Who misses MCI diagnosis before dementia?

Topic: Risk, prevention and care in population studies

Among 32,430 individuals (mean age at first hospital encounter 76.6±10.9 years; 59.1% female; 4.2% African American; 5.0% Hispanic), only 16.0% received an MCI diagnosis before their dementia diagnosis. African American and Hispanic patients had 31% and 44% lower odds (OR=0.69, p <.001; OR=0.56, p <.001), respectively, of receiving an MCI diagnosis before dementia in comparison to White non-Hispanic patients. Individuals with at least a high school education (OR=1.37, p <.001) and those who were married (OR=1.51, p <.001) were more likely to be diagnosed with MCI before dementia. Greater socioeconomic adversity and a higher comorbidity burden were associated with lower odds of receiving an MCI diagnosis (OR=0.92, p <.001; OR=0.98, p =0.04). Routine care utilization, including vaccinations and annual wellness visits, was linked to increased likelihood of MCI detection prior to dementia diagnosis (OR=1.48-1.67, p <.001). Sociodemographic and routine healthcare utilization factors strongly influence the likelihood of receiving an MCI diagnosis prior to dementia within a healthcare system. These findings highlight strategies to improve early detection of cognitive impairment.

Key findings

• Among 32,430 individuals (mean age at first hospital encounter 76.6±10.9 years; 59.1% female; 4.2% African American; 5.0% Hispanic), only 16.0% received an MCI diagnosis before their dementia diagnosis.
• African American and Hispanic patients had 31% and 44% lower odds (OR=0.69, p <.001; OR=0.56, p <.001), respectively, of receiving an MCI diagnosis before dementia in comparison to White non-Hispanic patients.
• Individuals with at least a high school education (OR=1.37, p <.001) and those who were married (OR=1.51, p <.001) were more likely to be diagnosed with MCI before dementia.
• Greater socioeconomic adversity and a higher comorbidity burden were associated with lower odds of receiving an MCI diagnosis (OR=0.92, p <.001; OR=0.98, p =0.04).
• Routine care utilization, including vaccinations and annual wellness visits, was linked to increased likelihood of MCI detection prior to dementia diagnosis (OR=1.48-1.67, p <.001).

Why it matters

Among 32,430 individuals, only 16.0% received an MCI diagnosis before their dementia diagnosis, and African American and Hispanic patients had 31% and 44% lower odds of receiving an MCI diagnosis before dementia compared to White non-Hispanic patients. These findings are about who gets diagnosed early, not about treating, curing, or preventing Alzheimer's disease.

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Study details

• Participants32,430
• Effect size59.1%; 4.2%; 5.0%
• Evidence strengthLow

Read the original

• DOI: 10.1002/alz70861_108609
• PubMed: 41434064
• Original source →
• Free full text: Alzheimer s & Dementia →

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

@article{wu2025-41434064,
  author  = {Wu, Chao‐Yi and He, Yingnan and Dodge, Hiroko Hayama and Das, Sudeshna},
  title   = {{Who misses MCI diagnosis before dementia?}},
  journal = {Alzheimer s \& Dementia},
  year    = {2025},
  doi     = {10.1002/alz70861_108609},
  pmid    = {41434064},
  url     = {https://doi.org/10.1002/alz70861_108609}
}

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