Whats The Difference Between Mild Cognitive Impairment And Decline Due To Normal Aging
Some gradual mental decline is seen with normal aging. For example, the ability to learn new information may be reduced, mental processing slows, speed of performance slows, and ability to become distracted increases. However, these declines due to normal aging do not affect overall functioning or ability to perform activities of daily living. Normal aging does not affect recognition, intelligence, or long-term memory.
In normal aging, a person may occasionally forget names and words and misplace things. With mild cognitive impairment, the person frequently forgets conversations and information that one would ordinarily remember such as appointments and other planned events.
Cognitive Change And Frontotemporal Dementia
This information is for health and social care professionals.
Some people with MND will experience changes in thinking, reasoning and behaviour. For many people the changes will be subtle and have little or no effect on daily life, but a small number of people will develop frontotemporal dementia and need additional support.
People with MND appear to fall into four groups:
- around 50% are unaffected by cognitive change
- around 35% experience mild cognitive change, with specific deficits in executive functions, language and/or social cognition
- up to 15% develop frontotemporal dementia , either at the same time or after diagnosis of MND
- up to 15% of people diagnosed with FTD go on to develop MND. Symptoms of dementia may lead to FTD being diagnosed before movement is affected and MND is diagnosed.
There is a wide spectrum of changes in cognition in MND. Some people experience very mild changes, barely noticeable, whereas for others the changes can be more pronounced and obvious.
Other possible causes
It is important to rule out other potential causes of temporary confusion or problems with thinking, memory and behaviour, including infections, a build-up of carbon dioxide in the body caused by respiratory muscle weakness, mood and emotional lability.
Whats The Difference Between Mci And Dementia
The word dementia describes a group of symptoms that can affect a persons ability to carry out daily activities without help. These include memory problems, confusion and mood changes. A person with dementia will usually have two or more of these symptoms, such as problems with their memory or getting lost. Someone with MCI may have only one of these symptoms and unlike dementia, it would normally be too mild to get in the way of day-to-day life.
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What Is Cognitive Impairment
Cognitive impairment is not an illness, but a description of someone’s condition. It means they have trouble with things like memory or paying attention. They might have trouble speaking or understanding. And they might have difficulty recognising people, places or things, and might find new places or situations overwhelming.
Family and friends might notice that someone with cognitive impairment is confused, or agitated, or very moody. They might notice a change in their speech or behaviour, or that they have difficulty with their usual daily tasks.
Cognitive impairment can come and go. In this situation, it is often called delirium. Delirium can be a sign of serious medical problems.
Cognitive impairment can be mild, or severe, or anything in between.
How Hearing Loss May Change The Brain
Hearing loss does seem to shrink some parts of the brain responsible for auditory response. In a study led by Jonathan Peelle, now at Washington University in St. Louis, older adults underwent brain scans while they listened to sentences of varying complexity. They also took tests that measured gray matter, the regions of the brain involved in muscle control, and sensory perception such as seeing and hearing, memory, emotions, speech, decision making, and self-control.
It turned out that the neurons in people with hearing loss were less active when they focused on complex sentences. They also had less gray matter in the auditory areas. These effects may accumulate with time or be triggered by age: In other research, Peelle found that older adults with hearing loss do worse on speech comprehension tasks than younger adults with hearing loss.
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Reasoning And Executive Functioning
- Mood fluctuations, including agitation and crying
- Negative reaction to questioning
- Loss of initiative and motivation
Behavioral and psychosocial symptoms are common in dementia . Responsive behaviorsa subset of these symptomsare thought to be expressions of unmet needs , responses to the environment , expressions of psychosocial needs , and responses to caregivers and other individuals.
Behavioral and psychosocial changes can lead to frustration and misunderstanding between the individual with dementia and his or her caregiver. Since these reactions are often forms of communication, it is important for caregivers to consider why the behavior is occurring and to explore ways to facilitate better communication .
See Behaviors: How To Respond When Dementia Causes Unpredictable Behaviors from the Alzheimer’s Association for more information.
Vascular Dementia And Vascular Cognitive Impairment: A Resource List
Vascular dementia, a most common form of dementia in older adults, and vascular cognitive impairment result from injuries to vessels that supply blood to the brain, often after a stroke or series of strokes. The symptoms of vascular dementia can be similar to those of Alzheimers, and both conditions can occur at the same time . Symptoms of vascular dementia and VCI can begin suddenly and worsen or improve over time.
Caregivers of people with vascular dementia or VCI face a variety of challenges. Learning more about these disorders can help. This resource list is a place to start. All resources on this list are available free online.
The items on this list are in three categories:
The Dementias: Hope Through Research
This booklet from the National Institute on Aging and the National Institute of Neurological Disorders and Stroke describes different kinds of dementia, including vascular dementia. It discusses brain changes, symptoms, and treatments for many dementias, as well as risk factors and diagnosis for dementia generally. It also summarizes dementia research supported by the National Institutes of Health. The booklet includes a glossary and list of resources.
