Is it mild cognitive impairment? Many want to know

By Megan Rauscher

NEW YORK (Reuters Health) - There appears to be considerable interest among healthy older adults in screening and treatment for mild cognitive impairment, a condition now generally considered to be a precursor to Alzheimer's disease.

Among 149 healthy adults aged 35 and older, 98 percent said they would be willing to be tested for mild cognitive impairment if a family member suggested they had memory problems. African Americans were more willing than whites to be screened at the suggestion of a family member (75 percent vs. 57 percent).

Ninety-nine percent would be willing to take a drug if it would halve their risk of progressing from mild cognitive impairment to Alzheimer's disease, while 92 percent would take a medication to delay onset of AD by 1 year.

Dr. William Dale from the University of Chicago and colleagues report their survey results in the Journal of the American Geriatrics Society.

"We were somewhat surprised interest was this high," Dale noted in an E-mail to Reuters Health. "For the responses to some questions, it was nearly unanimous that people wanted screening for a disease they knew little about."

Although mild cognitive impairment is a risk factor for Alzheimer's, the condition can also be relatively stable.

Such high interest in screening and treatment for mild cognitive impairment is "potentially troubling," Dale said, "because current screening tests do not meet basic scientific standards for justifying their use in standard medical practice."

Furthermore, "none of the available therapies for mild cognitive impairment...have been shown to substantively impact the clinical course of the disease and there may be negative psychological, social, and ethical considerations from being given the label of mild cognitive impairment, which has been linked to Alzheimer disease."

The author of a commentary states: "On the present evidence, despite the enthusiasm of the (medical) profession, and probably the public, screening for mild cognitive impairment is not justified."

Echoing Dale's view, Dr. A. Mark Clarfield of Soroka Hospital, Beer-Sheva, Israel warns that being given the label mild cognitive impairment "may offer to otherwise normal older people a new diagnostic concern about which they did not have previously to worry about."

SOURCE: Journal of the American Geriatrics Society, September 2006.