Mild Cognitive Impairment

What Is Mild Cognitive Impairment?

Mild Cognitive Impairment (MCI) is a decline in cognitive function that may include memory, language, or critical thinking. It is considered more serious than expected age-related decline but less serious and concerning than dementia. Some cases of MCI proceed to dementia and some do not, making MCI especially alarming to those who experience it.

A person with symptoms of MCI might begin losing items, for example, or forget scheduled appointments. While these changes are notable to the individual, they do not routinely interfere with activities of daily living.  

Neurologists divide MCI into two broad categories: amnestic impairment, in which memory loss is the predominant symptom, and nonamnestic impairment, in which other cognitive areas, such as decision making or orientation in space, are primarily affected. 


How Is MCI Diagnosed and Treated?

Clinicians rely on brief neurocognitive tasks, such as a Mini-Mental State Examination, in which a patient is asked to state the current date, day of the week, and remember lists of items. Doctors also conduct family interviews and screen for comorbid conditions, such as depression, when deciding on a diagnosis.

It is important to rule out side effects of medication, neurovascular problems, sleep deprivation, depression, or other factors that may be contributing to MCI and do not represent an underlying neurological process. 

Due to the complicated nature of the condition, treatment will be tailored to each individual and can range from taking the person off of medication that might contribute to cognitive issues to discussing care and planning for the future. 

Can Mild Cognitive Impairment Be Reversed? 

MCI affects about 6 percent of 60-year-olds and 25 percent of 80-year-olds, most of whom do not go on to develop neurodegenerative disorders, according to a 2018 report by the American Academy of Neurology (AAN).

Even though people with MCI are at a higher risk of progressing to dementia compared to people of the same age without impairments, they may also remain stable for years, and an estimated 15 percent to 41 percent of patients will get better within a year of the diagnosis.

In other cases, however, MCI will progress to dementia and Alzheimer’s. The same AAN report states that individuals 65 and older with MCI are three times more likely to develop dementia and Alzheimer’s than members of the general population who do not exhibit these symptoms. 

Causes and Prevention 

MCI is a complicated condition that involves many potential causes, both genetic and environmental, with age perhaps the most universal factor.

One of the genes strongly associated with MCI and Alzheimer’s in both men and women is APOE ε4, although it is unclear whether the gene just influences the chances of getting the diagnosis or if it also promotes conversion of MCI to Alzheimer’s or dementia. To put it into perspective, the APOE ε4 gene is associated with a 25-to-37% chance of developing MCI in people ages 60 to 75, compared with a 15% chance in people with a different variant of the same gene, according to a 2017 study.

For a 2017 analysis published in Jama Neurology, researchers reviewed multiple studies with a total of 58,000 participants and found no significant difference in rates of MCI between men and women ages 55 and 85 years old. However, women appeared to be more at risk for MCI when they were in the 65-to-75 age bracket, which researchers believe might be due to hormonal changes that occur during menopause.

There are other reasons why someone might develop MCI, including certain medications, sleep deprivation, elevated cholesteroldepression, and even lack of education

In other instances, however, the underlying cause is neurological decline, which makes an expert medical opinion extremely important. There are currently no FDA-approved drugs for treating MCI, and there is limited evidence that any drugs or supplements are effective.

Some lifestyle choices have been linked to better brain health, including regular physical activity, continuous learning, and social engagement. Dietary recommendations include adequate folic acid intake and a regimen high in fruits and vegetables and low in sugar, alcohol, and saturated fats. 

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