{"id":18992,"date":"2024-03-21T10:00:08","date_gmt":"2024-03-21T17:00:08","guid":{"rendered":"https:\/\/dornsife.usc.edu\/news\/?p=18992"},"modified":"2026-03-05T09:47:39","modified_gmt":"2026-03-05T17:47:39","slug":"millions-with-mild-cognitive-impairment-undiagnosed","status":"publish","type":"post","link":"https:\/\/dornsife.usc.edu\/news\/stories\/millions-with-mild-cognitive-impairment-undiagnosed\/","title":{"rendered":"New studies suggest millions with mild cognitive impairment go undiagnosed, often until it&#8217;s too late"},"content":{"rendered":"\n\n\n    \n                                \n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--article-hero \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--article-hero\"\n    \n      >\n\n    \n<div class=\"inner-wrapper\">\n          \n<div class=\"f--field f--image\">\n\n    \n    \n    \n    \n    \n    \n              \n      <img\n                            data-src=\"https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/03\/Mattke_MCI_Top-768x432.png\"\n          data-srcset=\"https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/03\/Mattke_MCI_Top-1920x1080.png 1920w,https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/03\/Mattke_MCI_Top-1280x720.png 1280w,https:\/\/dornsife.usc.edu\/news\/wp-content\/uploads\/sites\/7\/2024\/03\/Mattke_MCI_Top-768x432.png 768w\"          data-sizes=\"(min-width:1200px) 75vw, (min-width:768px) 83vw, 100vw\"          class=\"lazyload\"\n        \n                  role=\"none\"\n        \n        \n                                      \/>\n\n    \n    \n  \n  \n\n<\/div>\n  \n      <div class=\"image-caption\">\n          \n<div class=\"f--field f--description\">\n\n    \n  Mild cognitive impairment can be an early sign of Alzheimer\u2019s disease or other dementias. (Photo: iStock.)\n\n\n<\/div>\n    <\/div>\n  \n  <div class=\"text-wrapper\">\n          <nav aria-label=\"Breadcrumb\" class=\"breadcrumbs\">\n        <ul>\n                      <li><a href=\"\/news\/stories\/\">News<\/a><\/li>\n                      <li><a href=\"\/news\/stories\/\/?category=health\">Health<\/a><\/li>\n                  <\/ul>\n      <\/nav>\n    \n              \n<div class=\"f--field f--page-title\">\n\n    \n  <h1>New studies suggest millions with mild cognitive impairment go undiagnosed, often until it&#8217;s too late<\/h1>\n\n\n<\/div>\n    \n          <div class=\"subtitle\">\n            \n<div class=\"f--field f--description\">\n\n    \n  Medicare covers an annual well-check visit that could potentially identify cognitive issues, but only about half of beneficiaries take advantage of them.\n\n\n<\/div>\n      <\/div>\n    \n           <strong class=\"author-field\"><span >By<\/span><a href=\"mailto:communication@dornsife.usc.edu\">Soeren Mattke and Ying Liu<\/a><\/strong>\n    \n          <span class=\"post-date-field\">March 21, 2024<\/span>\n      <\/div>\n<\/div>\n\n\n  <\/div><\/div>\n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--social-share \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--social-share\"\n    \n      >\n\n    \n  <div class=\"content-wrapper\">\n    <span class=\"a2a_kit a2a_kit_size_32 addtoany_list\" style=\"line-height: 32px;\">\n      <span class=\"title\">\n        Share\n      <\/span>\n                        <a class=\"a2a_button_copy_link\" target=\"_blank\" href=\"\/#copy_link\" rel=\"nofollow noopener\" title=\"Link\">\n            <span class=\"a2a_svg a2a_s__default a2a_s_copy_link\">\n              <svg height=\"19\" viewBox=\"0 0 19 19\" width=\"19\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"m7.43475275 9.52380952-2.17490843 2.26076008c-1.08745421 1.058837-1.68841575 2.518315-1.68841575 4.0350275 0 1.5167124.60096154 2.9475732 1.68841575 4.0350274 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xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"m8.14285714 9.42857143c-.17142857 0-.34285714 0-.51428571.08571428l7.28571427 6.34285719c.3428572.2571428.6857143.2571428.9428572 0l7.2857142-6.34285719c-.0857142-.08571428-.2571428-.08571428-.4285714-.08571428zm-1.28571428 1.11428567v.1714286 8.5714286c0 .6857143.6 1.2857143 1.28571428 