Vascular Dementia: What Is It, and What Causes It?
Available from the Alzheimers Society, London.
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Eating And Swallowing Difficulties
Swallowing function changes as we age. These changes may be more pronounced in individuals with dementia, and swallowing difficulties may appear sooner . Overall, 13%57% of individuals with dementia have swallowing impairment . Rates of swallowing impairment for individuals with dementia in long-term care may be as high as 53%60% .
Difficulties are not limited to swallowing dysfunctioncognitive and behavioral changes associated with dementia can also have an impact on eating. Early on, individuals may have difficulty shopping for groceries and planning and preparing meals independently . They may forget to eat, initiate eating less often, or have difficulty determining the need to eat . As the disease progresses, they may become more distracted during mealtime or have difficulty self-feeding, recognizing foods, or using various eating utensils .
Eating and swallowing difficulties may place an individual at greater risk for choking and aspiration pneumonia and may eventually result in malnutrition, dehydration, and weight loss .
Causes
Alzheimer’s disease is the most common cause of dementia, accounting for approximately 70% of all cases .
The remaining cases are accounted for by vascular dementia, Lewy body dementia, Parkinson’s disease, frontotemporal dementia, and mixed dementia types . See ASHA’s resource on common dementias.
Causes Of Frontotemporal Dementia
This is an important cause of dementia in younger people. It’s most often diagnosed between the ages of 45 and 65.
It’s caused by an abnormal clumping of proteins, including tau, in the frontal and temporal lobes at the front and sides of the brain.
The clumping of these proteins damages nerve cells in the frontal and temporal lobes, causing brain cells to die. This leads to shrinking of these areas of the brain.
Frontotemporal dementia is more likely to run in families than other, more common causes of dementia.
Read more about frontotemporal dementia.
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Does Having Mild Cognitive Impairment Always Lead To The Development Of Dementia
There are some cases in which the cause of the mild cognitive impairment is due to the effects of a treatable illness or disease. However, researchers have now determined that for most patients with mild cognitive impairment , the MCI is a point along the pathway to dementia. The MCI is considered the stage between the mental changes that are seen in normal aging and early-stage dementia. MCI can be due to a variety of diseases, such as Alzheimers or Parkinsons disease, just as dementia can be due to a variety of reasons such as Alzheimers or Parkinsons disease, dementia with Lewy bodies, vascular dementia, frontotemporal dementia, and other causes.
According to the American Academy of Neurology, of people aged 65 or older who have mild cognitive impairment:
- About 7.5 percent will develop dementia in the first year after diagnosis of mild cognitive impairment
- About 15 percent will develop dementia in the second year
- About 20 percent will develop dementia in the third year
New Pharmacological Approaches: Vortioxetine
Evidence has emerged in recent years that the underlying cause of depression lies in dysfunctions not only of the known aminergic neurotransmitter systems, but also of other circuits, such as the glutamatergic ones similarly, the role of other pathogenetic mechanisms, such as loss of synaptic plasticity in areas involved in regulation of emotion and affect, has increasingly been clarified as well This has led to a growing interest in new molecules able to interfere with these systems and mechanisms, known to be involved in cognitive processes. However, the currently available antidepressant drugs have never been shown to have any efficacy on cognitive disorders In recent years, vortioxetine has emerged as an agent capable of acting on the serotonergic system through a peculiar mechanism of action, completely different to those characterizing the previously available therapeutic options. Having being shown, both in various animal models and in clinical trials, to improve cognitive performance, in 2013, this drug, which has a distinctive pharmacological profile, was approved in the European Union and in the USA for the treatment of MDD in adults. In 2015, the European Medicines Agency updated its data on the clinical efficacy of vortioxetine, stating that its effects include effects on cognitive and global functioning .
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Epidemiology Of Atrial Fibrillation And Dementia
Both AF as well as dementia are frequent diseasesespecially in the elderly. Moreover, both are expected to be among the most prominent global epidemiological trends of the 21st century with an overwhelming burden on worldwide health care systems. The number of patients with dementia seems to stabilize in European countries despite population ageing. However, the estimated prevalence rates remain substantial in Western Europe: 2600 per 100 000 for those aged 65 years and older, while up to 21 700 per 100 000 for those aged 85 years and above. Women have a 1.5-fold higher life-time risk of developing Alzheimers dementia. The estimated prevalence rates for AF range from 3700 to 4700 per 100 000 in those aged 6070 years and from 10 000 to 17 000 per 100 000 for those aged 80 years and older according to a recent review of European data. In addition, AF is more prevalent in men, who have a 1.2-fold greater risk of developing AF than women after adjustment for age and predisposing conditions. According to the Rotterdam study, the lifetime risk of developing AF by the age of 55 years is 24% in men and 22% in women. Given a prevalence of dementia of 2.6% and AF of 3.7%, in theory 6.2% of individuals will be suffering from either one or both diseases, assuming independence of these two conditions.
