Mild Cognitive Impairment

Mild cognitive impairment (MCI) is a noticeable decline in memory and thinking. It may affect your judgment, like spotting a scam phone call. Or it could affect your ability to plan, like remembering appointments.

You or a loved one might notice these changes. But you can still manage your daily routine without needing help.

MCI isn’t always permanent. In some cases, symptoms may improve. MCI also raises the risk of developing dementia caused by Alzheimer’s disease or other conditions that gradually affect brain function.

Types of mild cognitive impairment

There are two types of MCI:

• Amnestic MCI (aMCI): This type mostly affects memory. You might forget important information that you used to be able to remember.
• Non-amnestic MCI (naMCI): This type mostly affects thinking. You may have trouble with judgment, making decisions or completing complex tasks.

Symptoms of mild cognitive impairment

The main symptom of mild cognitive impairment is a decline in the following skills:

• Attention
• Judgment
• Language
• Memory
• Planning
• Reasoning

You may notice the following:

• Becoming easily distracted or losing focus
• Difficulty finding the right words to say
• Misplacing items more often than usual
• Falling behind on a bill payment
• Missing important events or dates

In some cases, you may have trouble with movement and/or your sense of smell with MCI.

Mild cognitive impairment causes

Parts of your brain that help with memory and thinking may have damage or structural changes. These include your hippocampus, temporal lobes, parietal lobe and other connected regions. These brain changes may make it harder to remember things, think clearly or focus as well as before.

MCI may be an early stage of certain neurodegenerative conditions, like:

• Alzheimer’s disease
• Frontotemporal dementia
• Lewy body dementia
• Parkinson’s disease
• Vascular dementia

These conditions get worse over time and affect how your brain works.

Risk factors for mild cognitive impairment

Anyone can develop mild cognitive impairment. But you may be more at risk if you:

• Are above age 65
• Have a biological family history of dementia
• Have the APOE-ε4 (APOE4) gene variant (a gene that increases your risk of Alzheimer’s disease)

The following conditions may increase your risk:

• Brain injuries or disorders, like traumatic brain injury and normal pressure hydrocephalus
• Chronic conditions, like diabetes, COPD and osteoarthritis
• Heart and blood vessel issues, like high blood pressure, high cholesterol and stroke
• Infections, like urinary tract infections (UTIs) and HIV
• Mental health conditions, like anxiety and depression
• Metabolic and nutritional issues, like hypothyroidism, vitamin B12 deficiency and dehydration
• Sleep conditions, like obstructive sleep apnea

MCI may be a side effect of taking one of the following medications:

• Antihistamines
• Antidepressants
• Blood pressure medications
• Antiseizure medications
• Benzodiazepines
• Muscle relaxants
• Opiates

Complications of MCI

MCI may progress into dementia. Dementia is a more severe decline in mental functioning that affects your daily life. You may need assistance or supportive care if you develop Alzheimer’s disease, the most common form of dementia.

Coming to terms with changes to your cognitive abilities can be tough. It’s normal to feel a range of emotions with this diagnosis. Some people develop depression or anxiety as a result. You may react negatively to assistance from others. That’s why your healthcare provider may recommend talking with a mental health professional. They can help you feel more at ease and supported.

How doctors diagnose mild cognitive impairment

To diagnose MCI, a provider will perform a physical and neurological exam. During the exams, they’ll learn more about your symptoms. They’ll also take a detailed medical history and review your current medications. Let your provider know if you have any knowledge of biological family members diagnosed with memory conditions or dementia.

If a loved one notices changes in your mental functioning and is with you during the exam, your provider may ask them about what they’ve observed.

Mild cognitive impairment test

There isn’t a single test to diagnose MCI. Your provider may offer a variety of tests to rule out conditions with similar symptoms and measure your cognitive and memory skills. These could include:

• Blood and urine tests
• Lumbar puncture
• Imaging tests (CT scan or MRI)
• Neuropsychological testing (like cognitive tests)

Mild cognitive impairment treatment

Treatment for MCI depends on the cause. Your provider may recommend:

• Making adjustments to the medications you take
• Participating in brain-stimulating activities, like puzzles and socializing
• Prioritizing your safety (like securing rugs in your living space to avoid tripping or asking someone to drive you to the store)
• Reducing your risk factors, like not smoking or drinking alcohol, or changing your eating habits and activity routines
• Treating or managing conditions, like depression, sleep apnea or vitamin deficiency, among others
• Joining a clinical trial (if available)

If you have MCI, you may want to think about your future. Planning ahead can give you peace of mind and make things easier for your loved ones later. An advance directive tells your loved ones and doctors what kind of care you want if you can’t speak for yourself. If you’re at risk of dementia, having these documents in place ensures your preferences are clear and respected.

When should I see my healthcare provider?

If you have MCI, your provider will want to schedule follow-up visits every six to 12 months. This may vary based on your treatment plan. These visits help your provider check your overall health. They also track changes in your thinking and memory.

Call your provider if you notice any new symptoms or if things get worse.

What can I expect if I have mild cognitive impairment?

MCI looks different for each person. For example, your thinking and memory may stay the same or even return to normal for your age after treatment.

In some cases, it’s an early sign of a brain disease that gets worse over time, like Alzheimer’s or Parkinson’s. But MCI doesn’t always lead to these conditions. Research shows that about 2 in 10 people over age 65 with this condition will develop dementia within a year.

Many people with MCI continue to live independently. Staying in regular contact with loved ones is important. It keeps you socially connected, which supports brain health, and gives you extra help keeping track of daily tasks that might sometimes slip your mind.

A healthcare provider can help you understand your outlook and what to expect.

How fast does mild cognitive impairment progress

The progression from MCI to dementia varies from person to person. For some, it may happen within a year. For others, it can take several years.

What is the life expectancy of someone with mild cognitive impairment?

Studies show that people with MCI may not live as long as those without it. Averages show that you may lose five years off your lifespan. This is just an estimate. Your healthcare provider will have the best information based on your situation.

Can mild cognitive impairment be prevented?

Not all cases of MCI are preventable, but these healthy habits may help protect your brain:

• Challenge your brain with puzzles, reading or learning new skills.
• Don’t smoke or drink too much alcohol.
• Eat balanced meals and stay physically active.
• Keep blood pressure, cholesterol and blood sugar in check.
• Manage stress and get quality sleep.
• See your provider regularly to manage chronic conditions.
• Stay socially connected.