Does MRI Play An Essential Role In Screening For Cognitive Impairment Within A Population Of Community-Dwelling Older Adults?

Abstract Background Practice varies as to whether MRI is included as part of workup in older adults referred for assessment of cognitive impairment. Guidelines are unclear as to when imaging is indicated. Access to MRI can be challenging, especially when assessing community-dwelling older adults. This study evaluated the use of MRI within the assessment process, in a local Integrated Care Programme for the Older Person (ICPOP). Methods Data was retrospectively collected on all referrals received by the ICPOP team since August 2024 (following the implementation of a new digital dictation IT service, “T-pro”). Relevant search terms included “cognitive impairment”, “dementia”, “memory” and “scan”. The study focused on patients referred for cognitive assessment, reviewing their imaging workup and MRI results. Results A total of 214 patients were referred during the 10-month period. Of these, 17 (8%) were referred for brain imaging, and 13 underwent MRI as part of their cognitive impairment workup. MRI findings included as described by reporting radiologist: Involutional Change N=7 (53.8%), Small vessel ischaemic disease N=10 (76.9%), Chronic ischaemic infarct N=0 (0%), Acute ischaemic infarct N=1 (7.7%), Acute intracranial haemorrhage N=1 (7.7%), Microhaemorrhage(s) N=1 (7.7%) and Distinguishing features of Alzheimer’s dementia N=0 (0%) Conclusion While the occurrence of significant MRI findings, such as acute stroke, was low, these results were clinically important. MRI remains a valuable tool in the community-based assessment of cognitive impairment, but its use should be considered on an individual case basis.