Stage : Mild Cognitive Impairment
Clear cognitive problems begin to manifest in stage 3. A few signs of stage 3 dementia include:
- Getting lost easily
- Noticeably poor performance at work
- Forgetting the names of family members and close friends
- Difficulty retaining information read in a book or passage
- Losing or misplacing important objects
- Difficulty concentrating
Patients often start to experience mild to moderate anxiety as these symptoms increasingly interfere with day to day life. Patients who may be in this stage of dementia are encouraged to have a clinical interview with a clinician for proper diagnosis.
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Diagnosing Mild Cognitive Impairment
Theres no official diagnostic test for MCI. Your doctor will likely take a thorough history and perform blood tests to look for any underlying conditions that may be contributing to memory issues.
They may conduct interviews and mental function tests, on top of brain imaging and neurological exams, to assist with a diagnosis. Biomarker tests can also help determine whether you have Alzheimers disease.
Your doctor will ask questions about your ability to carry out common activities associated with daily life. These activities, which are called instrumental activities of daily living include:
- taking medications
- using a phone or other electronic device
- shopping
The Seven Stages Of Dementia
One of the most difficult things to hear about dementia is that, in most cases, dementia is irreversible and incurable. However, with an early diagnosis and proper care, the progression of some forms of dementia can be managed and slowed down. The cognitive decline that accompanies dementia conditions does not happen all at once – the progression of dementia can be divided into seven distinct, identifiable stages.
Learning about the stages of dementia can help with identifying signs and symptoms early on, as well as assisting sufferers and caretakers in knowing what to expect in further stages. The earlier dementia is diagnosed, the sooner treatment can start.
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Causes Of Vascular Dementia
Vascular dementia is caused by reduced blood flow to the brain, which damages and eventually kills brain cells.
This can happen as a result of:
- narrowing and blockage of the small blood vessels inside the brain
- a single stroke, where the blood supply to part of the brain is suddenly cut off
- lots of “mini strokes” that cause tiny but widespread damage to the brain
Not everyone who has a stroke will go on to develop vascular dementia.
Read more about vascular dementia.
Both Atrial Fibrillation And Dementia Share The Same Risk Factors
Studies evaluating a causal relationship of AF and dementia have to account for overlapping risk factors. Various conditions such as old age, diabetes, chronic kidney disease, sleep apnea, hypertension, heart failure, heavy alcohol consumption, and coronary heart disease are associated with AF as well as dementia, for further details see Table .
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Can Diabetes Lead To Cognitive Impairment
Learn about cognitive impairment risk in people with diabetes and how to adapt treatments for patients with cognitive problems.
José A. Luchsinger, MD, is a professor of medicine and epidemiology at Columbia University Irving Medical Center, New York. As an expert in aging and cognition, he shares his insights on the relationship between diabetes and cognitive impairment, and how health care professionals can adapt treatment for patients with cognitive problems.
Q: What is cognitive impairment, and why does it matter for people with diabetes?
A: Cognitive impairment is a decline from usual cognitive abilities. There are different types. The one most people are concerned about is forgetfulness, which is the inability to remember events or learn material. Other types of cognitive impairment are not related to memory or can co-occur with memory problems. These include problems with attention and executive functionthe ability to start, conduct, and finish a complex task.
When these problems are mild and do not impact a persons ability to function by themselves, they’re called mild cognitive impairment. When cognitive impairment is so severe that it affects peoples ability to live independentlymeaning they need help to remember things, keep track of things, or conduct activities of daily livingthen we call that dementia.
People with diabetes are at risk of developing cognitive impairment, which presents challenges for following treatment.
Common Causes Of Cognitive Impairment In Older Adults
Cognitive impairment, like many problems in older adults, is often multifactorial. This means that the difficulties with memory, thinking, or other brain processes are often due to more than one cause.
Common causes of cognitive impairment in older adults include:
- Medication side-effects. Many medications interfere with proper brain function.
- Sedatives, tranquilizers, and anticholinergic medications are the most common culprits. For more information, see 4 Types of Medication to Avoid if Youre Worried About Memory.
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Hearing Loss And Dementia
Overall, 15% of the adult population in the United States age 18 and older report having some trouble hearing . Self-reported hearing loss increases with age, with 5.5% of adults ages 1839, 19% of adults ages 4069, and 43% of adults over age 70 reporting difficulty hearing without a hearing aid .
Adjusting for other risk factors , studies show that hearing loss is independently associated with increased risk of dementia . For individuals over 60 years of age, more than one third of the risk of all-cause dementia was found to be associated with hearing loss .
Further, individuals with baseline hearing loss were found to have greater rates of cognitive decline over time than individuals with normal hearing , and the mean time to develop dementia was reported to be faster for individuals with self-reported hearing loss than for individuals without self-reported hearing loss .
Several hypotheses have been proposed to account for the association between hearing loss and dementia. They include the following:
It is possible that the mechanism proposed by each of these hypotheses is not mutually exclusive, and that each contributes individually or in combination to increase the risk of dementia. Further investigation is needed to clarify the relationship between hearing loss and dementia .
Roles and Responsibilities