Our Neurologist diagnosed my spouse w/MCI three years ago at age 60. At that time, he said a diagnosis of ALZ was reserved for only patients over 65. Our Psychiatrist was much more forthcoming and helped us prepare for what was to come. I don't understand why some in the medical community choose to blur the line in this regard. It is as if "Mild" denotes something like a cold...something that will improve. In my case, MCI not only gave us false hope, but it didn't help to prepare us for the changes that would begin very shortly.
My husband was also dx with MCI at age 60, but I never heard anything about it being because of age--it was due to the MMSE score. As Tom said, it did give me false hope; however, since my husband's Dad had EOAD in his 40's, I knew that the hope was very shaky. Although even MCI was like dropping a nuclear bomb on us, at least the dx gave us a chance to adjust before AD "officially" presented.
The new diagnositic criteria described in the article sounds more accurate than the previous one. I know that when my husband was dx, he had already experienced changes in reasoning and logic, but the former criteria for MCI didn't include that.
AD Dx only for people over 65? That makes it hard to explain all the people dying of "MCI" in their 40s or 50s. You wouldn't think mild impairment would be all that lethal, would you?
It's interesting that Tom's neurologist said "Alzheimer" was only diagnosed in people over 65. Dr. Alzheimer's original case died at the age of 50!!! When I was in medical school AD was only for people UNDER 65. Over that age it was just the usual "senile dementia".
Oh – don’t get me started! It took a year and a half to get my DH diagnosed – all the while the family physician claiming it couldn’t be Alzheimers’ – he’s too young - period! DH was 59.
When DH was diagnosed with MCI, DH clung to the word “Mild” like it was the lone life preserver in an open sea. Ironically he came home and said. “The Dr. said I have mild…mild…mild something or other.” The Dr told him that MCI progresses to Alzheimer’s only 8% of the time; she failed to tell him it’s 8-10% PER YEAR. She told him this was good news. Can you imagine? The only thing that kept me from storming her office was the very real possibility that DH had misunderstood what she actually told him.
Now a year and a half later, I have a spouse who continues to decline and yet refuses to return to the neurologist for follow-up. He refuses to get additional neuro-imaging that was recommended after his neuropsych tests. He has stopped clinging to the “Mild” label because he has now convinced himself a) there was never anything wrong with him – the tests were flawed and/or b) he’s now cured because he’s scoring higher on a computer memory test he repeats over and over and over every day.
I think the true unwritten rule in diagnosis of non-elderly patients is: if the patient has not been fired or asked to resign – it’s MCI and not yet Alzheimer’s. The job is the focus of the “activities of daily living” evaluation. Of course, this glosses over the fact that my DH can no longer count money, make financial decisions, serve on community boards, fill out an application, update anti-virus software, order tickets, drive safely, follow a movie plot, play a board game, reason his way out of a paper bag, etc. etc. etc. But he can still sell and therefore it’s MCI :)
When I read the article I wondered if their goal is to keep more people in the MCI category for longer, so they don’t have to pay for meds…