Mild cognitive impairment (MCI) is a stage of cognitive decline between cognitive decline expected of a normal aging process and dementia, a more serious decline in cognitive ability.
MCI may involve issues with:
The challenges to these everyday processes may be greater when a person has MCI than the struggles associated with age-related changes on a normal scale.
Those with MCI may be aware that their ability to remember details or think critically or quickly is slowing down; family and friends may also notice some changes. However, these changes typically don’t present such a challenge as to dramatically interfere with the quality of a person’s usual activities and their everyday life.
Symptoms of Mild Cognitive Impairment
Just as the rest of the body changes with age, so does the brain. Many people find that as they grow older, they experience an increase in forgetfulness. They may struggle to find the right word, remember a name, or remember an appointment without a reminder.
Many of these changes are natural – they are simply part of growing tired.
However, some people experience these issues to a greater degree. They may find that they are not only forgetful but worryingly so. If a person’s cognitive performance becomes a cause for their own concern, they may be experiencing mild cognitive impairment.
These are some of the things people with mild cognitive impairment may find they experience:
- They forget more things or forget things often.
- They forget birthdays, appointments, coffee dates, or other pre-planned engagements.
- They find they lose their train of thought during a conversation.
- They may lose their train of thought or the thread of the plot when watching a movie or reading a book.
- They feel overwhelmed when making decisions, making plans, or following instructions.
- They find familiar environments may feel foreign.
- They may show poor judgment or act impulsively.
- Their family and friends notice changes in their behaviors reflecting any of the above.
MCI is not only characterized by forgetfulness, confusion, or difficulties in concentration. It can also be comorbid with other issues like:
Changes in Symptoms
There is no single outcome for MCI. Some people may find their symptoms remain stable after the initial onset. Others may even find their symptoms easing over time. Unfortunately, others may find that their symptoms grow worse over time or even serve as a precursor to the onset of dementia.
Causes of Mild Cognitive Impairment
Mild cognitive impairment is unlike other neurological disorders in that there is no one cause.
There is some evidence that mild cognitive impairment may sometimes derive from some of the same changes underlying Alzheimer’s disease.
Some of these changes include:
- Small strokes
- Reduction in blood flow through blood vessels in the brain
- Lewy bodies (microscopic clumps of proteins associated with dementia with Lewy bodies, some Alzheimer’s disease cases, and Parkinson’s disease)
- Abnormal plaques (clumps of beta-amyloid protein) or tangles (microscopic protein clumps)
An MRI or another brain-imaging study may also reveal some brain changes associated with MCI:
- Enlargement of ventricles in the brain
- Reduction in glucose in key regions of the brain
- Shrinkage of the part of the brain known as the hippocampus
Who’s at Risk?
Those at the greatest risk for MCI are those who have the APOE-e4 gene, which is also associated with Alzheimer’s disease. The gene is linked to other forms of cognitive decline, but it is possible that people with the gene may not experience MCI or any other cognitive issues.
Increasing age is another risk factor for MCI.
Other issues may play a role in risk for MCI. These include:
- High blood pressure
- High cholesterol
- Infrequent physical exercise
- Infrequent participation in activities that provide mental or social stimulation
Mild Cognitive Impairment and Dementia
Some people with MCI experience mild initial changes but never see their issues grow or worsen. Others may even find their impairment abates over time or are better able to handle complications associated with their new issues.
However, mild cognitive impairment may increase the risks of later progression into full-fledged dementia.
Dementia may be caused by Alzheimer’s disease or another neurological condition. Out of the whole population of older adults, only 1-2% may develop dementia every year. Among the same population who have MCI, the number grows to 10-15%.
Treating Mild Cognitive Impairment and Dementia
People diagnosed with mild cognitive impairment typically visit their neurologist every 6 months to evaluate their symptoms. Regular checkups provide an understanding of symptoms and whether symptoms are steady, increasing in severity, or improving.
These regular checkups also provide an opportunity to assess dementia at its onset.
Currently, there are no approved medications for treating mild cognitive impairment. Those drugs used to treat symptoms of Alzheimer’s disease have not yet shown to provide any benefit to those with MCI nor do the drugs delay or prevent progression to dementia.
Instead, some studies show that lifestyle factors are the most effective treatments for slowing potential decline.
Regular exercise benefits the body’s blood vessels, including blood vessels in the brain. In some cases, MCI is related to a lack of blood flow in the brain.
Omega-3 fatty acid supplementation may help halt the progression of MCI, according to one study that shows that low levels of Omega-3s are associated with accelerated brain aging and cognitive decline.
Protecting the cardiovascular system is also considered to be a potential treatment strategy because it also protects the body’s heart and blood vessels, including those serving the brain.
Finally, those with MCI are encouraged to participate in activities they find mentally and socially stimulating.
Supporting Loved Ones with Cognitive Impairment
Family and friends of those with MCI can help their loved one live a productive and independent life by:
- Accepting the reality of memory loss
- Recognizing signs and symptoms
- Treating their loved one like an adult
- Encouraging strategies for usefulness, success, and nurturing
- Providing moments to allow them to remember or find their train of thought
- Avoiding being over protective
Those living with MCI can live full, happy lives. Living with MCI is not a sign that a person should sit back and wait for Alzheimer’s disease to arrive.