Overview

Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more-serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes.

If you have mild cognitive impairment, you may be aware that your memory or mental function has "slipped." Your family and close friends also may notice a change. But generally these changes aren't severe enough to significantly interfere with your day-to-day life and usual activities.

Mild cognitive impairment may increase your risk of later progressing to dementia, caused by Alzheimer's disease or other neurological conditions. But some people with mild cognitive impairment never get worse, and a few eventually get better.

Mild cognitive impairment care at Mayo Clinic

Source: http://www.mayoclinic.com

Symptoms

Your brain, like the rest of your body, changes as you grow older. Many people notice gradually increasing forgetfulness as they age. It may take longer to think of a word or to recall a person's name.

But consistent or increasing concern about your mental performance may suggest mild cognitive impairment (MCI). Cognitive issues may go beyond what's expected and indicate possible MCI if you experience any or all of the following:

• You forget things more often.
• You forget important events such as appointments or social engagements.
• You lose your train of thought or the thread of conversations, books or movies.
• You feel increasingly overwhelmed by making decisions, planning steps to accomplish a task or interpreting instructions.
• You start to have trouble finding your way around familiar environments.
• You become more impulsive or show increasingly poor judgment.
• Your family and friends notice any of these changes.

If you have MCI, you may also experience:

• Depression
• Irritability and aggression
• Anxiety
• Apathy

Source: http://www.mayoclinic.com

Causes

There's no single cause of mild cognitive impairment (MCI), just as there's no single outcome for the disorder. Symptoms of MCI may remain stable for years, progress to Alzheimer's disease or another type of dementia, or improve over time.

Current evidence indicates that MCI often, but not always, arises from a lesser degree of the same types of brain changes seen in Alzheimer's disease or other forms of dementia. Some of these changes have been identified in autopsy studies of people with MCI. These changes include:

• Abnormal clumps of beta-amyloid protein (plaques) and microscopic protein clumps of tau characteristic of Alzheimer's disease (tangles)
• Lewy bodies, which are microscopic clumps of another protein associated with Parkinson's disease, dementia with Lewy bodies and some cases of Alzheimer's disease
• Small strokes or reduced blood flow through brain blood vessels

Brain-imaging studies show that the following changes may be associated with MCI:

• Shrinkage of the hippocampus, a brain region important for memory
• Enlargement of the brain's fluid-filled spaces (ventricles)
• Reduced use of glucose, the sugar that's the primary source of energy for cells, in key brain regions

Source: http://www.mayoclinic.com

Diagnosis

There is no specific test to confirm a diagnosis of mild cognitive impairment (MCI). Your doctor will decide whether MCI is the most likely cause of your symptoms based on the information you provide and results of various tests that can help clarify the diagnosis.

Many doctors diagnose MCI based on the following criteria developed by a panel of international experts:

• You have problems with memory or another mental function. You may have problems with your memory, planning, following instructions or making decisions. Your own impressions should be corroborated by someone close to you.
• You've declined over time. A careful medical history reveals that your ability has declined from a higher level. This change ideally is confirmed by a family member or a close friend.
• Your overall mental function and daily activities aren't affected. Your medical history shows that your overall abilities and daily activities generally aren't 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 brief test such as the Mini-Mental State Examination (MMSE). More-detailed neuropsychological testing may shed additional light on the degree of memory impairment, which types of memory are most affected and whether other mental skills also are impaired.
• Your diagnosis isn't dementia. The problems that you describe and that your doctor documents through corroborating reports, your medical history or mental status testing aren't severe enough to be diagnosed as Alzheimer's disease or another type of dementia.

Neurological exam

As part of your physical exam, your doctor may perform some basic tests that indicate how well your brain and nervous system are working. These tests can help detect neurological signs of Parkinson's disease, strokes, tumors or other medical conditions that can impair your memory as well as your physical function. The neurological exam may test:

• Reflexes
• Eye movements
• Walking and balance

Lab tests

Blood tests can help rule out physical problems that can affect memory, such as a vitamin B-12 deficiency or an underactive thyroid gland.

Brain imaging

Your doctor may order an MRI or CT scan to check for evidence of a brain tumor, stroke or bleeding.

Mental status testing

Short forms of mental status testing can be done in about 10 minutes. In testing, doctors ask people to conduct several specific tasks and answer several questions, such as naming today's date or following a written instruction.

Longer forms of neuropsychological testing can provide additional details about your mental function compared with others' of a similar age and education level. These tests may also help identify patterns of change that offer clues about the underlying cause of your symptoms.

Source: http://www.mayoclinic.com

Complications

People with MCI have a significantly increased risk — but not a certainty — of developing dementia. Overall, about 1 to 2 percent of older adults develop dementia every year. Among older adults with MCI, studies suggest that around 10 to 15 percent develop dementia every year.

Alternative medicine

Some supplements — including vitamin E, ginkgo and others — have been purported to help prevent or delay the progression of mild cognitive impairment. However, no supplement has shown any benefit in a clinical trial.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

Study results have been mixed about whether diet, exercise or other healthy lifestyle choices can prevent or reverse cognitive decline. Regardless, these healthy choices promote good overall health and may play a role in good cognitive health.

• Regular physical exercise has known benefits for heart health and may also help prevent or slow cognitive decline.
• A diet low in fat and rich in fruits and vegetables is another heart-healthy choice that also may help protect cognitive health.
• Omega-3 fatty acids also are good for the heart. Most research showing a possible benefit for cognitive health uses fish consumption as a yardstick for the amount of omega-3 fatty acids eaten.
• Intellectual stimulation may prevent cognitive decline. Studies have shown computer use, playing games, reading books and other intellectual activities may help preserve function and prevent cognitive decline.
• Social engagement may make life more satisfying, and help preserve mental function and slow mental decline.
• Memory training and other thinking (cognitive) training may help improve your function.

Source: http://www.mayoclinic.com

Risk factors

The strongest risk factors for MCI are:

• Increasing age
• Having a specific form of a gene known as APOE-e4, also linked to Alzheimer's disease — though having the gene doesn't guarantee that you'll experience cognitive decline

Other medical conditions and lifestyle factors have been linked to an increased risk of cognitive change, including:

• Diabetes
• Smoking
• High blood pressure
• Elevated cholesterol
• Depression
• Lack of physical exercise
• Infrequent participation in mentally or socially stimulating activities

Source: http://www.mayoclinic.com