Abstract
With the advancement of diagnostic tests, the call for an ever-earlier diagnosis of people with memory problems is becoming louder. Diagnostic tests for people with mild cognitive impairment are in fact prognostic tests, complicating the application and interpretation of test results. There is currently insufficient evidence on the incremental diagnostic (or prognostic) value of specific diagnostic tests including MRI, CSF and PET scanning in representative memory clinic populations. Labelling large groups of people who may never develop dementia as having prodromal Alzheimer's disease may be more harmful than a postponed nosological diagnosis in those with mild cognitive impairment. The current Dutch practice guideline on dementia, with a reticent attitude towards the use of diagnostic tests in patients with cognitive impairment, is appropriate and scientifically sound.
