New research studies conducted by the University of Southern California (USC) Dornsife College of Letters, Arts and Sciences have revealed concerning levels of underdiagnosis of mild cognitive impairment (MCI), an early indicator of Alzheimer's disease. The studies emphasize the importance of early detection and treatment to manage the progression of Alzheimer's, particularly among older adults and disadvantaged groups.

According to the research, more than 90% of the estimated 8 million Americans with MCI are unaware of their condition. This finding raises significant concerns since early diagnosis plays a crucial role in delaying the onset of dementia and Alzheimer's disease.

The studies, published in Alzheimer's Research & Therapy and the Journal of Prevention of Alzheimer's Disease, analyzed data from 40 million Medicare beneficiaries aged 65 and older. The researchers found that fewer than 8% of expected MCI cases were actually diagnosed. Out of the predicted 8 million individuals who are likely to have MCI based on their demographic profile, approximately 7.4 million remain undiagnosed.

Soeren Mattke, director of the Brain Health Observatory at USC Dornsife's Center for Economic and Social Research, who led the investigations, emphasizes the need to raise awareness of the problem. Mattke states, "We want to reach physicians to say, 'There's a measurable difference between aging and pathologic cognitive decline, and detecting the latter early might identify those patients who would benefit from recently approved Alzheimer's treatments."

The prevalence of MCI is influenced by various factors, including socioeconomic status and clinical conditions such as cardiovascular disease, diabetes, hypertension, and other health issues. Disadvantaged groups, including those with lower education levels and Black and Hispanic Americans, are more susceptible to these health conditions and subsequently at higher risk of cognitive decline, including dementia.

Worryingly, underdiagnosis of MCI is even more prominent in these disadvantaged groups, compounding the overall disease burden they face. Mattke highlights the challenges faced by these populations, stating, "So, they're hit twice: They have higher risk and yet lower detection rates."

Another significant finding from the studies revealed that 99% of individual primary care clinicians underdiagnosed MCI. This indicates a limited number of physicians who are in a position to detect MCI early and ensure maximum therapeutic potential through early intervention.

MCI manifests in different forms, including forgetfulness, executive dysfunction affecting daily tasks, and behavioral changes. It is crucial to understand that MCI refers to a level of cognitive functioning rather than a specific disease state. Recent advancements in the treatment of Alzheimer's disease have increased the urgency to improve the detection of MCI.

Several factors contribute to the widespread underdiagnosis of MCI in the United States. Individuals may not be aware of their cognitive concerns, physicians may not notice subtle signs of difficulty, or clinicians may not correctly document the diagnosis in medical records. Additionally, brain health assessments are often not prioritized during clinical visits unless specifically planned for.

To address these challenges, the researchers recommend risk-based MCI detection, focusing on individuals with a higher risk, and utilizing digital tests that can be administered before a medical visit to assess cognitive functioning.

Early treatment is crucial, as the brain's ability to recover is limited. Mattke emphasizes the significance of timely intervention, stating, "For MCI caused by Alzheimer's disease, the earlier you treat, the better your outcomes. Every day counts."

The research findings underscore the critical need for early detection and intervention for MCI to manage the progression of Alzheimer's disease. Raising awareness among both the general public and healthcare professionals is essential to ensure that individuals with MCI have access to preventive measures and new treatments that can slow its progression.