Mild Cognitive Impairment

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Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

Mild cognitive impairment–amnestic type (MCI-AT) is mild, repeated memory loss. It lies between the normal memory loss of aging and the more serious conditions of dementia and Alzheimer’s disease (AD) . MCI-AT only involves problems with memory. Dementia and Alzheimer's involve loss of other cognitive abilities, such as:
  • Learning
  • Reasoning
  • Making decisions
  • Problems with confusion, language, and attention

People with MCI-AT who are over age 65 have a higher chance of developing dementia and Alzheimer's. However, many people with MCI-AT never develop these disorders. Some even return to normal.

Some Areas of the Brain Affected by Dementia and Alzheimer's Disease

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Causes

The causes are not clear. However, genetic factors may be a cause.

Risk Factors

These risk factors increase your chance of developing MCI-AT. Tell your doctor if you have any of these risk factors:
Research also suggests that these may be risk factors for MCI-AT:
  • Lack of physical activity
  • Lack of social contact
  • Low educational level
  • Excessive response to stress
  • Poor nutrition and lack of vitamins
  • Exposure to toxins

Symptoms

The main symptom is frequent, ongoing memory loss beyond what is normally expected for one’s age. That means having more than small lapses of memory. If you have MCI-AT, you may:
  • Remember much less of what you have just read or seen than people who have only the normal memory changes of aging
  • Take longer to recall information

Diagnosis

The doctor will ask about your symptoms and medical history. She will also:
  • Do a physical exam
  • Tests your cognitive skills, including memory
  • Do additional tests if needed, such as:
    • Blood tests
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
    • Lumbar puncture (spinal tap)—removal of a small amount of fluid that surrounds the brain and spinal cord

The doctor may also talk with family members and caregivers. If you have this condition, you should have your cognitive abilities tested regularly.

Treatment

Treatment is focused:
  • Preventing, or at least slowing down, further loss of memory and other cognitive abilities
  • Preventing dementia and Alzheimer's disease

Researchers are currently studying the effects that several medicines may have on slowing cognitive decline. Examples include donepezil , vitamin E , tacrine, among other medicines.

Prevention

The following are being studied as ways to reduce the risk of cognitive decline:
  • Managing medical conditions that may lead to MCI-AT, especially high blood pressure
  • Getting treatment for depression and hypothyroidism
  • Staying mentally active by doing things like memory exercises, crossword puzzles, reading, taking classes
  • Getting regular exercise
  • Participating in social activities
  • Reducing stress
  • Getting help for emotional problems
  • Eating a healthy diet

RESOURCES:

CANADIAN RESOURCES:

References:

  • Alzheimer’s disease education and referral center. Connections: News from the ADEAR Center 1999;8(2).
  • Birks J, Flicker L. Donepezil for mild cognitive impairment. Cochrane Database Syst Rev . 2006;3:CD006104.
  • DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginko biloba for prevention of dementia: a randomized controlled trila. JAMA . 2008;300:2306-2308.
  • Feldman HH, Jacova C. Mild cognitive impairment. Am J Geriatr Psychiatry . 2005;13:645-655.
  • Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment. Lancet . 2006;367:1262-1270.
  • Institute for the Study of Aging and International Longevity Center–USA (March 2001). Achieving and Maintaining Cognitive Vitality With Aging: A Workshop Report . New York, NY.
  • National Institute on Aging. 2001-2002 Progress Report on Alzheimer’s Disease . July 2003.
  • Petersen RC. Mild cognitive impairment: current research and clinical implications. Semin Neurol . 2007;27. Available at: http://www.medscape.comn/viewarticle/553257 . Accessed March 23, 2007.
  • Petersen RC, Roberts RO, Knopmann DS, et al. Mild cognitive impairment: ten years later. Arch Neurol . 2009;66(12):1447-1455.
  • Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology . 1999;56:303-308.

Last reviewed March 2011 by Rimas Lukas, MD

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