Early cognitive declines are going undiagnosed

It’s rare to hear of an Alzheimer’s diagnosis being a total shock. By the time the presence of the disease is confirmed in an older adult, it's easy to look back and see initial signs of mental decline: a forgotten Thanksgiving recipe, a story from early childhood told one too many times, an extra confusing grocery bill. This slight change in functioning that’s just outside the realm of normal, even for an older person, is referred to as mild cognitive impairment, or MCI. It’s a precursor to a number of conditions that cause dementia, and early detection is critical for the effectiveness of aducanumab, the first-ever Alzheimer’s medication.

With the arrival of treatment, doctors are being forced to reckon with how infrequently MCI is diagnosed. Recently, a research team at the University of Southern California has suggested that of more than 7 million cases of MCI nationwide, only around 10% are caught. I talked to Soeren Mattke, one of the lead authors of the study, and he made the following observations:

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