Mild Cognitive Impairment

Overview

Mild cognitive impairment (MCI) causes mild cognitive symptoms greater than expected for a patient’s age. MCI causes impaired thinking and memory that can be worrisome to patients and their loved ones but does not affect the patient’s ability to perform everyday activities. While patients with MCI are more likely to develop Alzheimer’s disease and other dementias compared to those without MCI, patients do not always progress to another type of dementia.

Types

  • Amnestic MCI is the most common type of MCI and causes forgetfulness and memory impairment.
  • Nonamnestic MCI is a decline in cognitive abilities not related to memory.

Symptoms

  • Forgetfulness such as forgetting to go to appointments or meetings
  • Impaired interpretation of visual and spatial clues
  • Impaired problem-solving
  • Language impairment, word-finding difficulties
  • Often losing or misplacing items such as car keys
  • Problems with attention

Prevention

The causes of MCI are not completely understood at this time, but there are some proven and speculated theories on prevention:

  • Avoid smoking.
  • Eat a healthy, balanced diet (such as the Mediterranean diet or other diet recommended by your provider).
  • Ensure adequate control of conditions that increase the risk of heart disease and stroke.
  • Keep active:
    • Mentally by learning a new hobby, skill or language. Play games or solve puzzles
    • Physically by engaging in regular exercise, unless your doctor has advised against it due to comorbid issues
    • Socially by gathering or speaking regularly with others
  • Limit alcohol consumption to only moderate levels.
  • Treat hypertension. A large, randomized clinical trial shows that treating hypertension reduces the risk of MCI.

Risk Factors

  • Advanced age
  • Diabetes
  • Excessive alcohol consumption
  • Family members with a history of dementia
  • Heart disease
  • High blood pressure
  • High cholesterol
  • Medical conditions or modifiable risk factors that raise the risk of heart disease and stroke: 
  • Obesity
  • Sleep apnea
  • Smoking

Diagnosis

  • Medical history and symptom review. The provider will review your symptoms and inquire about your ability to perform daily tasks.
  • Physical examination. The doctor will perform a neurologic exam and cognitive assessment testing.
  • Imaging tests. While imaging tests don’t help confirm a diagnosis of MCI, MRI or CT may be ordered to rule out other conditions if deemed appropriate.

Treatment

Unfortunately, there is currently no proven treatment for MCI, but since it can sometimes progress to other forms of dementia for which there are proven treatments, patients should be periodically reevaluated. One may also consider:

  • Employing a healthy lifestyle and staying active to improve overall health and well-being
  • Keeping a routine such as putting keys or other frequently lost items in the same place each day

Follow-up Care

  • Periodic reevaluation (usually every 6–12 months) to assess any changes or progression of the condition
  • Follow-up for abrupt changes in symptoms