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

摘要

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.