Cognitive health is vastly underestimated. We use our cognitive skills all the time. At the moment, you’re reading this post and using cognitive abilities to do so.
Various problems can impair cognition and cause a number of symptoms, especially as we age. In this post, we are going to focus on mild cognitive impairment and its symptoms, causes, treatment options, and more.
What is mild cognitive impairment?
Mild cognitive impairment (MCI) is defined as a stage between the expected cognitive decline of the normal aging process and the more serious decline of dementia.
Cognitive changes in MCI are serious enough to be noticed by the affected person, family, and friends. However, at this point, the cognitive changes do not affect a person’s ability to carry out daily activities.
The healthy aging process and MCI are often mistaken and misunderstood. Normal age-related cognitive decline is subtle and primarily affects the attentional control and speed of thinking. On the other hand, abnormal age-related decline, such as MCI, is more severe and may include thinking abilities and impairments in the motor system. Cognitive change in MCI is more noticeable.
It’s also useful to differentiate between MCI and dementia. Based on the symptoms, it’s easy to think they’re the same thing. Mild cognitive impairment means the cognitive deficit doesn’t affect performance with daily tasks, whereas dementia indicates a person is unable to perform everyday activities anymore.
Not all cases of MCI are the same. We can distinguish between two types of mild cognitive impairment. These include:
- Amnestic MCI – clinically significant memory impairment that doesn’t meet the criteria for dementia. Other cognitive functions are spared, though. Persons with amnestic MCI are at a higher risk of Alzheimer’s dementia.
- Non-amnestic MCI – memory remains intact, but one or more of the other cognitive abilities are significantly impaired. Individuals with non-amnestic MCI are at a higher risk of developing other dementias, e.g., frontotemporal dementia, dementia with Lewy bodies, Parkinson’s disease, vascular dementia, and primary progressive aphasia.
We can also divide mild cognitive impairment into a single cognitive domain and multiple domains MCI. In a single-domain mild cognitive impairment, only memory or one other domain of cognition is impaired. In multiple domains MCI, people experience impairments of memory plus one or several other domains of cognition. Having multiple domains MCI also increases the likelihood of developing dementia.
Mild cognitive impairment may increase the risk of dementia caused by Alzheimer’s disease or other neurological factors. However, not all MCI patients develop dementia. Some people don’t get worse.
What are the symptoms of mild cognitive impairment?
Cognitive impairment doesn’t develop out of the blue. Instead, it develops gradually over the years. You may notice that forgetfulness worsens gradually, or it takes longer to remember someone’s name. We can also notice these symptoms in other people.
However, sometimes these problems go away once we get more rest and relieve stress, but a bigger issue could be involved if they happen persistently. You see, this cognitive disorder may go beyond what we expect. Some of the most significant signs and symptoms of mild cognitive impairment include:
- Forgetting things more often.
- Becoming more impulsive or exhibiting increasingly poor judgment
- Forgetting important events, appointments, etc.
- Difficulty finding way around familiar environments
- Losing train of thought or thread of conversations, movies, books
- Making decisions becomes increasingly overwhelming.
- Friends and family members became concerned about any of these changes.
Basically, mild cognitive impairment involves memory loss, language problems, attention difficulties, and other issues with cognitive ability.
The exact symptoms may vary depending on whether a person has amnestic mild cognitive impairment or non-amnestic mild cognitive impairment.
It’s also important to mention that a person with MCI may also have a mental disorder such as depression, anxiety, apathy, and display signs of irritability and aggression.
What are the causes?
A single cause of mild cognitive impairment doesn’t exist. Cognitive impairment often, but not always, stems from a lesser degree of the same types of brain changes observed in Alzheimer’s disease and other forms of dementia. Some of these changes include:
- Small strokes of decreased blood flow through blood vessels in the brain
- Lewy bodies, microscopic clumps of a protein linked with Parkinson’s disease, some cases of Alzheimer’s disease, and Lewy body dementia
- Abnormal clumps of beta-amyloid protein, i.e., plaques, and microscopic protein clumps of tau characteristic of Alzheimer’s, i.e., tangles
Mild cognitive impairment may be associated with changes such as the hippocampus’s shrinkage, a brain region important for memory. Enlargement of the brain’s ventricles (fluid-filled spaces) and decreased glucose use in key brain regions are also related to mild cognitive impairment.
The exact cause that leads to these changes is still unknown. A lot more studies are necessary to uncover mechanisms underlying the development of cognitive dysfunction.
Everyone can develop MCI, but some people have a higher risk than others. Generally speaking, a risk factor for MCI includes:
- Advancing age (MCI is more common in older adults)
- Carrying a specific gene, APOE e4, which is also associated with Alzheimer’s disease
- Hypertension (high blood pressure)
- High cholesterol
- Sedentary lifestyle
- Low education level
- Social isolation
Remember that having one or several of these factors doesn’t necessarily mean you will develop MCI. Cancer can also induce some cognitive changes. But these changes don’t necessarily mean you have MCI. It’s useful to keep that in mind and consult your doctor.
How many people with MCI develop dementia?
Cognitive problems are common, including MCI. According to the American Academy of Neurology study, the prevalence of MCI among people aged 60-64 is 6.7%.
