Mild cognitive impairment (MCI)

As you grow older, a decrease in your brain's cognitive functions – including memory and thinking – is normal. However, if you notice slight problems with your mental abilities that's more than other adults your age, you may have mild cognitive impairment (MCI).

Mild cognitive impairment, also known as mild cognitive dysfunction, is a phase between the typical cognitive decline after age 65 and more serious neurodegenerative conditions. MCI is a risk factor for developing Alzheimer’s disease or other forms of dementia.

While the symptoms of MCI usually don't disrupt your daily life, it's crucial to speak with your doctor. Some causes of mild cognitive impairment are treatable and it’s possible to stabilize or regain regular cognitive functioning. It's important to monitor MCI with your health care team to catch any signs the condition is advancing.

What is mild cognitive impairment?

Cognitive impairment occurs when your brain function changes. These changes also occur with other neurodegenerative conditions, but they happen to a lesser degree.

Other neurodegenerative conditions include:

• Vascular dementia
• Lewy body dementia
• Frontotemporal dementia
• Alzheimer’s disease
• Parkinson’s disease

Changes in your brain that are associated with mild cognitive impairment include:

• Build-up of protein clumps called Lewy bodies in the brain, which is also associated with Lewy body dementia, Parkinson’s disease and Alzheimer’s disease.
• Abnormal enlargement of your brain’s ventricles, which puts pressure on your brain.
• Lack of sufficient blood flow through your brain’s blood vessels, which may cause small strokes and eventually lead to vascular dementia.
• Lack of glucose in the brain, which is the main source of energy for your cells.
• Decrease in the size of your hippocampus, which plays a major role in your learning and memory.
• Increase in tau proteins or beta-amyloid proteins, which are also associated with Alzheimer’s disease.

With MCI, you might find it tricky to remember words or struggle a bit with complex tasks, but you can still take care of yourself and enjoy your usual activities. The symptoms might stay the same or improve with treatment.

Other neurodegenerative conditions have more serious symptoms that impact your daily life. And unfortunately, these symptoms tend to get worse as time goes on.

Causes of MCI

There’s no definitive cause of mild cognitive impairment. Many factors may impact your cognitive performance. Sometimes, these causes can be treatable.

Causes of MCI include:

• Sleep disorders like sleep apnea
• Excessive alcohol use
• Blood clots or tumors in the brain
• Side effects of certain prescription medications
• Head injuries
• Thyroid, kidney or liver problems
• Vitamin B12 deficiency
• Depression and anxiety
• Infections like a urinary tract infection (UTI)

Risk factors of MCI

Mild cognitive impairment can have various risk factors. Family history and genetics usually play the biggest role in developing MCI.

Other risk factors for MCI include:

• Family history of dementia
• Age 65 or older
• Diabetes
• Stroke
• Depression
• High cholesterol levels
• High blood pressure

Can you recover from mild cognitive impairment?

It’s possible to return to your normal cognitive function, especially if your cause of MCI is reversible. Reversible causes include sleep apnea, vitamin B12 deficiency and side effects from medications.

How fast does mild cognitive impairment progress?

If you have mild cognitive impairment, there's a higher chance of progressing to another type of dementia. MCI can act as the initial phase of these conditions. Research indicates that within two years of an MCI diagnosis, about 15% of individuals aged 65 or older went on to develop dementia.

MCI symptoms

There are two main types of mild cognitive impairment symptoms – amnestic MCI (primarily affects memory) or nonamnestic MCI (primarily affects areas of thinking other than memory). Amnestic MCI is the most common type of MCI symptom. Sometimes, you may also experience movement problems or the loss of your sense of smell.

Amnestic MCI symptoms include:

• Misplacing items frequently
• Forgetting important information like appointments
• Repeating the same questions or stories

Nonamnestic MCI symptoms include:

• Trouble completing complex tasks
• Problems with decision making
• Losing attention easily
• Difficulty coming up with the right words

Diagnosing MCI

Diagnosing mild cognitive impairment can be challenging due to overlapping symptoms with other conditions. Regardless, it’s crucial to accurately diagnose MCI to prevent complications.

During your appointment, your doctor will discuss your family history, current medications and symptoms. If a family member has observed your symptoms, bringing them along could be beneficial. Following this, your doctor will conduct a series of tests to confirm the diagnosis, eliminate other potential conditions and identify any underlying causes of MCI.

Tests may include:

• Cognitive testing: Includes verbal and written testing that evaluates your mental abilities.
• Neurological exam: Tests your eye movements, reflexes and balance.
• Blood or urine tests: Checks your thyroid levels and looks for vitamin deficiencies.
• CT or MRI scan: Looks for brain tumors, signs of stroke or bleeding in the brain.
• Spinal tap (lumbar puncture): Checks your cerebrospinal fluid (CSF) for neurodegenerative diseases.

MCI treatment

Your mild cognitive impairment treatment plan will be tailored specifically for you. Your doctor will consider various factors, such as your age, any identified causes of MCI and your medical history. You’ll have regular appointments with your doctor to monitor how your symptoms are progressing.

If there are reversible causes, your doctor will work with you closely to manage your treatment while minimizing potential side effects. For some, neurological physical therapy may help regain lost function.

Researchers are actively exploring new approaches to treat MCI. One promising treatment involves the potential use of medications designed for Alzheimer’s disease.

Preventing MCI

Prioritizing good cognitive health is crucial if you are at risk of developing mild cognitive impairment. This involves incorporating regular exercise into your routine, adopting a healthy diet that includes Omega-3 fatty acids and actively engaging your brain. Research indicates that activities such as playing word games, socializing and reading books can contribute to preserving your brain function.