- Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the most serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes.
As we age we many of us become very good a filtering what we remember. There are also many times we are on overload with information so some of it is lost in the shuffle. Much of this is natural and cannot be seen as any sort of impairment or decline - we choose to “file away” that which is relevant and can be used later.
With Mild Cognitive Impairment, things begin to change, though. According to the Mayo Clinic (Mild Cognitive Impairment: Practice Essentials, Overview …) the symptoms are as follows:
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
These symptoms may be linked to a future onset of Alzheimer’s and Lewy Body Dementia but without testing and finding oneself on a downward spiral, this may not necessarily be the case. While the indicators demonstrate that the beta-amyloid plaques or Lewy bodies may be causing this, it could also be the result of small strokes resulting in mild vascular dementia, as well.
In England, according to Ken Clasper, who was originally diagnosed with LBD and then, after 10 years, was re-diagnosed with MCI, the National Health determined that those with diagnoses of dementia who were still able to function at some higher level were reduced in their diagnosis to MCI. While perplexing, it does make sense on some levels. There are other issues this brings up, but for the purposes of this blog and post, I’d like to keep it simple.
To bring this to Mom, saying she exhibited signs of MCI earlier makes sense. People began asking about her and wondering if she was, indeed, doing fine. Of course, we determined she was simply aging and the process was taking a natural toll on her mind and thinking processes.
However, in retrospect, perhaps we weren’t taking it seriously enough, or despite the signs, didn’t fully understand the full purport of the condition. Nevertheless, while it could have been benign and simply caused by the aging process, how were we to determine otherwise.
According to the United Kingdom chapter of the Alzheimer’s Society,
A lot of research has focused on identifying people with MCI who will go on to develop dementia. This is important because it would mean that people could be offered a range of support at an early stage in the illness. In the future, for example, researchers might seek to develop drugs to prevent the progression of MCI to dementia.
Researchers have tried to identify people with MCI who will progress to developAlzheimer's disease by using different types of scans, including magnetic resonance imaging (MRI). These help to detect changes in brain structure and activity. A different approach is to measure the concentration of proteins in the cerebrospinal fluid, which circulates around the brain and spinal cord. These proteins are studied because they may reveal that the changes in the brain seen in Alzheimer's disease are already underway. Some of these techniques show promise, and some are beginning to be introduced into routine use by doctors. This is, however, an area of ongoing research and it is not yet possible to predict with certainty whether a person with the memory loss type of MCI will develop Alzheimer's disease.
Research to identify which people with non-memory loss MCI will go on to develop dementia is progressing but is much less advanced.
In short, if you know or have someone who is beginning to exhibit signs at an earlier age than what you may believe to be normal, and there are indications that things aren’t quite falling into place, you may want to encourage a check-up. It’s not that doctors are armed with the best tools to make any real form of prognosis, but at least you may be able to begin making some judgments and calls that could ease the future.
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