichi Hirose
Affiliation:
School of Mathematics, Statistics and Computer Science, Victoria University of Wellington, New Zealand
*
Correspondence should be addressed to: Dr. Terry Mitchell, Older People's Health, 6th Floor, Support Building, Auckland City Hospital, PB 92024, Auckland, New Zealand. Phone: +64 2162 0549; Fax: +64 9387 2897. Email: terrym@adhb.govt.nz.
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Abstract

Objectives: 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.

Method: 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.

Keywords

cognitive disordersquestionnairesagedattitude of health personnel
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 1 , February 2008 , pp. 77 - 85
Copyright
Copyright © International Psychogeriatric Association 2007

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