1.2857143h14.57142856c.6857143 0 1.2857143-.6 1.2857143-1.2857143v-8.5714286c0-.0857143 0-.0857143 0-.1714286l-7.2 6.3428572c-.7714286.6857143-1.8857143.6857143-2.6571429 0z\" fill-rule=\"evenodd\" transform=\"translate(-6 -9)\"\/><\/svg>\n            <\/span>\n            <span class=\"a2a_label visually-hidden\">Email<\/span>\n          <\/a>\n                  <\/span>\n  <\/div>\n\n  <\/div><\/div>\n \n\n\n\n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--rich-text \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--rich-text\"\n    \n      >\n\n    \n      \n<div class=\"f--field f--wysiwyg\">\n\n    \n  <p>Mild cognitive impairment \u2013 an early stage of dementia \u2013 is widely underdiagnosed in people 65 and older. That is the key takeaway of two recent studies from our team. <\/p>\n<p>In the first study, we used Medicare data for about 40 million beneficiaries age 65 and older from 2015 to 2019 to estimate the prevalence of mild cognitive impairment in that population and to identify what proportion of them had actually been diagnosed. <\/p>\n<p>Our <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1186\/s13195-023-01272-z\">finding was sobering<\/a>: A mere 8% of the number of cases with mild cognitive impairment that we expected based on a statistical model had actually been diagnosed. Scaled up to the general population 65 and older, this means that approximately 7.4 million cases across the country remain undiagnosed. <\/p>\n<p>In the second study, we analyzed data for 226,756 primary care clinicians and found that <a target=\"_blank\" href=\"https:\/\/doi.org\/10.14283\/jpad.2023.131\">over 99% of them underdiagnosed mild cognitive impairment<\/a> in this population. <\/p>\n<h2>Why it matters<\/h2>\n<p>Mild cognitive impairment is an early symptom of Alzheimer\u2019s disease in <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1001\/jama.2019.2000\">about half of cases<\/a> and progresses to dementia <a target=\"_blank\" href=\"https:\/\/www.alz.org\/alzheimers-dementia\/what-is-dementia\/related_conditions\/mild-cognitive-impairment\">at a rate of 10% to 15% per year<\/a>. It includes symptoms such as losing the ability to remember recent events and appointments, make sound decisions and master complex tasks. Failure to detect it might deprive patients of an opportunity to get treated and to slow down disease progression. <\/p>\n<p>Mild cognitive impairment can sometimes be caused by easily addressable factors, such as medication side effects, thyroid dysfunction or <a target=\"_blank\" href=\"https:\/\/theconversation.com\/vitamin-b12-deficiency-is-a-common-health-problem-that-can-have-serious-consequences-but-doctors-often-overlook-it-192714\">vitamin B12 deficiency<\/a>. Since mild cognitive impairment has <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1016\/j.amjopharm.2008.06.004\">the same risk factors as cardiovascular disease<\/a>, such as high blood pressure and cholesterol, medication management of these risks combined with diet and exercise <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1016\/S0140-6736(15)60461-5\">can reduce the risk of progression<\/a>.<\/p>\n<p>In 2023, the Food and Drug Administration <a target=\"_blank\" href=\"https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-converts-novel-alzheimers-disease-treatment-traditional-approval\">approved the drug lecanemab<\/a> as the <a target=\"_blank\" href=\"https:\/\/theconversation.com\/what-the-fdas-accelerated-approval-of-a-new-alzheimers-drug-could-mean-for-those-with-the-disease-5-questions-answered-about-lecanemab-197460\">first disease-modifying treatment<\/a> <a target=\"_blank\" href=\"https:\/\/www.nia.nih.gov\/health\/alzheimers-causes-and-risk-factors\/what-happens-brain-alzheimers-disease\">for Alzheimer\u2019s disease<\/a>, the most common cause of mild cognitive impairment. In contrast to previous drugs, which can temporarily improve symptoms of the disease, such as memory loss and agitation, this new treatment addresses the underlying cause of the disease. <\/p>\n<p>Lecanemab, a monoclonal antibody, <a target=\"_blank\" href=\"https:\/\/www.news-medical.net\/health\/What-are-Amyloid-Plaques.aspx#\">reduces