Mild cognitive impairment (MCI)
Mild cognitive impairment (MCI)
Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes. If you have mild cognitive impairment, you may be aware that your memory or mental function has "slipped." Your family and close friends also may notice a change. But generally these changes aren't severe enough to interfere with your day-to-day life and usual activities.
Mild cognitive impairment may increase your risk of later progressing to dementia, caused by Alzheimer's disease or other neurological conditions. But some people with mild cognitive impairment never get worse, and a few eventually get better.
Your brain, like the rest of your body, changes as you grow older. Many people notice gradually increasing forgetfulness as they age. It may take longer to think of a word or to recall a person's name.
But consistent or increasing concern about your mental performance may suggest mild cognitive impairment (MCI). Cognitive issues may go beyond what's expected and indicate possible MCI if you experience any or all of the following:
If you have MCI, you may also experience:
There's no single cause of mild cognitive impairment (MCI), just as there's no single outcome for the disorder. Symptoms of MCI may remain stable for years, progress to Alzheimer's disease or another type of dementia, or improve over time.
Current evidence indicates that MCI often, but not always, arises from a lesser degree of the same types of brain changes seen in Alzheimer's disease or other forms of dementia. Some of these changes have been identified in autopsy studies of people with MCI. These changes include:
Brain-imaging studies show that the following changes may be associated with MCI:
These MRIs reveal shrinkage of the hippocampus, a part of the brain associated with memory, during the transition from normal cognitive function to mild cognitive impairment. The inset on each MRI is ...
The strongest risk factors for MCI are:
Other medical conditions and lifestyle factors have been linked to an increased risk of cognitive change, but the evidence for these risk factors is less clear. These risk factors include:
People with MCI have a significantly increased risk — but not a certainty — of developing Alzheimer's disease or another type of dementia. Overall, about 1 to 2 percent of older adults develop dementia every year. Among older adults with MCI, studies suggest that 6 to 15 percent develop dementia every year.
Preparing for your appointment
You're likely to start by seeing your family doctor. If your doctor suspects you have cognitive changes, you may be referred to a specialist with expertise in evaluating mental function. The specialist may be a neurologist, psychiatrist or neuropsychologist.
Because appointments can be brief and there's often a lot to talk about, it's good to be well prepared. Here are some suggestions to help you get ready for your appointment and know what to expect from your doctor.
What you can do
Questions to ask your doctor
In addition to the questions you've prepared ahead of time, don't hesitate to ask your doctor to clarify anything you don't understand.
What to expect from your doctor
Tests and diagnosis
There is no specific test to confirm a diagnosis of mild cognitive impairment (MCI). Your doctor will decide whether MCI is the most likely cause of your symptoms based on the information you provide and results of various tests that can help clarify the diagnosis.
Many doctors diagnose MCI based on the following criteria developed by a panel of international experts:
Mental status testing
Longer forms of neuropsychological testing can provide additional details about your mental function compared with others' of a similar age and education level. These tests may also help identify patterns of change that offer clues about the underlying cause of your symptoms.
Treatments and drugs
Currently, no mild cognitive impairment (MCI) drugs or other treatments are specifically approved by the Food and Drug Administration (FDA). However, MCI is an active area of research. Clinical studies are under way to shed more light on the disorder and find treatments that may improve symptoms or prevent or delay progression to dementia.
Treating other conditions that can affect mental function
Lifestyle and home remedies
Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. Regardless, these healthy choices promote good overall health and may play a role in good cognitive health.
Some supplements — including vitamin E, ginkgo and others — have been purported to help prevent or delay the progression of mild cognitive impairment. However, no supplement has shown any benefit in a clinical trial.
Last Updated: 2012-08-21
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