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Nearly Everyone With Mild Cognitive Impairment Goes Undiagnosed


Millions of people over the age of 65 likely have mild cognitive impairment, or MCI—minor problems with memory or decision-making that can, over time, turn into dementia. However, a pair of recent studies both concluded that 92 percent of people experiencing MCI in the United States are not getting diagnosed at an early stage, preventing them from accessing new Alzheimer’s treatments that may be able to slow cognitive decline if it’s caught soon enough.

“We knew it was bad. But we didn’t know it was that bad,” says Ying Liu, a statistician at the University of Southern California Dornsife’s Center for Economic and Social Research and a researcher on both studies.

In the first, published this summer in Alzheimer’s Research & Therapy, Liu’s team aimed to figure out how often MCI is being diagnosed—and how often it’s overlooked. Using data from the Health and Retirement Study, a longitudinal survey of some 20,000 people in the US about a wide range of age-related factors, Liu built a model predicting the number of expected MCI diagnoses for the over-65 population overall: about 8 million. Then, Liu’s team pulled data from all Medicare beneficiaries aged 65 and up enrolled from 2015 to 2019 to see how many were diagnosed with the condition. They found that only 8 percent of the people whom their model predicted would be candidates for MCI, based on their health demographics, actually received a diagnosis. This number was even lower for Black and Hispanic beneficiaries and among lower-income people. (The team used eligibility for Medicaid, health coverage that supplements Medicare, as a marker of income status.)

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