Early MCI diagnosis - necessary and possible
Patients with mild cognitive impairment (MCI) who additonally show evidence for Alzheimer‘s disease biomarkers in the brain have a more than 90% risk of developing Alzheimer‘s disease within five years1. This further emphasizes the importance of early detection of MCI with Alzheimer‘s pathology.
In 40% of those affected, the progression of Alzheimer's-related memory impairment to dementia can be prevented or at least slowed down - provided that the most important risk factors are systematically controlled.2
For early diagnostics, you can now rely on neotivCare’s digital, non-invasive tests. The app for smartphones and tablets can help you make an initial medical assessment of people with cognitive complaints without the need for complex test batteries.
Arguments in favor of an early MCI diagnosis
Avoidance of fears and worries
Early advice and information for patients and their relatives
Targeted care
Early initiation of drug therapies* to slow the rate of cognitive decline
Utilize prevention potential
Initiation of health-promoting measures (lifestyle interventions)
Better risk management
(e.g., with regard to anesthesia, sedation, bed rest, vascular risks, potentially inadequate medication, metabolic risks)
Challenges in primary care
It is difficult to recognize Alzheimer's disease at an early stage, especially in general practice. The reason: memory complaints do not allow any clear conclusions to be drawn about the actual presence of MCI. Diagnosis must always be based on detailed neuropsychological testing of cognitive functions, as the available screening procedures cannot detect memory deficits typical of MCI.
Short tests such as the MMSE (Mini-Mental State Examination), the DemTect and the TFDD (test for the early detection of dementia with depression differentiation) do not have sufficient sensitivity for the diagnosis of MCI, as they can lead to ceiling effects.3 Complicated test batteries such as CERAD and PACC are difficult to carry out in everyday practice because they require extensive time and neuropsychologically trained specialists to administer them.
How to ask about memory changes
Subjectively perceived memory decline Subjectively perceived memory decline is a key symptom of MCI. Therefore, encourage your patients to consider the following questions:
- how well do you remember the names of friends and family?
- how long have you been experiencing memory problems?
- has your forgetfulness increased over time?
If memory loss is subjectively perceived but there is no evidence of MCI, this is referred to as subjective cognitive decline (SCD).
New directions in digital diagnostics
Early diagnosis of Alzheimer's disease is crucial - it makes it possible to initiate measures for secondary prevention, risk management, drug therapy and the preservation of cognitive health and quality of life at an early stage.
The interactive mobile app neotivCare provides you with a digital, non-invasive tool for assessing and monitoring episodic memory. The digital tests support you in recognizing differences between age-related and pathological cognitive impairments at an early stage. Reliable findings, early in the course of the disease.
The overall assessment of the test results is then presented in the app in a report. Validated against an established neuropsychological test battery, the PACC5**, the composite test result from neotivCare (composite score) is a comparative value, indicating the relationship to the normative value of the results of cognitively unimpaired people in the corresponding age group (aged 60 and over).
* Active ingredient Lecanemab, approved for the treatment in the USA www.eisai.com/news/2023/news202301.html
** PACC5: Preclinical Alzheimer's Cognitive Composite-5, a composite score of 5 neuropsychological tests (to assess episodic memory, executive functions and global cognitive performance). An established test battery with high sensitivity for early risk assessment of memory disorders typical of Alzheimer's disease.
1. Vos et al., Brain 138.5 (2015): 1327-1338. doi.org/10.1093/brain/awv029 /
2. Livingston et al., Lancet 2020; 396(10248): 413–446. doi.org/10.1016/S0140-6736(20)30367-6 /
3. S3-Leitlinie Demenzen. (2017). Deutschland: Springer Berlin Heidelberg