amyloid plaques<\/a> in the brain, which are toxic protein clumps that are believed to contribute to the progression of the disease. In a large clinical trial, lecanemab was able to <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1056\/NEJMoa2212948\">reduce the progression<\/a> of early-stage Alzheimer\u2019s disease. A similar drug, donanemab, also <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1001\/jama.2023.13239\">succeeded in a clinical trial<\/a> and is expected to be <a target=\"_blank\" href=\"https:\/\/www.medicalnewstoday.com\/articles\/fda-delays-approval-of-alzheimers-drug-donanemab-what-experts-think\">approved sometime in 2024<\/a>. <\/p>\n<p>However, these drugs must be used in the early stages of Alzheimer\u2019s disease, ideally when a patient has only mild cognitive impairment, as there is <a target=\"_blank\" href=\"https:\/\/www.alz.org\/alzheimers-dementia\/treatments\/lecanemab-leqembi#\">no evidence that they are effective in advanced stages<\/a>.<\/p>\n<figure>\n<div class=\"video-embed\"><iframe loading=\"lazy\" width=\"440\" height=\"260\" src=\"https:\/\/www.youtube.com\/embed\/w3IbAscNjsQ?wmode=transparent&amp;start=0\" frameborder=\"0\" allowfullscreen=\"\"><\/iframe><\/div><figcaption><span class=\"caption\">An earlier diagnosis leads to early treatment and better outcomes.<\/span><\/figcaption><\/figure>\n<h2>What still isn\u2019t known<\/h2>\n<p>Many factors contribute to the <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1002\/alz.13051\">lack of timely detection<\/a>. But researchers don\u2019t have a good understanding of the relative importance of those individual factors or how to reduce the high rate of underdiagnosis.<\/p>\n<p>While distinct, symptoms are subtle and their slow progression means that they can be overlooked or misinterpreted as normal aging. A neurologist in China told our research team that diagnosis rates spike in China after the New Year\u2019s holiday, when children who haven\u2019t seen their parents for a year notice changes that are harder to pick up when interacting with someone daily. <\/p>\n<p>Doctors also commonly discount memory concerns as normal aging and doubt that much can be done about it. While cognitive tests to distinguish mild cognitive impairment from pathologic decline do exist, they take about 15 minutes, which can be hard to come by during the limited time of a doctor\u2019s visit and may require a follow-up appointment. <\/p>\n<h2>What\u2019s next<\/h2>\n<p>People, particularly those in their 60s and beyond, as well as their families and friends need to be vigilant about cognitive decline, bring it up during doctor\u2019s appointments and insist on a formal assessment. <\/p>\n<p>The <a target=\"_blank\" href=\"https:\/\/www.medicare.gov\/coverage\/yearly-wellness-visits\">Medicare yearly \u201cwellness\u201d visit<\/a> is an opportunity to explore such concerns, but only about half of beneficiaries <a target=\"_blank\" href=\"https:\/\/doi.org\/10.1377\/hlthaff.2019.01795\">take advantage of it<\/a>. <\/p>\n<p>Just as physicians ask patients about unexplained weight loss and take those concerns seriously, we believe questions that explore a patient\u2019s cognitive state need to become the norm. <\/p>\n<p><em>The <a target=\"_blank\" href=\"https:\/\/theconversation.com\/us\/topics\/research-brief-83231\">Research Brief<\/a> is a short take on interesting academic work.<\/em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/counter.theconversation.com\/content\/216892\/count.gif?distributor=republish-lightbox-basic\" alt=\"The Conversation\" width=\"1\" height=\"1\" style=\"border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important\" referrerpolicy=\"no-referrer-when-downgrade\" \/><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https:\/\/theconversation.com\/republishing-guidelines --><\/p>\n<p><span><a target=\"_blank\" href=\"https:\/\/theconversation.com\/profiles\/soeren-mattke-1484707\">Soeren Mattke<\/a>, Director of the USC Dornsife Brain Health Observatory, <em><a target=\"_blank\" href=\"https:\/\/theconversation.com\/institutions\/university-of-southern-california-1265\">University