“Mild cognitive impairment (MCI) is a slight but noticeable and measurable decline in cognitive abilities, such as remembering names or a list of items. While changes may not be severe enough to disrupt daily life, a clinical diagnosis of MCI indicates an increased risk of eventually developing Alzheimer’s disease or another type of dementia.
In a paper published in the current Journal of Alzheimer’s Disease, researchers at University of California San Diego School of Medicine and Veterans Affairs San Diego Healthcare System say existing screening tools for MCI result in a false-negative error rate of more than 7 percent. These persons are misclassified as not having MCI based on standard screening instruments, but actually do have MCI when more extensive testing is conducted.
“There are consequences to misdiagnosis…At the individual level, people incorrectly identified as cognitively normal might not receive appropriate medical advice or treatment…(beyond that) If research participants are misclassified when they enroll in a study, this can weaken the study’s results, which makes it even more difficult to find and develop effective treatments or therapies.”
“We have previously found that as many as one-third of MCI cases diagnosed with the standard method are false-positive errors,” said Edmonds. “This, coupled with our recent finding of a 7 percent false-negative error rate, is concerning and tells us that the diagnostic criteria could be improved.”
Study: “Missed” Mild Cognitive Impairment: High False-Negative Error Rate Based on Conventional Diagnostic Criteria (Journal of Alzheimer’s Disease)
- Abstract: Mild cognitive impairment (MCI) is typically diagnosed using subjective complaints, screening measures, clinical judgment, and a single memory score. Our prior work has shown that this method is highly susceptible to false-positive diagnostic errors. We examined whether the criteria also lead to “false-negative” errors by diagnostically reclassifying 520 participants using novel actuarial neuropsychological criteria. Results revealed a false-negative error rate of 7.1%. Participants’ neuropsychological performance, cerebrospinal fluid biomarkers, and rate of decline provided evidence that an MCI diagnosis is warranted. The impact of “missed” cases of MCI has direct relevance to clinical practice, research studies, and clinical trials of prodromal Alzheimer’s disease.
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