. Author manuscript; available in PMC: 2022 Mar 24.

Published in final edited form as: J Alzheimers Dis. 2022;85(1):273–282. doi: 10.3233/JAD-210565

Table 2:

Representative Quotations Supporting Study Themes

Theme	Representative Quotes
Lack of adequate understanding of the distinction between MCI and dementia	Participant Equation of MCI with Dementia “We probably would tend to think of everything on like a dementia spectrum, so we might think MCI means like mild dementia.” (Physician 11, Internist) “Unless if you have formal training in the various definitions, it’s easy to get skewed into thinking it’s all one thing.” (Physician 1, Neurologist) Avoidance of MCI Diagnosis “MCI is not familiar waters - we just talk about maybe early dementia versus full blown dementia.” (Physician 5, Internist) Colleagues Conflate MCI with Dementia “It’s a problem and I think we should be better equipped to deal with mild cognitive impairment versus dementia because they are two very different things with two very different prognoses that don’t get talked about enough.” (Physician 22, Cardiologist) Lack of Training in MCI and Dementia “I don’t know if there is good training at the level of the residency. I think there is very little emphasis from the medical school on cognitive aspects of the neurology residency training.” (Physician 18, Neurologist) “I’m even trying to remember back to like specific, like neurology-based training experiences, and I’m not even remembering that we talked so much about this.” (Physician 11, Internist) “Well, if I say we are very well educated [on MCI], that’s not true.” (Physician 14, Internist)
Variation in physician approaches to identifying whether a patient has MCI	“I typically will assess our older patients’ functionality…it’s easier in a snapshot to assess, you know, the ADLs (activities of daily living) and asking, you know, the family if they function and those types of things than potentially to be able to easily assess a cognitive impairment.” (Physician 11, Internist) “You know, usually in getting to know the patient and their living circumstances, and what they do and how I have to tailor my speech to them, that is usually how I judge.” (Physician 18, Neurologist) “We always ask I mean the kind of common things as part of a physical exam…where you are or, you know, what the date is and things like that. But that’s usually probably beyond a little bit of a mild cognitive impairment. I would think if you can’t remember the day or the place.” (Physician 17, Cardiologist) “One of the first things that would make me think about mild cognitive impairment in a patient would be sometimes just when you initially start talking to a patient, sometimes they can have a blank look on their face at times, and they can have trouble fully comprehending the things that you’re saying to them as you even begin to interview them in a patient interview setting.” (Physician 13, Neurologist)

Theme

Representative Quotes

Lack of adequate understanding of the distinction between MCI and dementia

Participant Equation of MCI with Dementia
“We probably would tend to think of everything on like a dementia spectrum, so we might think MCI means like mild dementia.” (Physician 11, Internist)
“Unless if you have formal training in the various definitions, it’s easy to get skewed into thinking it’s all one thing.” (Physician 1, Neurologist)
Avoidance of MCI Diagnosis
“MCI is not familiar waters - we just talk about maybe early dementia versus full blown dementia.” (Physician 5, Internist)
Colleagues Conflate MCI with Dementia
“It’s a problem and I think we should be better equipped to deal with mild cognitive impairment versus dementia because they are two very different things with two very different prognoses that don’t get talked about enough.” (Physician 22, Cardiologist)
Lack of Training in MCI and Dementia
“I don’t know if there is good training at the level of the residency. I think there is very little emphasis from the medical school on cognitive aspects of the neurology residency training.” (Physician 18, Neurologist)
“I’m even trying to remember back to like specific, like neurology-based training experiences, and I’m not even remembering that we talked so much about this.” (Physician 11, Internist)
“Well, if I say we are very well educated [on MCI], that’s not true.” (Physician 14, Internist)

Variation in physician approaches to identifying whether a patient has MCI

“I typically will assess our older patients’ functionality…it’s easier in a snapshot to assess, you know, the ADLs (activities of daily living) and asking, you know, the family if they function and those types of things than potentially to be able to easily assess a cognitive impairment.” (Physician 11, Internist)
“You know, usually in getting to know the patient and their living circumstances, and what they do and how I have to tailor my speech to them, that is usually how I judge.” (Physician 18, Neurologist)
“We always ask I mean the kind of common things as part of a physical exam…where you are or, you know, what the date is and things like that. But that’s usually probably beyond a little bit of a mild cognitive impairment. I would think if you can’t remember the day or the place.” (Physician 17, Cardiologist)
“One of the first things that would make me think about mild cognitive impairment in a patient would be sometimes just when you initially start talking to a patient, sometimes they can have a blank look on their face at times, and they can have trouble fully comprehending the things that you’re saying to them as you even begin to interview them in a patient interview setting.” (Physician 13, Neurologist)