Mitchell Terry, Woodward Michael, Hirose Yuichi
Older People's Health, Auckland City Hospital, New Zealand.
Int Psychogeriatr. 2008 Feb;20(1):77-85. doi: 10.1017/S1041610207005583. Epub 2007 Jun 13.
The aim of the study was to assess the attitudes of clinicians to the diagnostic construct of mild cognitive impairment (MCI), their approach to relaying the diagnosis to patients and families, and recommended treatment and follow-up.
An anonymous questionnaire was sent out to 503 members of the Australian Society for Geriatric Medicine (ASGM) and New Zealand Geriatrics Society (NZGS), of whom 163 replied.
Most responders (83%) had diagnosed MCI. About 70% rated the importance of separating MCI from dementia, or MCI from normal cognition, as 4 or 5 on a scale from 1 (not very important) to 5 (very important). Most responders reported that they would inform their patients and families of a diagnosis of MCI, and used that term. A minority used the term "early Alzheimer's disease," but 44% of NZGS members used other terms to relay the diagnosis compared to 13% of ASGM members. Follow-up was most often recommended at 6-12 months. Non-pharmacological treatment (such as mental stimulation strategies) was recommended most often, followed by no treatment.
The diagnostic entity of MCI appears to have a general acceptance among those who responded to the survey, and the term has gained use in clinical practice. Most clinicians are recommending follow-up, recognizing the high risk for progression. Treatment recommendations do not favor pharmaceuticals, reflecting the current evidence for lack of effect.
本研究旨在评估临床医生对轻度认知障碍（MCI）诊断概念的态度、向患者及其家属传达诊断结果的方式以及推荐的治疗和随访方案。
向澳大利亚老年医学学会（ASGM）和新西兰老年医学学会（NZGS）的503名成员发放了一份匿名问卷，其中163人进行了回复。
大多数回复者（83%）曾诊断过MCI。约70%的人将区分MCI与痴呆症或MCI与正常认知的重要性评为4或5（从1（不太重要）到5（非常重要））。大多数回复者表示他们会告知患者及其家属MCI的诊断结果，并使用该术语。少数人使用“早期阿尔茨海默病”这一术语，但44%的NZGS成员使用其他术语来传达诊断结果，而ASGM成员中这一比例为13%。随访最常建议在6至12个月进行。最常推荐的是非药物治疗（如心理刺激策略），其次是不进行治疗。
MCI的诊断实体在参与调查的人群中似乎得到了普遍认可，并且该术语已在临床实践中得到应用。大多数临床医生建议进行随访，认识到其进展的高风险。治疗建议不倾向于使用药物，这反映了目前缺乏疗效的证据。
