More than 7 million American have hidden cognitive impairment, study finds

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Many of us have experienced moments of forgetfulness or difficulties in planning tasks as we age.

While these lapses may seem like a normal part of getting older, they can sometimes signal a more serious condition known as Mild Cognitive Impairment (MCI).

This condition could be an early warning sign of Alzheimer’s disease, a devastating form of dementia.

Two recent studies conducted by researchers at the USC Dornsife College of Letters, Arts, and Sciences shed light on the alarming underdiagnosis of MCI in older adults and the urgent need for early detection.

The Hidden Problem of MCI

MCI is a condition characterized by subtle cognitive decline that doesn’t yet cause significant disability, unlike full-blown dementia.

People with MCI may experience sporadic challenges in their daily lives, such as memory lapses or difficulties in completing tasks that were once routine.

There are different forms of MCI, including forgetfulness, executive difficulties (struggles with tasks like managing finances), and behavioral changes. Often, these forms coexist in affected individuals.

MCI is a level of cognitive functioning rather than a specific disease. Recent advancements in treating the most common cause of MCI, Alzheimer’s disease, emphasize the importance of early detection.

The Underdiagnosis Issue

Despite the potential impact on patients’ lives, MCI often goes undiagnosed for several reasons.

Patients may not recognize their own cognitive decline, physicians may not notice subtle signs, or clinicians may not correctly document the diagnosis.

Additionally, brain health discussions are often not prioritized during medical visits unless specifically scheduled.

As a result, cognitive impairment may remain hidden, leading to missed opportunities for intervention and treatment.

Two separate studies conducted by USC Dornsife researchers revealed startling statistics regarding MCI underdiagnosis.

In the first study, the researchers analyzed data from 40 million Medicare beneficiaries aged 65 and older. They found that less than 8% of the expected cases of MCI were actually diagnosed.

This means that out of approximately 8 million individuals who were predicted to have MCI based on demographic factors like age and gender, around 7.4 million went undiagnosed.

The situation was even worse among historically disadvantaged groups, including individuals with lower education levels and Black and Hispanic Americans, who face both higher risk and lower detection rates.

In the second study, the researchers examined 200,000 primary care clinicians and discovered that a staggering 99% of them underdiagnosed MCI. This alarming figure highlights the critical need for improved detection methods.

The Importance of Early Detection

Early detection of MCI is crucial because the brain has limited capacity for recovery.

Unlike some other bodily tissues, damaged brain cells cannot regenerate, and any harm incurred cannot be reversed.

This is especially relevant for MCI caused by Alzheimer’s disease. The sooner treatment begins, the better the chances of slowing down the progression of the disease.


Mild Cognitive Impairment may hide in plain sight, affecting the lives of millions of older adults in the United States.

The underdiagnosis of MCI presents a significant challenge, particularly among high-risk populations. To address this issue, healthcare professionals and patients alike must prioritize discussions about brain health during medical visits.

Additionally, risk-based detection methods and digital tests could help identify MCI cases earlier, allowing individuals to take advantage of emerging treatments that may preserve their cognitive function for longer.

In the battle against Alzheimer’s disease, every day of early intervention counts, making the timely recognition of MCI a vital step towards a healthier future.

If you care about dementia, please read studies that walking patterns may help identify specific types of dementia, and common high blood pressure drugs may help lower your dementia risk.

For more information about brain health, please see recent studies about this tooth disease linked to dementia, and results showing this MIND diet may protect your cognitive function, prevent dementia.

The research findings can be found in Alzheimer’s Research & Therapy.

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