Diagnosis and management of mild cognitive impairment in the community: What is the role of primary care physician?

Dementia is a large and growing problem in the ageing population but often not diagnosed in its earlier stages which is Mild Cognitive Impairment (MCI). MCI represents the phase between normal ageing and early dementia. About 12% of patients with MCI develop dementia per year, usually Alzheimer's disease. It is a diagnosis given to individuals who have cognitive impairments beyond that is expected for their age and education. However, this condition does not interfere significantly with daily activities as these individuals retain their critical thinking and reasoning skills. Nevertheless, due to its complexity and vague initial presentation, many cases of MCI can be missed. Therefore, it is imperative for primary care physicians to recognise these symptoms as opposed to normal ageing memory changes, and refer these patients to the memory clinic early to confirm the diagnosis. This paper illustrates a common primary care presentation of a patient with MCI. As there is no proven pharmacological treatment for MCI, the mainstay of management is to provide lifestyle intervention and long term support to these patients in the community. Primary care physicians should work as a team with the geriatrician, allied health personnel, support groups and caregivers in providing this care.