The National Institute on Aging and Alzheimer’s Association in July released proposed guidelines on how to diagnose Mild Cognitive Impairment (MCI) and Alzheimer’s Disease. The diagnostic guidance describes both non-invasive and invasive testing options.
Central to the non-invasive diagnostic guidance is cognitive assessment. For example, the MCI guidelines propose cognitive tests for episodic memory, which measure for signs of memory loss and impairment. The NIA also suggest cognitive tests for executive function, working memory, attention, and verbal fluency.
While the suggested cognitive assessment tests are a reasonable starting point, it is unfortunate that the NIA did not propose a protocol of core cognitive tests for MCI and Alzheimer’s that include a common scoring method. Practitioners will need to use their own scoring and weighting algorithms for cognitive assessments, which means there won’t be a common standard. Lack of a common scoring method also makes it difficult to compare baseline cognitive tests with re-tests, sometimes years later, for an individual patient.
With the increasing number of people at risk for Alzheimer’s and MCI, having a standard, computer-based cognitive assessment that can be easily administered in a doctor’s office or other outpatient setting is the most logical course.