Posted on December 9, 2015
Cognitive decline is normal as the brain and body age. The most common extreme memory conditions are dementia and Alzheimer’s, which is a form of dementia. However, a lesser-known condition called Mild Cognitive Impairment (MCI) also exists and affects between 10 and 20 percent of seniors in the United States.
MCI signifies a stage of cognitive impairment that surpasses the normal and expected age-related changes, but a person’s functional activities remain largely intact and therefore do not meet the criteria for dementia.
Many people notice their own gradually increasing forgetfulness as they age. For example, it may take longer to think of a word or to recall a person’s name. MCI involves problems with memory, language, thinking, and judgment that are greater than typical age-related changes. With MCI, family or friends may notice a change, but these changes aren’t severe enough to interfere with day-to-day life and usual activities.
The Mayo Clinic lists these risk factors for developing MCI: increasing age; some medical conditions such as diabetes, high blood pressure, and elevated cholesterol; lack of physical exercise; and infrequent participation in mentally or socially stimulating activities.
Signs and symptoms of the different stages of cognitive decline
Source: Mayo Clinic and National Institutes of Health
|Normal Cognitive Decline||Mild Cognitive Impairment||Dementia|
|Memory functions that remain relatively stable with increasing age:||Forgetting things more often||Dementia usually first appears as forgetfulness|
|Facts and general knowledge about the world remain stable with age, especially if the information is used frequently. However, retrieval of highly specific information, such as names, typically declines.||Forgetting important events such as appointments or social engagements.||Difficulty performing tasks that take some thought, but that used to come easily. Examples include balancing a checkbook, playing games (such as bridge), learning new information or routines, preparing meals, and choosing clothing.|
|Acquistions and performance of cognitive and motor skills.||Losing a train of thought or the thread of conversations, books, or movies.||Getting lost on familiar routes and misplacing items.|
|Memory functions that increase with age:||Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task, or interpreting instructions.||Getting lost on familiar routes and misplacing items.|
|Working memory – Holding and manipulating information in the mind such as reorganizing a short list of words into alphabetical order.||Start to have trouble finding the way around familiar environments.||Losing interest in things previously enjoyed or having a flat mood.|
|Episodic memory – personal events and experiences.||Becoming more impulsive or showing increasingly poor judgement.||Experiencing personality changes and loss of social skills, which can lead to inappropriate behaviors.|
|Processing speed.||Family and friends noticing any of these changes.||Experiencing personality changes and loss of social skills, which can lead to inappropriate behaviors.|
|Prospective memory – the ability to remember to perform an action in the future such as remembering an appointment or to take a medication.||Depression||Seeing changes in sleep patterns|
|The ability to remember new text information, to make inferences about new text information, to access prior knowledge in long-term memory, and to integrate prior knowledge with new text information.||Irritability and aggression.||Forgetting details about current events and events in your own life history; losing awareness of who you are.|
|General recall ability.||Irritability and aggression.||Having delusions, depression, or agitation.|
|Anxiety and apathy||Having poor judgement and losing the ability to recognize danger.|
See a physician for help if experiencing an increase in the number of memory-challenged episodes. A healthcare provider can perform tests that will indicate what is going on. The physician may perform a quiz on thinking, memory, and language skills to see if the senior has MCI, and he may refer the patient to a specialist for more tests. MCI may be an early sign of Alzheimer’s so it’s really important to see a healthcare provider every 6 to 12 months.
When attempting to diagnose MCI, doctors use the following benchmarks, which a panel of international experts developed:
- The patient has problems with memory or another mental function such as planning, following instructions, or making decisions. Ideally, a person’s own impressions are corroborated by someone else close to you.
- You’ve declined over time. A careful medical history reveals that your ability has declined from a higher level. Again, this change is ideally confirmed by a family member or a close friend.
- Your overall mental function and daily activities are not affected. Your medical history shows that your general abilities and daily activities are basically not impaired, although specific symptoms may cause worry and inconvenience.
- Mental status testing shows a mild level of impairment for your age and education level.Doctors often assess mental performance with a test such as the Mini-Mental State Examination (MMSE). More detailed neuropsychological testing may show the degree of memory impairment, which types of memory are most affected, and whether other mental skills are also impaired.
- Your diagnosis is not dementia. The problems that you describe and that your doctor documents through corroborating reports, your medical history, or mental status testing are not severe enough to be diagnosed as Alzheimer’s disease, which is a type of dementia. In that case, your doctor may give you a neurological exam that tests for other diseases that impair memory and physical functioning. Lab tests can help to pinpoint other problems such as a vitamin B-12 deficiency. An MRI or CT scan of your brain helps to rule out brain tumor, stroke or bleeding.
Treatment through home remedies and lifestyle
Changing lifestyle habits can make you feel better overall and may help to deter mental decline. These include:
- Regular exercise
- A diet low in fat and rich in fruits and vegetables
- Omega-3 fatty acids, which are also good for the heart
- Social engagement and intellectual stimulation, which may make life more satisfying and help preserve mental function
The Journal of the American Medical Association has a guide on MCI. Click here to obtain a copy.
Currently, there is no cure or treatment for mild cognitive impairment. If you believe that you are experiencing MCI symptoms, contact your doctor for further evaluation. MCI does not necessarily lead to dementia and Alzheimer’s although those who have MCI are at a greater risk for developing these conditions. It’s good to know that many people who have MCI remain at a steady level of cognitive ability or even improve their symptoms. Work with your doctor for optimum results and the best approach to treatment.
Submitted by Gabriela Brown, CSA
Constant Companions, Home Care San Diego and S.W. Riverside
Content provided by Society of Certified Senior Advisors