Introduction:

The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications.

Methods:

We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports.

Results:

Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual’s abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving.

Conclusion:

Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.

中文翻译：

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轻度神经认知障碍的法学意义。

介绍：

轻度认知障碍 (MCI) 或轻度神经认知障碍 (MiND) 综合征，通常是痴呆症（严重神经认知障碍）的前驱症状，其特征是一个或多个认知领域的获得性临床显着变化，尽管保持独立性。轻度损伤对受影响的人及其护理系统具有重大的法医后果。我们回顾了 MiND 的更常见病因，并对其法医学意义进行了系统回顾。

方法：

我们使用全面的搜索词对经过同行评审的关于 MCI 或 MiND 法医学方面的英文文献进行了系统审查，并将我们的审查范围扩大到包括这些报告引用的来源。

结果：

记忆力、执行功能、社会认知、判断、洞察力或抽象能力的损害可以改变个人在多个领域的能力，包括决策、知情同意、指定替代决策者（例如医疗保健代理人）、理解和管理财务、遗嘱执行或安全驾驶。

结论：

即使是轻度认知障碍也会产生严重的行为后果。临床医生可以通过提醒护理伙伴和患有 MCI 或 MiND 的人注意通常伴随认知能力下降的法学问题来帮助他们。早期识别和讨论可以帮助护理系统更有效地管理法医学风险并促进周到的预先计划。