Current Screening Methods Miss Worrisome Number of Persons With MCI

This is extremely worrisome to stroke survivors since we already have a documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
Is your doctor even testing you for MCI post-stroke?
 http://dgnews.docguide.com/current-screening-methods-miss-worrisome-number-persons-mci?
 
A study published in the current issue of the Journal of Alzheimer’s Disease suggests that existing screening tools for mild cognitive impairment (MCI) result in a false-negative error rate of more than 7%.
These persons are being 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,” said Emily C. Edmonds, PhD, Department of Psychiatry, University of California San Diego School of Medicine, San Diego, California. “At the individual level, people incorrectly identified as cognitively normal might not receive appropriate medical advice or treatment. This could include preventive measures, such as diet or lifestyle changes to maintain cognitive function, or a referral to other health care providers.”
Beyond that, Dr. Edmonds said diagnostic errors can also negatively impact research studies of MCI and early Alzheimer’s disease.
“If research participants are misclassified when they enrol in a study, this can weaken the study’s results, which makes it even more difficult to find and develop effective treatments or therapies,” she said.
Current diagnostic criteria for MCI, which are broadly used, rely upon subjective memory complaints by the person being screened, a single test score indicating impaired memory, and clinical judgment. The study authors said this approach can produce significant errors in diagnosis. They noted that their past research has also shown a high rate of false-positives.
“We have previously found that as many as one-third of MCI cases diagnosed with the standard method are false-positive errors,” said Dr. Edmonds. “This, coupled with our recent finding of a 7% false-negative error rate, is concerning and tells us that the diagnostic criteria could be improved.”
For the current study, the researchers examined data from 520 individuals participating in the Alzheimer’s Disease Neuroimaging Initiative, a nationwide, multi-institution study of MCI and Alzheimer’s Disease. All of the participants, almost evenly split by gender with a mean age of 74.3 years, underwent standard MCI screening and a more in-depth diagnostic process that involved additional memory and learning tests.
Thirty-seven individuals (7.1%) were identified as cognitively normal based on standard criteria, but qualified for MCI diagnosis using the more comprehensive testing. In addition to mildly impaired cognitive performance, they showed tell-tale biomarkers in their cerebrospinal fluid indicating they are at-risk for future dementia. The remaining participants tested normal using both methods -- a true-negative rate of 92.9%.
The findings show that the use of rigorous diagnostic criteria that include formal neuropsychological tests and less reliance on standard screening methods for MCI can improve clinical research studies and better predict who is likely to progress from MCI to dementia.
SOURCE: University of California, San Diego Health Sciences