P2‐142: The bio‐psycho‐socio‐legal impact of mild cognitive impairment (MCI)

There is an impetus for pushing back the diagnostic criteria for Alzheimer's disease to include predementia disease states such as mild cognitive impairment (MCI). The bio-psycho-socio-legal consequences of such early diagnosis are unknown. Survey data on the bio-psycho-socio-legal impact of the diagnosis of MCI from 45 MCI subjects at the UK ADC was compared to similar survey data collected on the bio-psycho-socio-legal impact of normal aging in normal control subjects (n = 45) matched for age, gender, and education. Survey items were compared on the basis of diagnosis and informant-subject differences in response. Demographic, clinical, and cognitive test measures were compared between highest and lowest quartiles on total MCI impact scores. MCI subjects underreported physical limitations, and over reported compliance with medical regimens (p < 0.001 & p = 0.008). MCI subjects were less confident, interested in learning new things and excited about the future (p-values 0.027, <0.0001, and 0.016). MCI subjects were also less likely to consider POA important, have made such arrangements, or be concerned about health care costs (p-values 0.002, 0.02, 0.0001), but were more likely to want and have received help managing financial affairs (p-values 0.008 & 0.009) than their cognitively normal counterparts. Informants were more likely to report lower compliance with medical regimens and greater changes in mood compared with MCI subjects (p-values 0.006 & 0.03). Subjects scoring high on the negative impact of aging or MCI were younger, healthier, and scored lower on category fluency, Trailmaking A&B, and WAIS digit-symbol tests (p-values 0.03, 0.003, 0.008, 0.001, 0.03, 0.04). The diagnosis and development of MCI has an impact on medical care, psychological well-being, social interactions and legal/economic outlook that should be considered when applying this diagnosis. The development of support mechanisms to counter the negative bio-psycho-socio-legal effects of MCI need to be developed.