International Psychogeriatrics

Research Article

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

Terry Mitchella1 c1, Michael Woodwarda2 and Yuichi Hirosea3

a1 Older People's Health, Auckland City Hospital, New Zealand

a2 Aged and Residential Care, Heidelberg Repatriation Hospital, Victoria, Australia

a3 School of Mathematics, Statistics and Computer Science, Victoria University of Wellington, New Zealand

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.

(Received January 15 2007)

(Online publication March 08 2007)

(Revised March 26 2007)

(Accepted March 28 2007)

(Online publication June 13 2007)

Correspondence:

c1 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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