About Alzheimer's & Dementia
What is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) is a condition characterized by a slight but noticeable and measurable decline in a person’s cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer's disease or another dementia. Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by the people experiencing them (or those close to them), but not severe enough to interfere with daily life or independent function.
Since the symptoms caused by MCI are not severe enough to affect daily life, a person with mild cognitive impairment does not meet the diagnostic guidelines for dementia. However, people living with mild cognitive impairment do have an increased risk of developing Alzheimer's or another type of dementia.
MCI can be classified based on the skills affected:
- MCI that primarily affects memory is known as amnestic MCI. A person may start to forget important information that he or she would previously have recalled easily, such as appointments, conversations or recent events.
- MCI that affects thinking skills other than memory is known as nonamnestic MCI.Thinking skills that may be affected include the ability to make decisions, judge the time or sequence of steps needed to complete a complex task, or visual perception.
Causes & risk factors
The causes of MCI are not yet completely understood. Experts believe that many cases could result from brain changes occurring in the very early stages of Alzheimer's disease or other dementias.
The risk factors most strongly linked to MCI are the same as those for dementia, including advancing age, family history of Alzheimer's disease or another dementia and conditions that raise the risk for cardiovascular disease.
How is it diagnosed?
Mild cognitive impairment (MCI) is a "clinical" diagnosis representing a physician’s professional judgment about the reason for a person's symptoms. There are currently no confirmed tests or procedures to demonstrate conclusively that a person has MCI, nor is it possible to determine the underlying cause of MCI in a person. Diagnosis is based on medical history, physical assessment, blood tests, mental status assessment, neurological examination and imaging studies.
A medical workup for MCI includes the following core elements:
- Thorough medical history (including input from a family member or a friend) where the physician documents current symptoms, previous illnesses and medical conditions, any family history of significant memory problems or dementia and changes in functioning.
- Assessment of independent function and daily activitieswhich focuses on anychanges in a person's typical level of functioning.
- Cognitive assessment using brief tests designed to evaluate memory, planning, judgment, ability to understand visual information and other key thinking skills.
- Neurological assessment to check the function of nerves and reflexes, movement, coordination, balance and senses.
- Evaluation of mood to detect depression; symptoms may include problems with memory or feeling “foggy.” Depression is widespread and may be especially common in older adults.
- Blood tests and imaging of the brain's structure.
If the workup doesn't create a clear clinical picture, the doctor may recommend neuropsychological testing, which involves a series of written or computerized tests to evaluate specific thinking skills.
What kind of treatment is available?
Currently, there aren’t any medications to treat mild cognitive impairment. Pharmaceutical drugs approved to treat symptoms of Alzheimer's disease have not shown any lasting benefit in delaying or preventing the progression of mild cognitive impairment (MCI) to dementia.
The following strategies may help slow any further decline in thinking skills, though more research is needed to confirm the results.
- Exercise on a regular basis to benefit your heart and blood vessels, including those that nourish your brain.
- Maintain blood pressure, blood sugar, cholesterol, and body weight in the recommended range to protect your heart and blood vessels
- Participate in mentally stimulating and socially engaging activities which may help sustain brain function.
Experts recommend that a person diagnosed with MCI be re-evaluated every six months to determine if symptoms are remaining consistent, improving or progressing.
MCI increases the risk of developing dementia at a later period, but it is not for certain. Others with MCI have test results that return to normal for their age and education.
Researchers are working on new diagnostic tools that would help identify and measure underlying brain changes linked to specific types of dementia and help predict the outcome of MCI for each individual.