A Test for Mild Cognitive Impairment

Many older people experience what’s called mild cognitive impairment – moments of forgetfulness, uncertainty in decision making, and lack of attention. And they (and their friends and family) wonder if it will progress to Alzheimer’s disease. Often it’s hard to distinguish between old-age forgetfulness and actual mild cognitive impairment; now a test has been developed that can be used to identify people with mild cognitive impairment. It’s been developed by a group of physicians at the University of Pittsburgh, and is described in the journal Postgraduate Medicine.

The Computer Assessment of Mild Cognitive Impairment, or CAMCI, is a self-administered, easily-completed test that can be taken in any quiet space, such as a doctor’s exam room. The 20-minute test has modules that analyze verbal memory, visual memory, attention, incidental recall, and executive function. In the study reported in the journal, the sensitivity and specificity of the CAMCI are compared with those of the Mini Mental State Examination (MMSE), the presently accepted standard test for diagnosing dementia.

Over 500 non-demented people over 60 had comprehensive neurological, psychological and clinical assessments, and then took both the CAMCI and MMSE tests. Their actual cognitive status – mild cognitive impairment or normal - was determined based on the clinical assessments.

The CAMCI was found to be highly sensitive (it identified 86% of subjects with mild cognitive impairment) and specific (it correctly identified those subjects with normal cognition 94% of the time). These results were superior to those obtained with the MMSE, which was relatively insensitive to mild cognitive impairment.

This test, if it’s generally adapted, will enable family practitioners to identify cases of mild cognitive impairment relatively early, so that appropriate lifestyle changes can be suggested, and a more careful watch for development of Alzheimer’s instituted.