A Systematic Review of Assessment Protocols for the Discrimination between Mild Cognitive Impairment and Normal Cognitive Ability in the Aging Population

Abstract

Mild cognitive impairment (MCI) is a concept that an aging individual has reached a point of cognitive decline that is not yet severe enough to be termed dementia, but is not considered normal. Subtle declines in cognitive ability are many times difficult to discriminate from normal ability. This thesis took a systematic approach to reviewing the literature to obtain all available research on the various assessment protocols available to discriminate between MCI and normal cognitive ability. This systematic review was accomplished by searching the following databases: MEDLINE, PsycINFO, ERIC, CINAHL and DISSERTATION ABSTRACTS, putting the gather articles through multiple levels of rigorous sorting for of the study, analyzing and synthesizing the data and rating the methodological design of each study. Conclusions drawn to the scope of practice of a speech-language pathologist yielded a multitude of appropriate diagnostic protocols with adequate support from the research. Specific screening protocols and short, focused formal tests were found to be appropriate for the use of a speech-language pathologist, although these tests may be more appropriate to determine who needs further evaluation and who does not. The most rigorous, powerful research was found in formal, more exhaustive test batteries that may require a referral to a neuropsychologist. Overall, speech-language pathologists have an active role in the early identification of MCI and should be aware of the available tests and how sensitive they are to detect the subtle changes associated with mild cognitive impairment.