Mild Cognitive Impairment

Mild Cognitive Impairment (MCI) Explained
Worried old woman looking away thinking

Noticeable memory loss doesn't always mean Alzheimer's disease. All adults forget names, lose keys, and can't remember what they walked into a room to retrieve. Although many people reach their 80s and 90s with sharp minds, some forgetfulness is considered a normal side effect of busy, stressed lives and aging bodies.

But there's a degree of the problem that's more serious -- though not severe enough to be defined as dementia. It's a subtle decline in mental ability known as mild cognitive impairment (MCI).

People with MCI can have noticeable trouble with language (including speaking, reading, and writing), reasoning, judgment, and memory. But generally they can manage their daily affairs independently and may not even seem impaired to those who don't know them well. According to the Mayo Clinic, 12 percent of those over age 70 have MCI.

Types of MCI

There are two types of mild cognitive impairment:

  • Amnestic MCI, which significantly affects memory as well as other cognitive functions. People with this type of cognitive impairment are three to four times more likely to develop Alzheimer's than someone without MCI.
  • Non-amnestic MCI, which affects cognitive functions other than memory. This form of MCI is more often linked with non-Alzheimer's dementia, such as frontotemporal dementia or dementia caused by Lewy bodies.

Causes of MCI

The root of MCI isn't completely known. Possible causes include:

  • A neurodegenerative disease, such as what could become Alzheimer's
  • A vascular condition, such as what could become vascular dementia
  • A psychiatric condition, such as depression
  • An injury, such as brain trauma

Not everyone with MCI goes on to develop dementia. However, since early diagnosis of Alzheimer's and other forms of dementia can help caregivers make better long-term plans and possibly delay the progression of symptoms, it's smart to take action when you first suspect a memory problem or notice behavioral changes in an older adult.

Signs of MCI

Some possible signs of MCI:

  • The person begins forgetting appointments or regularly scheduled events (Sunday dinner with you, a weekly club meeting).
  • She increasingly repeats questions or stories.
  • She starts asking you more questions about managing finances (a cognitively challenging task).
  • She occasionally forgets to take medications.
  • Although still capable, she shows less interest in cooking (it's just getting too complicated).

All of these are subtle changes that may or may not be warning signs, but they present reasonable red flags that warrant a medical exam. (Basic, well-rehearsed daily tasks like bathing and grooming tend to be less affected. By the time you notice problems in this area, actual dementia is more likely.)

How to Convince Someone to Get Checked for MCI

Try a straightforward approach: "Mom, have you noticed having trouble remembering things recently? It seems like you've been forgetting to do things lately. There are a lot of different reasons memory can be affected, so why don't you mention this to your doctor so he can see if there's anything you can do about it. It might be nothing, but then again there might be a simple explanation or remedy."

If you already accompany the person to medical appointments, mention what you've noticed to her doctor, and ask if she can be screened for MCI.

Be sure that she gets a complete medical workup. Simply mentioning memory loss to a physician and walking out of the appointment with a prescription for Aricept isn't good medicine in action. A proper exam should involve an extensive interview, memory tests, and lab tests to rule out other ailments. It's ideal if you, the person's spouse, or a sibling is at the exam to provide input, as she may not be fully aware of changes.

MCI Treatments

There aren't yet any FDA-approved medications or other treatments for MCI. There's some evidence that donepezil (Aricept) can, in the short term, slow the progression of MCI to Alzheimer's disease in people with amnestic MCI.

If someone is indeed found to have MCI but not Alzheimer's or another form of dementia, her abilities may not decline any further. But at least you have the advantage of having had a distant early warning so that you (and her physician) can monitor her behavior and make appropriate plans in the event of further decline.

She can also take steps to cope with memory problems. Depression is often found in people with MCI, although it's unclear whether the depression causes the cognitive decline or the other way around. Treatment for depression may help her cope with the changes she'll be facing.


almost 5 years ago, said...

Just all the information there and it is easy to understand.


almost 5 years ago, said...

I found the description of the symptoms of MCI were informative.


about 5 years ago, said...

Thank you for the article on MCI it help understand what is happening to my mother.She was diagnosed with cardiovascular dementia. Although, she was treated for many years for Alzheimer drugs that at the end of 15 years of use she was taken off of them and since her decline on short term memory has gotten worse. i wished the Dr. would have left her with Aricep and Namanda they were keeping her level of memory stable. I am taking her to get a second opinion with another Neurologist.


over 5 years ago, said...

