What role do cognitive screening tools play in the assessment of MCI in a general practice setting?

Cognitive screening tools play a crucial role in the initial assessment of mild cognitive impairment (MCI) within a general practice setting. They provide a brief, structured, and validated method to detect cognitive deficits that may indicate MCI or early dementia, facilitating timely identification and appropriate referral.

In UK general practice, cognitive testing is recommended after taking a history and excluding reversible causes of cognitive decline through physical examination and laboratory tests. Validated brief instruments such as the 10-point cognitive screener (10-CS), 6-item cognitive impairment test (6CIT), Mini-Cog, and others are advised for this purpose ¹. These tools help to identify cognitive impairment but should not be used in isolation to rule out dementia or MCI, as a normal score does not exclude these conditions ¹.

Moreover, cognitive screening in general practice should be complemented by gathering collateral history from someone who knows the patient well, potentially using structured informant questionnaires like the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) to provide a fuller picture of functional impact ¹.

Recent literature emphasizes the importance of early detection of MCI supported by emerging digital technologies and at-home cognitive assessments, which may enhance screening sensitivity and patient engagement beyond traditional tools (Sabbagh et al., 2020). These advances suggest that cognitive screening tools can be integrated with digital platforms to improve early identification and monitoring of cognitive changes in primary care.

In summary, cognitive screening tools in general practice serve as an essential first step to detect MCI, guide further investigations, and facilitate timely referral to specialist dementia diagnostic services when necessary. They should be used as part of a comprehensive assessment including history, examination, and informant input, with awareness of their limitations and the potential for emerging digital enhancements (Sabbagh et al., 2020) ¹.