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Comparison of Cognitive Impairment Diagnosis Criteria in Clinical Settings: Conventional vs. Neuropsychological
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  • Hye-Geum Kim,
  • Younggyo Kim,
  • Emily C. Edmonds,
  • Mark W. Bondi
Hye-Geum Kim
Yeungnam University

Corresponding Author:[email protected]

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Younggyo Kim
Yeungnam University Yeongcheon Hospital
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Emily C. Edmonds
Banner - University Medical Center Tucson
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Mark W. Bondi
University of California San Diego Department of Psychiatry
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Abstract

Objectives: Theories on Alzheimer disease (AD) pathogenesis propose a gap between pathological changes and the onset of clinical symptoms. The early detection of cognitive decline is crucial for the implementation of preventive strategies. Mild cognitive impairment (MCI) is a transitional stage and an accurate diagnosis is vital. However, the diagnosis of MCI varies due to inconsistent diagnostic criteria. This study aims to explore the effectiveness of comprehensive neuropsychological (NP) criteria, including all cognitive domains, for diagnosing cognitive impairment in clinical settings. Methods: The study included 509 subjects with subjective cognitive complaints between 2017 and 2021. They were diagnosed using the conventional and NP criteria, and the results were named the complex criteria (conventional criteria-NP criteria). Results: Concordance between the conventional and NP diagnostic criteria diagnoses was 87.82%. Some participants diagnosed with MCI or dementia using the conventional criteria were classified as normal according to the NP criteria. Notably, the MCI-NC and Demantia (DEM)-NC groups exhibited distinct characteristics. The MCI-NC group had higher depression scores and better memory performance and executive function than the MCI-MCI group. The DEM-NC group had better instrumental activities of daily living and lower functional impairment than the DEM-DEM group. Conclusion: This study highlights the complexity of diagnosing cognitive impairment in older adults and the importance of comprehensive criteria. Relying solely on conventional criteria may lead to an overdiagnosis. The NP criteria consider various cognitive domains and better discriminate between individuals with MCIs or other factors that contribute to cognitive difficulties. Further research is required to investigate long-term outcomes and clinical implications of these discrepant diagnoses.