What is mild cognitive impairment?

Mild cognitive impairment, or MCI, occurs when you notice a minor decline in your mental ability as compared to others your age. Mental abilities include the following:

• Reasoning and judgment
• Memory
• Plans and carrying out complicated tasks

The person themselves may notice these changes in capabilities or a family member may do so. However, these changes are not so severe as to interfere with activities of daily living.

What are the signs of minor cognitive impairment?

The main symptom of mild cognitive impairment is that of slight decline in the mental abilities. For example, one might forget about recent events or ask the same questions and tell the same stories repeatedly. One forgets friends' and family members' names and sometimes forgets appointments and planned events. In addition, you lose items more often.

• Language problems: You could not find the right words. You also can't understand written or verbal information as good as you did.
• Attention: You are likely to lose focus easily, as well as being distracted from what you used to do.
• Reasoning and judgment: You may have difficulty problem-solving and making decisions.
• Complex planning: It is much more difficult to plan and/or finish complex tasks, for instance, paying bills, taking medications, shopping, cooking, household cleaning and driving.

Other issues that MCI is also associated with are movement difficulties and problems with your sense of smell.

Mild cognitive impairment has many causes. Some are treatable; some aren't.

Some examples of reasons might include:

• Depression, chronic stress and anxiety
• Problems with thyroid, kidney or liver
• Sleep apnea and other sleep disorders
• Conditions that affect blood flow in your brain, like tumors, blood clots, stroke or traumatic brain injury
• Vitamin B12 deficiency and other nutrient deficiencies
• An infection, e.g. urinary tract infection (UTI)
• Side effects of certain prescription medications: calcium channel blockers; anticholinergic drugs; benzodiazepines; others
• Substance use disorder, alcohol use disorder
• MCI is also an early form of certain neurodegenerative diseases. Thus, MCI can be an early form of:
• Alzheimer’s disease.
• Parkinson’s disease.
• Lewy body dementia.
• Vascular dementia.
• Frontotemporal dementia.

There are many reasons that can lead to mild cognitive impairment. Some can be treated, while some cannot.

Some of the possible reasons include:

• Depression, chronic stress and anxiety
• Thyroid, kidney or liver problems
• Sleep apnea and other sleep disorders
• Conditions that affect blood flow in your brain, such as tumors, blood clots, stroke or traumatic brain injury
• Vitamin B12 deficiency or other nutrient deficiencies
• Such infections as urinary tract infection
• Side effects of certain prescription medications, for example: calcium channel blockers and anticholinergic drugs like barbital and others
• Substance use disorder, alcohol use disorder MCI is early in life for some neurodegenerative diseases.

MCI can be "early" form according to:

• Alzheimer's disease.
• Parkinson's disease.
• Lewy body dementia.
• Vascular dementia.
• Frontotemporal dementia.

How is mild cognitive impairment diagnosed?

There is no single test that may be used in diagnosing mild cognitive impairment. A diagnosis involves the physical exam and medical history of the patient, combined with specific diagnostic tests.

Diagnosis typically requires a set of tools that help exclude other potential conditions and aid in gaining insight into the patient's condition. Among the diagnostic tests employed are the following:

• Neurological exam
• CT scan
• Mental status examination
• Blood tests
• MRI

How is mild cognitive impairment treated?

Treatment for MCI depends upon the identified cause. However, some cases of MCI from neurodegenerative diseases cannot be reversed. Your healthcare provider will devise a treatment plan if your mental changes are due to causes like an infection, sleep problems, or mood or medication side effects.

It has not approved any drugs specifically for the treatment of mild cognitive impairment. However, there are treatment plans with non-medication interventions to enhance cognitive function. They differ according to the cause of MCI. Scientists believe that Alzheimer's disease medications might be useful in MCI treatment. They are investigating this.

Active treatment research is ongoing for MCI. You may be able to participate in a research study. Discuss your treatment choices with your provider.

Can MCI be prevented?

Not all MCI is preventable. But you can take steps to keep your brain healthy and reduce your chances of MCI. These include:

• Not smoking or quitting smoking
• Abstaining from alcohol or drinking in moderation
• A healthy, balanced diet.
• Regular exercise.
• Healthy blood pressure and cholesterol, and blood sugar.
• Reducing and managing stress.
• Quality sleep.
• Engage your brain by doing puzzles, reading, learning new skills and similar activities.
• Social activities
• Regularly visit your health care provider to manage any chronic conditions you have.

What is the prognosis for mild cognitive decline?

The prognosis (outlook) for mild cognitive decline depends on the cause and other factors. Researchers are still learning more about this condition.

Studies reveal that approximately 15% of patients older than age 65 years with MCI developed dementia within two years after the diagnosis of the first MCI. Additionally, they indicate that between 14% to 38% of the patients diagnosed with MCI returned to their usual cognition.

How can I maintain my well-being if I have mild cognitive impairment?

If you are diagnosed with MCI, you might consider discussing your future with your doctor as well as other people you may trust. This is more important if your doctor believes your MCI is the earliest stage of a neurodegenerative disease, such as Alzheimer's. Such talks are significant because they may prevent caregivers from acting against your will, should you not be in a position to decide what you want when that day comes.

In addition to those conversations, you should put your wishes and decisions in writing. That includes preparing documents connected to legal issues and what happens if you can't care for yourself or make decisions for your care or well-being.

When should I see my doctor?

Because MCI might be an early manifestation of more serious neurological conditions, a patient should visit a doctor or specialist every six to 12 months. This might depend on the patient's treatment plan. A patient's provider can follow any changes in memory and thinking skills over time and suggest any change that might be relevant to your health. A patient might also keep a personal record of such changes.

If you develop any new symptoms, see your provider.

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