Moreover, 8.4% of people aged 65-69 have mild cognitive impairment. Prevalence of mild cognitive impairment in age group 70-74 is 10.1%, 14.8% for 75-79, and 25.2% for 80-84.
The incidence of cumulative dementia in individuals older than 65 with MCI is 14.9%.
Figures reveal that 10% to 15% of people with MCI develop dementia each year.
If you experience one symptom or multiple signs of MCI and are persistent, it’s useful to schedule an appointment to see the doctor. If your friend or family member behaves in a way we described above, you may want to encourage them to see the doctor.
A specific set of tests to diagnose mild cognitive impairment doesn’t exist. However, your doctor may conclude MCI is the culprit based on the symptoms you describe. Many doctors diagnose mild cognitive impairment with the help from criteria developed by international experts. These criteria for the diagnosis of MCI include:
- Problems with memory or another mental function such as planning, making decisions, following instructions
- Cognitive abilities declined over time.
- Overall mental function and daily activities aren’t affected.
- Mild level of impairment for a patient’s age/education level present at mental status testing
- No dementia diagnosis
Your doctor may also perform a neurological exam to test reflexes, eye movements, walking, and balance. These tests indicate how well the brain and the nervous system are working. They can help detect cognitive impairments.
To rule out physical causes of the symptoms, the doctor will order lab tests to check for vitamin B12 deficiency or hypothyroidism (underactive thyroid gland).
Brain imaging such as CT or MRI can help determine whether there’s a tumor, bleeding, or stroke.
All these tests help doctors rule out other causes of the symptoms you experience. That way, your doctor can give a precise and accurate diagnosis. Your doctor may also provide short mental, i.e., cognitive tests to assess memory, attention, short-term recall, and other brain functions.
Sometimes, more in-depth tests are necessary for the form of neuropsychological testing. This test evaluates memory, planning, ability to understand information, decision-making, language, and other complex thinking tasks.
Once the doctor diagnoses mild cognitive impairment, they will recommend the most suitable intervention option. It’s useful to keep in mind that the FDA specifically approves no drugs or treatments to treat MCI. This condition is a broad subject, and scientists are working on clinical trials and clinical studies that would yield therapeutic approaches specifically targeting MCI.
The absence of a specific treatment doesn’t mean there’s nothing you can do about it.
In some cases, doctors prescribe cholinesterase inhibitor, a drug approved for Alzheimer’s disease. These drugs are most suitable for MCI patients with memory disorders. However, you need to bear in mind cholinesterase inhibitors aren’t the recommended routine treatment for MCI.
Treating reversible causes can also aid the management of MCI. Some medications can negatively affect cognitive function and contribute to MCI-related cognitive symptoms. These drugs include:
- Anticholinergics – affect chemicals in the nervous system and treat various conditions.
- Antihistamines – for allergy symptoms
- Benzodiazepines – treat sleep disturbances, seizures, and anxiety.
- Opioids – treat pain.
- Proton pump inhibitors – treat GERD (gastroesophageal reflux disease)
You shouldn’t stop taking these drugs without a doctor’s approval. Instead, discuss medications with your doctor. Report all medications you’re taking, and the doctor will advise you whether to start taking other drugs or tweak the dosage.
Besides medications, managing certain conditions that affect cognitive functioning can also promote the management of MCI. These conditions include:
- High blood pressure
- Sleep apnea
Management of hypertension is crucial because vascular risk factors play a role in the development of MCI.
You can also sign up to be a part of clinical trials that explore MCI and strive to develop therapeutic approaches to manage it more effectively. If there are no clinical studies in your area, you may want to read about the latest developments in the world.
Thanks to internet access, it’s easy to find the most recent news on any subject, including this one. The more you explore, the more you’ll know about treatment options.
Tips on managing mild cognitive impairment
There are no products or herbal medicines that would eliminate mild cognitive impairment entirely. The role of a healthy lifestyle in the management of MCI is still largely unknown, but it’s still something worth trying.
You see, a healthy lifestyle supports general health and wellbeing, and it’s important for cognitive health. It’s useful to make specific lifestyle changes that would support your health, especially if you have a condition associated with MCI.
These healthy lifestyle changes may include:
- Regular exercise
- Social engagement
- Low-fat diet
- Increased consumption of fruits and vegetables
- Increased intake of Omega-3 fatty acids
- Intellectual stimulation, e.g., reading books, writing, etc.
- Memory training
If you don’t have MCI, it’s possible to reduce the likelihood of developing this condition. Of course, this includes a healthy lifestyle. The best thing you can do to maintain brain health is to exercise twice a week.
Aerobic exercise is vital for brain health, but you may also want to sign up for a gym class or do any other physical activity you like.
You should also maintain good blood pressure, quit smoking, eat a well-balanced diet, maintain weight in a healthy range. Stress management and proper sleep are also crucial for brain health.
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Mild cognitive impairment is a common problem, but people often mistake it for normal aging or even dementia. Specific diagnostic tests and treatment approaches for MCI don’t exist, but hopefully, in the future, they will. A healthy lifestyle is important for the prevention of mild cognitive impairment and could also contribute to its management.