Aims Although Mild Cognitive Impairment (MCI) is a risk factor for progression to dementia, there is little guidance regarding what factors to consider when planning follow up. Unnecessary variation can have important implications for clinic efficiency. We aimed to examine the clinician and patient factors associated with the decision to follow up patients newly diagnosed with MCI in a single Cognition Dementia and Memory Service clinic (CDAMS).
Methods A retrospective, observational cohort study reviewing all patients with a new diagnosis of MCI between 2013-2023. Linear regression modelling was used to examine the associations between clinician specialty, patient factors and planned time to follow up.
Results Of 140 patients, 61 (44%) were seen by a neurologist, 52 (37%) by a geriatrician and 27 (19%) by a psychiatrist. The planned time to follow up by geriatricians (13.3 months, SD=5.3) was shorter than that of neurologists (16.1 months, SD=4.5) and psychiatrists (16.1 months, SD=4.8) (both p<0.03). A history of delirium was associated with a shorter planned time to follow up (β=-5.29, 95%CI -9.32 to - 1.26, p=0.01). Adjusting for patient factors did not meaningfully alter the difference between time to follow up between geriatricians and the other specialities (neurologists: β=2.62, 95%CI 0.78 to 4.47, p=0.006; psychiatrists: β=2.55, 95%CI 0.19 to 4.9, p=0.03).
Conclusions Both clinician specialty and patient factors appeared to influence variation in MCI follow up. Further work in larger cohorts is required to understand factors clinicians consider when planning follow up for those with MCI and reduce unnecessary variation in care.