Table 1 Example language to communicate the MCI diagnosis

MCI believed to be caused by AD

“Your complaints are concerning and not what we expect for a person your age. Any time someone presents with these types of memory concerns later in life, I worry that it is the early stages of Alzheimer’s disease.” “Although we can’t predict outcomes on an individual basis, people with cognitive performance similar to yours are at increased risk for Alzheimer’s dementia. We’re going to watch you closely and do everything we can to help your memory performance and lower your risk for future decline.”

MCI believed to be caused by a non-AD neurodegenerative condition or uncertain etiology

“I’m concerned that the types of changes in cognitive performance you are experiencing suggest the possibility of brain disease. There are some things we can discuss to try to help you with these symptoms, but we may need to run some more tests to try to determine what is causing these changes if that is something you wish to pursue.”

MCI with positive amyloid PET

“Your scan results suggest that amyloid levels in your brain are elevated. Combined with the other tests we’ve done, it leads me to conclude that Alzheimer’s disease is the most likely cause of your cognitive changes, although other less likely causes remain a possibility. Although I can’t be absolutely certain and we don’t have the individual estimates for timing, people with results like yours are at increased risk for developing dementia over the next few years. Given all of this, I think we need to talk about making an overall plan to manage your condition.”

MCI with negative amyloid PET

“Your scan results did not indicate that there is a significant amyloid burden at this time. This suggests that Alzheimer’s disease pathology is not currently present in your brain and your risk for getting dementia is lower than had the scan found amyloid build up. The scan results could change in the future but this could also mean that another brain disorder may be causing your cognitive changes. We still need to try to figure out why you are having these symptoms. We will do that together.”