The Care Pathway for Patients with Mild Cognitive Impairment in Korea: A Survey of Dementia Specialists

Abstract – Introduction: Mild cognitive impairment (MCI) represents a loss of memory or other cognitive function while maintaining the ability to independently perform most activities of daily living. This study assessed how Korean specialists in dementia care diagnosed and treated patients with MCI symptoms. Methods: A questionnaire on the current management of MCI was developed by 6 experts in MCI care. Specialists in MCI care (n = 24: 14 neurologists/10 psychiatrists) verbally answered questions relating to their experience/views in caring for MCI patients. Results: Respondents diagnosed MCI using the Seoul Neuropsychological Screening Battery (79%) and the Consortium to Establish a Registry for Alzheimer’s Disease – Korea (21%) neuropsychological battery tests. All or nearly all respondents also assessed patients with Mini-Mental State Examination, Geriatric Depression Scale, Clinical Dementia Rating, Activities of Daily Living (ADL), and Instrumental ADL tests. All respondents used MRI or CT for differential diagnosis of diseases causing MCI, about one-third used amyloid PET. Most respondents (96%) treated patients with MCI due to Alzheimer’s disease (AD) with medication, commonly choline alfoscerate (71%) and donepezil (53%), mainly as combination therapy. Unmet needs included patient/caregiver education (63%) and time constraints for consulting patients (54%). Most respondents considered that increased amyloid-β testing for patients with MCI due to AD or subjective cognitive decline is likely to increase. Conclusions: This survey described the current management of MCI due to AD, identified unmet needs and considered possible future developments in the changing landscape of early AD treatment. Early detection and diagnosis and continued development of emerging preventative or therapeutic interventions are critical for MCI outcomes.