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Mild Cognitive Impairment

Mild Cognitive Impairment (MCI) is a decline in cognitive function that may include compromised memory, language, or critical thinking. It is considered more serious than expected age-related decline but less serious and concerning than dementia. Some cases of MCI proceed to dementia and some do not, making such impairment especially alarming for some who experience it. A person with symptoms of impairment might begin losing items, for example, or forget scheduled appointments. While these changes are notable to the individual, they do not routinely interfere with activities of daily living.

What Is Mild Cognitive Impairment?

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Neurologists divide MCI into two broad categories: amnestic impairment, in which memory loss is the predominant symptom, and non-amnestic impairment, in which other cognitive areas, such as decision-making or spatial orientation, are primarily affected.

Is mild cognitive impairment serious?

As we age, we expect some decline in cognitive abilities. However, mild impairment is that middle ground between a normal age-related cognitive loss and more serious diminishment of function. MCI can impact a person’s judgment, speech, and reasoning.

At what age does cognitive decline start?

A minor decline in cognitive function can appear as early as the late twenties, but such decline is less pronounced until middle age, and it becomes more and more apparent among septuagenarians and people who are older.

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Diagnosing MCI

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Clinicians rely on brief neurocognitive tasks, such as the mini-mental status exam, in which a patient is asked to state the current date, day of the week, and remember lists of items. Doctors also conduct family interviews and screen for comorbid conditions, such as depression, when deciding on a diagnosis.

What factors contribute to MCI?

It is important to rule out the side effects of medication, neurovascular problems, sleep deprivation, depression, or other factors that may be contributing to MCI and do not represent an underlying neurological process.

 

Can MCI progress to dementia?

In some cases, MCI will progress to dementia and Alzheimer’s. An American Academy of Neurology report states that individuals 65 and older with MCI are three times more likely to develop dementia and Alzheimer’s than members of the general population who do not exhibit these symptoms.

The Causes of MCI 

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MCI affects about 6 percent of 60-year-olds and 25 percent of 80-year-olds, most of whom do not go on to develop neurodegenerative disorders, according to a 2018 report by the American Academy of Neurology. MCI is a complicated condition that involves many potential causes, both genetic and environmental, with age perhaps the most universal factor.

Can stress cause cognitive impairment?

Chronic stress will increase levels of the hormone cortisol, which in turn can shrink the brain and its function. Stress also contributes to the development of Alzheimer’s as well as dementia.

 

Is MCI genetic?

The ε4 allele of the APOE gene is strongly associated with MCI and Alzheimer’s in both men and women. However, it is unclear whether this variant of the gene just influences the chances of getting the diagnosis or if it also promotes conversion of MCI to Alzheimer’s or dementia.

Treating MCI

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Due to the complicated nature of the condition, treatment is best when tailored to each individual, which can range from taking the person off of a medication that might contribute to cognitive dysfunction to discussing care and planning for the future.

Are there medications for MCI?

There are currently no FDA-approved drugs for treating MCI, and there is limited evidence that any drugs or supplements are effective.

 

Does self-care make a difference?

Some lifestyle choices have been linked to better brain health, including regular physical activity, continuous learning, and social engagement. Dietary recommendations include adequate folic acid intake and a regimen high in fruits and vegetables and low in sugar, alcohol, and saturated fats.

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