Mild Cognitive Impairment
What Is Mild Cognitive Impairment?
Mild Cognitive Impairment (MCI) sounds like a descriptor, but it is a diagnosis used when someone experiences mild problems with memory, language, judgement, or other thinking skills that are confirmed by standardized testing. To arrive at an MCI diagnosis, the person or someone close to them reports noticing symptoms. However, the level of cognitive impairment is not significant enough to interfere with daily functioning.
People with MCI are able to function independently. In some cases, people with MCI may have underlying Alzheimer’s disease or another neurodegenerative disease. Some people with MCI never get worse; and, in some cases, symptoms of MCI get better, depending on the underlying cause of MCI.
Symptoms
Symptoms of MCI can include:
- Being overwhelmed by planning or decision-making
- Forgetting things more often
- Forgetting important events like social engagements or appointments
- Impulsivity and poor judgement
- Losing train of thought
- Trouble navigating familiar environments
- Depression and anxiety
- Experiencing apathy
- Feelings of irritability or aggression
Causes & Risks
There is no single cause of MCI, but the risk increases with age. MCI may be caused by a number of factors, including:
- Alzheimer’s disease, characterized by “plaques” and “tangles” in the brain
- Enlargement of ventricles, which are fluid-filled spaces in the brain
- Reduction in the brain’s use of glucose for energy
- Shrinking of the hippocampus, an area of the brain important for memory
- Illness, including psychiatric, neurological, and other medical conditions
- Small strokes or reduced blood flow through brain blood vessels
- Medications
Diagnosis
A work-up for MCI may be prompted by concerns about cognitive decline in oneself or a loved one. Scheduling an evaluation with a specialized healthcare professional is an important first step and may include:
- A neurological exam to determine how well the nervous system and brain are working. These tests include eye movement, walking and balance, and reflexes, to detect neurological signs of Parkinson’s disease, tumors, strokes, or other medical conditions that can impair memory and physical function.
- Biomarker tests, such as brain imaging, or cerebrospinal fluid testing, to determine if MCI is being caused by Alzheimer’s disease.
- Blood tests to rule out physical problems that can affect memory like a vitamin B-12 deficiency or an underactive thyroid gland.
- Brain scans, such as an MRI or CT scan, to check for evidence of a brain tumor, bleeding, or a stroke
- Standardized testing to characterize cognitive function compared to other patients of a similar age to identify underlying clues about the causes of symptoms.
Mild Cognitive Impairment is commonly undiagnosed. Studies show that 80% of patients in primary care have undiagnosed MCI and among those patients, 60-80% have Alzheimer’s disease. This makes contacting a specialized healthcare professional at the first sign of symptoms imperative since early diagnosis is key to prolonged cognitive function.
Treatments for MCI depend on the underlying cause of MCI, which is why early diagnosis is so important. In addition, mounting research indicates that certain lifestyle factors can help moderate healthy brain aging and symptoms of cognitive decline. These include:
- Eating a healthy diet
- Staying physically active
- Remaining cognitively engaged and stimulated
- Socializing with friends and family
- Getting adequate and restful sleep
- Reducing stress
Clinical Trials
Participation in clinical trials is an important way in which people can take a proactive approach to diagnosing and potentially treating MCI. MCI due to underlying Alzheimer’s is being carefully studied, as this is a phase of Alzheimer’s during which potential treatments could yield the most benefit, before underlying neuropathology becomes more extensive. Data collected as part of these trials provides researchers valuable information about the early stages of Alzheimer’s and often gives patients access to biomarker testing for more accurate diagnosis.
