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 pronounced decline of dementia. It involves problems with memory, language, thinking and judgment that are greater than typical age-related changes. If you have mild cognitive impairment, you may be aware that your memory or mental function has "slipped." And your family and close friends may also 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 increases your risk of later developing dementia, including Alzheimer's disease, especially when your main difficulty is with memory. But some people with mild cognitive impairment never get worse, and a few eventually get better.
Your brain changes as you grow older just like the rest of your body. 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 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 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, causes 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 are often 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-cut. 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 may develop dementia every year.
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner. 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 of ground to cover, it's a good idea to be well prepared. Here are some suggestions to help you get ready for your appointment and understand 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 MCI. Your doctor will make a judgment about 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 MCI drugs or other treatments are specifically approved by the Food and Drug Administration (FDA). But 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 B, vitamin C, vitamin E, folate, beta carotene and ginkgo — 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: 2010-08-26
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