International Psychogeriatrics

Research Article

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

Tiago Moreiraa1 c1, Julian C. Hughesa2a4, Thomas Kirkwooda2, Carl Maya3, Ian McKeitha2 and John Bonda2a3

a1 School of Applied Social Sciences, University of Durham, U.K.

a2 Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, U.K.

a3 Institute for Health and Society, Newcastle University, Newcastle upon Tyne, U.K.

a4 Northumbria Healthcare NHS Foundation Trust, U.K.

ABSTRACT

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.

Conclusion: The study shows the importance of combining values-based practice with evidence-based practice in the early diagnosis of dementia.

(Received September 20 2007)

(Online publication November 21 2007)

(Revised January 17 2008)

(Accepted January 23 2008)

(Online publication April 01 2008)

Correspondence:

c1 Correspondence should be addressed to: Tiago Moreira, School of Applied Social Sciences, University of Durham, 32 Old Elvet, Durham, DH1 3HN, U.K. Phone: +44 191 3346843. Fax: +44 191 3346821. Email: tiago.moreira@durham.ac.uk.