[Diagnostic procedures in patients with mild cognitive impairment and in patients with dementia]

To manage the growing numbers of people with dementia (PwD) preventive strategies are becoming more important. Therefore, the diagnostics of patients with mild cognitive impairment (PwMCI) are gaining in importance. Little is known about the current use of diagnostics tests among PwMCI in routine healthcare. The aim of the study was to examine the prevalence of diagnostic methods in newly diagnosed PwMCI over time in comparison to PwD.

The study was based on the complete nationwide patient claims data of the panel doctor services according to §295 of the German social code book V (SGB V). The incidences of PwMCI and PwD in 2011 and 2016 were identified and the use of neuropsychiatric testing, neuroimaging with computed tomography (CT) and magnetic resonance imaging (MRI), laboratory and cerebrospinal fluid (CSF) examinations was ascertained.

In 2016 the prevalence of neuroimaging as well as of laboratory examinations was higher in PwMCI compared to PwD (29% vs. 21% and 92% vs. 88%, respectively). There were only small differences in neuropsychiatric testing (70% vs. 72%). The prevalence of CSF examinations was very low in both groups (less than 1%). Between 2011 and 2016 the prevalence of neuroimaging decreased from 36% to 29% among PwMCI, while it remained constant at around 22% for PwD. The rates of neuropsychiatric testing increased over time in both PwMCI (from 49% to 70%) and PwD (from 36% to 72%). The prevalence of laboratory examinations remained unchanged.

The use of specific diagnostic methods was higher in PwMCI than in PwD. Referring to the recommendations of practice guidelines, the increase in neuropsychiatric testing is regarded as a pleasing development, whereas the decrease in neuroimaging rates and the very low prevalence of CSF examinations require improvement.