The importance of attentive primary care in the early identification of mild cognitive impairment: case series.

Abstract

Background: Mild cognitive impairment (MCI) is a condition often preceding Alzheimer's disease and other dementias, characterized by subtle changes in cognitive function. While the importance of early detection is recognised, MCI is frequently underdiagnosed, especially when patients consult primary care physicians for non-cognitive health concerns. The case series aims to investigate the incidental identification of MCI in older patients who visit primary care settings for reasons unrelated to memory issues.

Case description: This is a retrospective case series comprising eight patients, ranging in age from 67 to 77 years, who initially presented in primary care settings for diverse non-memory-related concerns such as headaches, urinary tract infection (UTI) symptoms, and knee pain. Despite the lack of memory-related complaints, incidental findings suggestive of MCI were observed during clinical evaluations. The study explores the distinctions in clinical presentations and diagnostic pathways through thorough history taking and cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and brain magnetic resonance imaging (MRI).

Conclusions: The study highlights the critical role that primary care settings can play in the early detection of MCI, even when patients present with non-cognitive complaints. It emphasizes the importance of comprehensive history taking as a tool for incidental identification of cognitive impairment. Although limited by sample size, the study calls for increased vigilance in primary care settings and suggests the need for future research aimed at optimizing early detection and management strategies for MCI in a primary care context.