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Practice Current: How do you manage mild cognitive impairment?

While recognizing each case is different, please choose the answer that best reflects your common practice and limit free text to strategies that are not included.

Estimated Time: 2 Minutes

CASE
A 61-year-old project manager presents with memory complaints noticed by both him and his spouse. In addition to short-term memory loss that is making it challenging to keep track of his high-level duties at work, he also has mild word-finding difficulties. He remains independent for all his instrumental activities of daily living. His father had dementia in his 80s, but there is no other known family history of dementia. A Montreal Cognitive Test shows objective evidence of cognitive impairment with a score of 25/30, with the patient unable to recall any of the 5 items after a 5-minute delay. You diagnose him with amnestic mild cognitive impairment. A standard depression screen appears negative. He is keen to continue working for the next few years and is eager to try any medications that may improve his functioning at work.
1. In addition to standard blood work and neuroimaging (CT/MRI) to investigate for reversible causes of cognitive impairment, are there more sophisticated investigations you would order for this patient? Check all that apply or select "None of the above". *This question is required.
2. Regardless of whether you would like to order them for this patient, which of these investigations are actually available to you in your current practice? Check all that apply or select "None of the above". *This question is required.
3. What non-pharmacological management would you offer this patient? Check all that apply or select "None of the above". *This question is required.
4. Standard blood work and CT/MRI are negative. Would you offer any pharmacological treatment at this point? Select one. *This question is required.
What pharmacological treatment(s) would you offer? Check all that apply. *This question is required.
When would you consider offering pharmacological treatment? Select the one option that would be most persuasive in changing your treatment plan. *This question is required.
Assume the patient now meets your criteria for offering treatment. What pharmacological treatment(s) would you offer? Check all that apply. *This question is required.
How would you evaluate whether the treatment is making a difference? Check all that apply. *This question is required.
How long would you continue the treatment? Select one.   *This question is required.
5. How frequently would you follow up this patient? *This question is required.
6. How many patients with cognitive impairment or dementia have you treated over the last 12 months? *This question is required.