Catching Alzheimer's Disease Early: Assessing Mild Cognitive Impairment in Primary Care

In this episode, 'Catching Alzheimer's Disease Early: Assessing Mild Cognitive Impairment in Primary Care,' the expert neurology and primary care panelists explored the following questions:

Mild cognitive impairment (MCI) is the stage where disease-modifying therapy may have the most benefit, but it's also the stage most likely to be missed. What does MCI look like clinically, how is it defined, and what separates it from normal aging in your clinic visit?

The panelists examined how mild cognitive impairment presents in practice. Dylan Gallacher, PA-C, described MCI as objective cognitive decline beyond what's expected for aging that still preserves daily independence, often marked by episodic memory loss, and explained why caregiver input and memory screeners like the MoCA are essential to separate it from normal aging, vascular disease, or depression. Jennifer Woodward, MD, MPH, and Joshua Oaks, MD, walked through the tiered testing pathways their systems use, from MiniCog screening at Medicare annual wellness visits to full cognitive assessment visits, blood-based biomarker testing, and referral into specialty care. Dr. Oaks emphasized that structured cognitive testing detects over 90% of MCI cases compared with roughly 20% through conversation alone, underscoring why routine screening is critical for catching patients while treatment can still make the biggest difference.

Throughout the conversation, the experts provided a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

The next episode in this series, 'Empowering Primary Care: Early Alzheimer's Detection and the Referral Pathway Challenge,' features the panelists advancing their conversation on Alzheimer's disease and focusing on how practices are building primary care capacity for diagnosis and addressing the shortage of dementia specialists.