It could be forgetting a name or date, trouble paying attention or finding it hard to make a decision, but subtle changes in memory and thinking should not always be dismissed as a normal part of ageing.
Mild cognitive impairment (MCI) is a brain condition that causes changes to memory that differ from normal age-related decline.
Doctors use tests that measure cognitive abilities in areas such as memory, language and attention to diagnose MCI. They also consider complaints of cognitive or memory issues from the individual or their family. Importantly, people with MCI can still manage their daily activities without significant difficulties.
Providing medical care for people with MCI may improve their quality of life and prevent more costly health care in the future.
But researchers at the Macquarie University Centre for the Health Economy (MUCHE) and the University of NSW Centre for Healthy Brain Ageing (CHeBA) say many older Australians may miss out on medical care to help them manage their condition because MCI has not been diagnosed.
Dr Anam Bilgrami, Senior Research Fellow at MUCHE, says it is important not to ignore symptoms of MCI given it is linked with an increased risk of developing dementia.
"We also emphasise the importance of encouraging help-seeking behaviours and community support, especially for those living alone or lacking caregiver assistance,"
Dr Bilgrami also points out that past research shows a substantial proportion of people with MCI remain stable or even improve, but it is difficult to tell which individuals will get better.
For people whose MCI raises the risk of dementia, a diagnosis can facilitate better access to ongoing health care and information to help manage their condition and substantially improve their quality of life. This includes lifestyle changes to manage and delay the progression of cognitive impairment.
"Past research has found accurate MCI diagnosis and care in the community can potentially produce large cost savings across health and social care, and prevent expensive hospital stays," Dr Bilgrami says.
Dr Bilgrami says researchers wanted to learn how older Australians with MCI – but who don't know they have it – use health services and medications.
"We also aimed to identify any service gaps for people with cognitive impairment living in the community, as this has been studied in the United States, but not in Australia," Dr Bilgrami says.
Drawing on the Sydney Memory and Ageing Study (MAS), which began in 2005, Dr Bilgrami and her co-authors studied about 1000 older Australians living in the community, utilising Medicare data to track their medical and pharmaceutical use over 10 years.
"We found that most people with MCI (unaware of their study diagnosis) were less likely than those with normal cognition to visit a doctor, get blood tests or have diagnostic imaging," Dr Bilgrami says.
People with MCI who live alone, experience non-memory symptoms or lack support from caregivers for transport or medical decisions were the least likely to seek and receive health care.
"Our findings align with past US findings linking service gaps to insufficient carer support, underdiagnosis and difficulty in identifying symptoms," she says.
The research study shows the need for accurate MCI screening in the community, clear communication of diagnoses and raising awareness of non-memory symptoms of MCI such as problems with language, decision making and concentration.
"We also emphasise the importance of encouraging help-seeking behaviours and community support, especially for those living alone or lacking caregiver assistance," Dr Bilgrami says.
"Additionally, the growth of telehealth may help close care gaps for older adults with cognitive impairment in the community, particularly those who have inadequate carer support or have transportation challenges."
Dr Anam Bilgrami (pictured above) is a Senior Research Fellow at the Macquarie University Centre for the Health Economy.