of Southern California<\/a><\/em> and <a target=\"_blank\" href=\"https:\/\/theconversation.com\/profiles\/ying-liu-1221170\">Ying Liu<\/a>, Research Scientist, Center for Economic and Social Research, <em><a target=\"_blank\" href=\"https:\/\/theconversation.com\/institutions\/usc-dornsife-college-of-letters-arts-and-sciences-2669\">USC Dornsife College of Letters, Arts and Sciences<\/a><\/em><\/span><\/p>\n<p>This article is republished from <a target=\"_blank\" href=\"https:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license. Read the <a target=\"_blank\" href=\"https:\/\/theconversation.com\/new-studies-suggest-millions-with-mild-cognitive-impairment-go-undiagnosed-often-until-its-too-late-216892\">original article<\/a>.<\/p>\n\n\n\n<\/div>\n\n\n  <\/div><\/div>\n\n\n\n  \n        \n  \n    \n\n\n\n\n\n\n<div\n  class=\"cc--component-container cc--article-related-stories \"\n\n  \n  \n  \n  \n  \n  \n  >\n  <div class=\"c--component c--article-related-stories\"\n    \n      >\n\n    \n  <div class=\"inner-wrapper\">\n              \n<div class=\"f--field f--section-title\">\n\n    \n  <h2>\n          Related Articles\n      <\/h2>\n\n\n<\/div>\n    \n                  <article>\n              \n<div class=\"f--field f--cta-title\">\n\n    \n  <h3>\n          <a href=\"https:\/\/today.usc.edu\/how-ai-and-advanced-computing-are-accelerating-alzheimers-research\/\" \n         target=\"_blank\"                 class=\"\" \n      >How AI and advanced computing are accelerating Alzheimer\u2019s research<\/a>\n      <\/h3>\n\n\n<\/div>\n        <\/article>\n              <article>\n              \n<div class=\"f--field f--cta-title\">\n\n    \n  <h3>\n          <a href=\"https:\/\/dornsife.usc.edu\/news\/stories\/older-patients-willing-to-travel-longer-than-expected-for-health-care\/\" \n                        class=\"\" \n      >How far will seniors go for a doctor visit? Often much farther than expected<\/a>\n      <\/h3>\n\n\n<\/div>\n        <\/article>\n              <article>\n              \n<div class=\"f--field f--cta-title\">\n\n    \n  <h3>\n          <a href=\"https:\/\/dornsife.usc.edu\/news\/stories\/eaton-fire-sent-a-pollution-wave-across-los-angeles\/\" \n                        class=\"\" \n      >Eaton fire sent a pollution wave across Los Angeles<\/a>\n      <\/h3>\n\n\n<\/div>\n        <\/article>\n            <\/div>\n\n\n  <\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Medicare covers an annual well-check visit that could potentially identify cognitive issues, but only about half of beneficiaries take advantage of them.<\/p>\n","protected":false},"author":13,"featured_media":18993,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[26],"tags":[87,106,60,83],"class_list":["post-18992","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health","tag-expert-viewpoint","tag-neuroscience","tag-research","tag-the-conversation"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.1.1 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>New studies suggest millions with mild cognitive impairment go undiagnosed, often until it&#039;s too late<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dornsife.usc.edu\/news\/stories\/millions-with-mild-cognitive-impairment-undiagnosed\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"New studies suggest millions with mild cognitive impairment go undiagnosed, often until it&#039;s too late\" \/>\n<meta property=\"og:description\" content=\"Medicare covers an annual well-check visit that could potentially identify cognitive issues, but only about half of beneficiaries take advantage of them.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/dornsife.usc.edu\/news\/stories\/millions-with-mild-cognitive-impairment-undiagnosed\/\" \/>\n<meta property=\"og:site_name\" content=\"USC Dornsife News\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/uscdornsife\" \/>\n<meta property=\"article:published_time\" content=\"2024-03-21T17:00:08+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-03-05T17:47:39+00:00\" \/>\n<meta property=\"og:image\" 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