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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Medical decision-making capacity in mild cognitive impairment: a 3-year longitudinal study
O C Okonkwo1, H R Griffith, J N Copeland
1Department of Psychology, SC 650K, University of Alabama at Birmingham, Birmingham, AL 35294-0017, USA.
Neurology
|November 5, 2008
Summary
Patients with mild cognitive impairment (MCI) show a slow decline in medical decision-making capacity (MDC), particularly in understanding, which worsens after conversion to Alzheimer disease (AD).
Area of Science:
- Neuroscience
- Gerontology
- Medical Ethics
Background:
- Mild cognitive impairment (MCI) affects cognitive functions crucial for decision-making.
- Assessing medical decision-making capacity (MDC) is vital for informed consent in vulnerable populations.
Purpose of the Study:
- To examine longitudinal changes in MDC among patients with amnestic MCI.
- To compare MDC trajectories between MCI patients and healthy controls.
- To investigate the impact of conversion to Alzheimer disease (AD) on MDC.
Main Methods:
- Longitudinal study of 116 MCI patients and 88 controls using the Capacity to Consent to Treatment Instrument.
- Baseline and 1-3 annual follow-up assessments.
- Covariate-adjusted random coefficient regressions analyzed MDC trajectories and conversion effects.
Main Results:
- MCI patients initially showed deficits in appreciation, reasoning, and understanding compared to controls.
- Over time, MCI patients declined significantly in understanding, but not other standards.
- Conversion to AD accelerated the decline in understanding and affected reasoning performance.
Conclusions:
- MDC decline in MCI is gradual but detectable, especially in understanding.
- Conversion to AD significantly impacts understanding and reasoning, increasing decisional impairment vulnerability.
- Clinicians must prioritize informed consent for MCI patients, especially when AD conversion is suspected.
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