Mild cognitive impairment (MCI) refers to problems with memory, attention, language or other cognitive tasks that exceed changes expected with normal aging. Symptoms of MCI often include difficulties and a decline with short term memory and planning, they are often subtle but persistent. The affected person may appear normal and still be working and be able to drive, however by definition, MCI leaves the person’s ability to perform daily activities intact.  

 

“According to an American Academy of Neurology review of dozens of studies, published in 2018, mild cognitive impairment affects nearly 7% of people ages 60 to 64, 10% of those 70 to 74, and 25% of 80- to 84-year-olds.”

 

Causes:

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MCI can be caused by biological processes (the accumulation of proteins and changes in the brain’s structure) linked to Alzheimer disease. However, symptoms of cognitive decline can be caused by other factors including;

·      Small strokes

·      Responses to medications

·      Poorly controlled conditions – diabetes, depression and sleep apnea

·      Thyroid disease

When these issues are treated, further decline can be prevented and normal cognition may be restored. 

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Diagnosis: 

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The process of diagnosis usually begins when an adult or loved one recognises that “something isn’t right with my memory” – a subjective cognitive complaint. MCI isn’t always easy to recognise as people’s thinking and memory changes constantly over time, so the question is often “is this more than that”? Short cognitive tests can confirm whether objective evidence of impairment exists. Other tests can determine whether a person is still able to perform daily activities successfully.

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Progression to dementia isn’t the only path people follow. A sizable portion of patients with mild cognitive impairment—from 14% to 38%—are discovered to have normal cognition upon further testing. Another portion remains stable over time. Still another group of patients fluctuate, sometimes improving and sometimes declining, with periods of stability in between. 

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Treatment:

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Currently there are no approved drug for treating MCI. It was initially hoped that certain Alzheimer's drugs would help with symptoms of MCI, or slow its progression to dementia, however after many trials they have shown no clear benefit to patients. 

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MCI is more likely to progress into dementia if the person has a poorly controlled heart condition or diabetes, or has strokes. Therefore treatment will often be targeted to controlling these conditions. People with MCI should also be encouraged to adopt a healthy lifestyle in order to decrease their risk of developing dementia. It is recommended to stop smoking and not drink above the daily recommended amount fo alcohol. Maintaining a healthy diet, regular exercise and keeping mentally active (for example by doing puzzles, or reading) and socially (for example by seeing friends) also seems to lower your risk of developing dementia. 

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