As people age, the brain — like the rest of the body — experiences physiological effects of aging. These effects can impact a person’s ability to think clearly, and to remember pertinent information.
Mild cognitive impairment is a medical condition and ICD-10 diagnosis, which may represent an early phase of an ongoing neurodegenerative process that can worsen with increasing age. The good news is that early detection and treatment of MCI can help mitigate its symptoms.
What Are the Signs of Mild Cognitive Impairment?
Part of the medical definition of mild cognitive impairment is that the person’s deficits aren’t serious enough yet to have a serious, noticeable impact on their activities of daily living (“ADLs” in medical parlance.)
The person can still manage most things they need to do in their day-to-day life. This includes things like preparing food, bathing, paying bills, and other routine things that everyone needs to do. Most of us take these things for granted, but for seniors, neurological problems can begin to interfere in serious ways.
The relatively minor nature of the impairments can sometimes make it hard for the person, or their family and friends, to notice that something is wrong. Unlike full blown dementia, MCI’s signs are usually subtle.
MCI is divided into subtypes, along two axes: amnestic versus non-amnestic, and single domain versus multiple domain.
- Amnestic MCI involves memory loss, and is considered to be an early stage in the development of Alzheimer’s disease. People with this subtype are at a greater lifetime risk of Alzheimer’s.
- Non-amnestic MCI impairs other aspects of cognition, other than memory. This can involve judgement, decision-making, problem-solving, language, and other cognitive domains.
- Single-domain MCI impacts one mental function, whether it’s memory or something else.
- Multiple domain MCI involves more than one function. For example, someone might have both language problems, like forgetting words or losing their train of thought suddenly, and problems remembering things.
Because MCI is a known risk factor for Alzheimer’s and other neurodegenerative diseases of aging, it’s important that it’s detected early.
Diagnosing Mild Cognitive Impairment
If you’re concerned that you or a family member might have MCI, the next step is a consultation with a neurologist. A general practitioner can refer a person if necessary.
To determine whether it’s MCI, the patient will usually undergo some neuropsychiatric testing. These tests are designed to both pinpoint deficits in memory and cognition, and to use specific features of these deficits to pinpoint the underlying cause.
There are also physical biomarkers that can aid in diagnosis. A neurologist or neuropsychiatrist may request neuroimaging studies to look for specific abnormalities in brain tissue, or they may draw cerebrospinal fluid from the person.
Here’s a basic rundown of the diagnostic process for mild cognitive impairment:
- Medical history. The person’s medical history is taken into account. This helps determine if they have a history of any other neurological or psychiatric issues — for example, major depressive disorder can impact memory and cognition. Family history is also examined, as it can impact someone’s susceptibility to MCI and related neurological problems as they get older.
- Assessment of the person’s ability to function independently. What physicians are looking for is changes from what could previously be considered normal for that person.
- Input from family members. A person with MCI isn’t always acutely aware of their own deficits, although this can vary from person to person. For this reason, doctors will often look to family members or very close friends for more insight into the person’s behavior.
- Mental status assessment tests. These tests assess how aware and alert a person is.
- In-office neurological examinations. These routine exams test reflexes, pupillary responses, and other neurological indicators.
- Psychiatric evaluation. As we’ve mentioned, depression and other mood disorders can impact memory and cognition. These form an important differential diagnosis in patients who might have MCI. It’s possible that they’re actually depressed, and need psychiatric treatment instead. This can include medications, as well as various styles of talk therapy.
- Labs and imaging. This looks for physiological abnormalities in the brain and body.
There aren’t any known medications specifically for MCI, but there are peer-reviewed approaches that can help reduce the symptoms and delay the onset of more serious dementia. Unfortunately, drugs like Aricept that work for Alzheimer’s don’t seem to have much effect on MCI.
Some of the actions a person can take include:
- Exercising regularly. This is good for cardiovascular health, including ensuring good blood flow to the brain.
- General cardiovascular health. Along with exercise and lifestyle changes that can improve cardiovascular function, underlying problems with blood pressure or other issues should be treated.
- Staying mentally and socially stimulated. Being social, reading regularly, learning new things, and using services like Lumosity that offer tests targeting specific cognitive functions, can all help sustain healthy brain function and stave off dementia.
Prognosis: Does MCI Get Worse Over Time?
While MCI does increase a person’s risk of later developing more severe dementia, some people with MCI never progress further, and don’t experience any worsening of their symptoms.
It depends on the person, but staying healthy — both mentally and physically — can do a lot to prevent or delay dementia.
With that said, early detection is important. If you or a loved one might be showing signs of MCI, like poor judgement or struggling to remember basic information, it’s always a good idea to have them referred to a neurologist for testing.
For more information on memory care and memory loss, visit Senior Care Center‘s blog. If you are looking for a memory care home for your loved one, give us a call today to speak to a Senior Care Advisor.