Yes i chose who me as a screen name as people r starting to talk about me, in front of me as if it doesn't bother me. It didn't take long for my diagnosis of MCI to get around. I am begining to believe it myself! Sure Ive had some changes as i was born with mild spina bifida, scoliosis and other anomalies and take a lot of meds for the Atheritus that has moved in too. I'm 59. I have chronic pain and take care of my 81yr old mom who is in bed most time. My ex drives me places as it scares me now for some reason. I want to find out more about me and get my ex some training so he will be more sensitive. Ive read that it could go to Alzheimers but day by day now....Fighting to be ME.


over 5 years ago, said...

Your article on (MCI) is great food for thought. Thank you!


over 5 years ago, said...

Hi mamag86, Thank you for your comment. I'm so sorry to hear about the loss of your dear husband, that must have been very difficult. If I may, I'd like to suggest some resources you may find supportive at this difficult time. Here is an information center designed specifically for those who are suffering from the loss of a loved one: ( http://www.caring.com/grief ). We also host an End of Life discussion forum where you can connect with others in similar situations: ( http://www.caring.com/community/groups/end-of-life. ) I'll be keeping you in my thoughts -- All the best, Emily | Community Manager


over 5 years ago, said...

My husband's dementia was not always apparent. He was very clever in hiding his symptoms. For 11 years we roamed the continent in our RV as retiree gypsies. Along the way there were several incidents that should have been a red flag but werent. He would be driving and suddently pull over to the side and tell me I'd better drive for awhile. No reason mentioned. Later he would say he felt funny. Finally it was his congestive heart failure that pulled us off he road. The next 12 years saw (at first) a gradual decline and then the last 2 years it was downhill at breakneck speed. He got lost often and laughed it off. He had more incidents of these "feeling funny" and each time there was more of a decline. His doctors and I disagreed as to his problem. I believe each of his "feeling funny" episode were mini strokes which further impaired his mental ability. Doc thought it AZ. Each time he had a funny feeling it became worse, as he could not speak or recognize anyone. In the last 13 months of his life he was in the hospital 7 times, including 3 trips to the emergency room. He was quite often delusional. At one time he demanded the hosital get rid of those awful bugs on the wall. He would wake up and not know where he was nor recognize anyone. One time he asked me if "they" would let him have a cup of coffee. His long term memory was intact but he had no short term memory at all. We had 3 sons and 1 daughter who was the apple of his eye. It broke her heart when she came to visit and he didn't recognize her. He continued to be physically fit, loved to walk and exercise. He never learned how to operate the remote for the TV, not even to change the channel. Early on he was convinced to stop driving because of getting lost but he insisted on keeping and renewing his driver's license. As I watched his decline I prayed that his heart would get him before his mind went completely. My prayers were answered.


over 5 years ago, said...

Hi jainnagraj, Thanks for your question. Just to be clear: are you asking if dementia following stroke induced hemiparesis is incurable? I think the best place you can get an answer is in our Ask & Answer section located here: (http://www.caring.com/questions/new). Thanks again for the question! -- Emily


over 5 years ago, said...

If in a stroke dementia follows hemiparasis invariably?


over 5 years ago, said...

Since no two cases are alike, at the present time, data from the accumulation of multiple case histories is all doctors have to go on. Alzheimers is so common, and growing due to the fact we are living longer, and Alzheimers is, primarily, a disease of old age. I try to stay current with what is going on in the published scientific litterature but there is nothing NEW about treatment once the disease has been diagnosed. There are no medications, at present, that deliver what we want to see.


over 5 years ago, said...

You suggest Somerset Mass for an assisted living facility. Why?


almost 6 years ago, said...

My Heart goes out to you. I am not very computer literite. I wrote a comment twice It wont show on the screen. So all I can say is you must not let your life pass you bye, remember you only get one life to live. From what you wrote, I don't think she wants your help. Hi I am truly sorry for all you have had to suffer in your life. I am sending you all the hugs and prayers you can use. Please remember YOU only get one life to live yourself. (NO PUN INTENDED). If she wants to treat you like Cr*p, then I would wait till she really needs you, but remember she is just using you. I wish I had better words of wisdom for you. I know you have a good HEART and want to do the right thing, but sometimes the right thing is doing nothing. Sorry if I seem cold, I also have a MEAN DRUNK for a parent. and yes empathys***s. I will keep you in my prayers. Remember to be good to yourself


about 7 years ago, said...

Thank you for a better understanding of what my Mother, who is 92, is dealing with - In other words, from HER point of view. Better understanding is helpful to my giving her the love, attention and care she needs and wants.


over 8 years ago, said...

Another important reason to seek medical attention for suspected MCI is to establish a baseline by which you can later determine if symptoms are worsening. In my opinion, knowing how quickly the condition is progressing is almost as important as an initial diagnosis.