Mild Cognitive Impairment


Age-related changes in brain function can be classified as “mild cognitive assessment.” This isn’t dementia. It’s not as bad as dementia. But the person does have worse memory (both short-term and long-term) and is less able to accurately reason and to learn new things. Complex tasks may become more difficult, and the person’s social skills may decline and they may have apathy or depression. Cognitive abilities underlyi the mechanisms of intelligence, so a person with MCI loses some intelligence, although he or she may still be smart. Amnesic MCI is when the person forgets things (people, location of objects, conversations). Non-amnestic MCI doesn't show up as memory loss, but the person may find it harded to hold a conversation and may get mixed up doing routine daily activities.

MCI isn’t a disease. It can be called a neurocognitive disorder. It can be considered a prodrome or precursor to dementia, but it’s not so simple that all MCI leads to dementia. There is no biomarker for MCI - nothing in the person’s body that indicates this condition. Doctors employ “clinical diagnosis” to establish if someone has it. If a patient has symptoms the doctor may search for other diseases that cause them; MCI is what’s left if there is no obvious cause. There is no known cause for MCI just as there is no known cause for Alzheimer's disease. Researchers have identified a gene called APOE-e4 that seems to be present in many patients with Alzheimer’s and MCI, but there no causal link between the gene and the conditions have been shown.

The person with MCI may notice he or she has reduced capacity and friends and family may also notice. There are tests health care professionals can administer but there is no immediate need to do so. MCI does not typically interfere with the patient’s day to day life. Further, the dividing line between decline due to normal aging and MCI is not firm. The occasional "senior moment" does not indicate MCI if it does not affect the person's life.

There’s also no treatment for MCI that is approved by the FDA. Many herbal supplements are sold that promise to help with memory, but these are unregulated and there is no medical consensus they work. Scientists have tried giving MCI patients the drugs used to treat Alzheimer’s (cholinesterase inhibitors and memantine) in hope that this will forestell the onset of dementia, but there is no evidence these help. Even so, the National Institute on Aging recommendeds people with MCI see a doctor regularly to keep tabs on the condition.

Mentally engaging games such as bridge and chess have been shown to help seniors maintain high scores on IQ tests, but it is not known whether this applies to people with MCI or dementia.

MCI sometimes progresses to dementia - it is estimated that this happens in a quarter to a third of people - but some patients live with it for years. Whether (some) cases of MCI are simply the early stage of Alzheimer's Disease is not clear.

Cognitive Fitness

Cognitive fitness is a term for procedures and practices people can do to prevent the onset of mild cognitive impairment, dementia, or any loss of mental functioning. It is supposed to be analogous to physical fitness, which may be defined as the ability of the body to respond to set challenges and to allow the person to thrive.

Framing brain function in terms of cognitive fitness puts the emphasis on what a person can do to stay sharp, rather than the passive approach of accepting decline as an inevitable disease. The recommendations for maintaining cognitive fitness are familiar: eat right, exercise, get enough sleep, have a social life, don't live with high levels of stress, and challenge yourself through puzzles, reading, learning new things.

Cognitive Reserve

How we think - how our brain does what it does - may affect how resilient we are to impairment. The brain is still little misunderstood so psychologists and neuoroscientists have come up with the idea of cognitive reserve to describe this ability to cope with disease or injury to the brain. Although not fully characterized, the connection between prevalence of dementia and life experiences are taken seriously by gerontologists. Educational achievement may correlate with cognitive reserve. People who used their brain for much of their lives are better able to cope with illness.

Testing and Assessment

MCI is a clinical diagnosis; there is no medical sign that shows up in a laboratory test. A doctor can do thinking, memory, and language tests to see if a person has MCI. The Alzheimer's Association website recommends some assessment tests. These include the Mini-Cog (which can be done in three minutes), the General Practitioner Assessment of Cognition (website), the Short Informant Questionnaire on Cognitive Decline in the Elderly, and the Eight-item Interview to Differentiate Aging and Dementia. Sometimes friends and family get involved.

Do doctors do these tests for MCI? Usually no. There is little action if the person has MCI so many feel there is little reason to diagnose it.