MCI vs. Dementia vs. Alzheimer's Disease

Contributed by: Dennis Fortier, President, Medical Care Corporation
Published in the latest issue of The Journal of Family Practice you will find a well-intentioned review article about the Best Practices Identified for Early Alzheimer's Detection.

While I heartily agree with the need to identify and publish standards of care in this field and I applaud the author (Diana Kerwin, MD) for her efforts, this article blurs the important differences between Mild Cognitive Impairment, Dementia, and Alzheimer's Disease. Helping the public to clearly differentiate and fully understand these terms, (as Dr. Kerwin surely does) is one of the main purposes of this blog.

Based on the title of the article, these are best practices for detecting early Alzheimer's disease. Theoretically, this could mean detection in a pre-symptomatic stage or a bit later when the disease has progressed to the MCI stage. However, when detection occurs later than the MCI stage, we are really no longer discussing early stage Alzheimer's but rather mid to late stage Alzheimer's disease. The confusion comes from the fact that mid to late stage Alzheimer's often causes early stage dementia. The terms "Alzheimer's" and "Dementia" are distinct and cannot be (should not be) carelessly interchanged.

On average, Alzheimer's disease begins with a seven year period of mild symptoms prior to a patient becoming demented. As such, mid to late stage Alzheimer's is usually contemporaneous with early stage dementia. Switching carelessly between the terms breeds unnecessary confusion.

As a final note, the author also included a list of "optimal screening tests and tools to prevent delayed diagnosis of mild-to-moderate dementia patients" which I contend perpetrates somewhat of a false frame. Patients who are mild to moderately demented have a cognitive deficit severe enough so as to be obvious to a caregiver or physician. These patients can no longer care for themselves and no screening tests or tools are necessary to detect the problem. Truly beneficial tests and tools are those that distinguish more subtle impairment from normal declines due to healthy aging.

1 comment :

  1. Superb blog post, I have book marked this internet site so ideally I’ll see much more on this subject in the foreseeable future!