What Is The Difference Between Mci And Dementia
Both MCI and dementia are characterized by objective evidence of cognitive impairments. The main difference between mild cognitive impairment and dementia is that in the latter there is evident interference with daily life functioning.
Another big difference between MCI and dementia is simply that based on your testing, you fall into the range of the memory scores that we would consider not to be dementia.
How To Know If Its Mci
Diagnosis
Currently there is no diagnostic test for MCI. Physicians use a variety of tests and assessments to rule out other possible causes of the symptoms before making a diagnosis. For example, blood tests may be done to check for treatable conditions that might contribute to memory issues and dementia-like symptoms. Common blood tests include a complete blood count and a comprehensive metabolic panel, as well as testing ones vitamin B-12 and thyroid hormone levels.
Just like for other forms of dementia, the evaluation will include an assessment of mental function as well, usually through an interview with the patient. Feedback from friends and families, neurological exams, and brain imaging may also help make a diagnosis.Difficulty performing Instrumental Activities of Daily Living is also considered in the diagnostic process. IADLs are activities that we perform from day to day that add to our quality of life, but do not include basic self-care tasks . The following tasks are considered to be IADLs:
Managing money Managing medications Cooking Housekeeping Using appliances Shopping Extracurriculars
MCI vs. Normal Aging
It can be difficult to determine whether symptoms are due to normal aging, Mild Cognitive Impairment, or early-stage dementia. Watch for these symptoms that are common in MCI but not normal aging:
MCI vs. Dementia
Bathing and/or showering
Spotting The Signs Of Mild Cognitive Impairment
An estimated 15% to 20% of people over age 65 meet the criteria for mild cognitive impairmentthe changes that exist between normal aging and dementia.
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An older woman starts forgetting regular appointments, and balancing her checkbook is more confusing than it used to be. Is this just an inevitable part of aging? Or are these warning signs of more serious problems to come?
Researchers are still seeking ways to treator even better, preventMCI. But theyve made strides toward better understanding and identifying this disorder. And psychologists have an important role to play in both studying and diagnosing this all-too-common condition.
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How Is Mci Detected
MCI is usually detected by using similar testing methods to those used for dementia. This begins with the doctor talking to both the person and, if possible, a friend or family member, to get a thorough understanding of the persons medical history, the medication they are taking, the memory problems they are experiencing, and any other relevant information.
A physical examination and blood tests may be done in order to rule out other causes of memory loss such as depression, stress, medication problems, or a nutritional deficiency.
People suspected of having MCI will also be tested with general tests for cognition and memory function such as those used in diagnosing dementia.
Understanding Mild Cognitive Impairment
Did you know that up to 20% of older adults above 65 experience mild cognitive impairment ? Symptoms can be something as simple as forgetting a name or taking longer to recall specific details. Other non-memory related symptoms include having difficulty multitasking or having trouble coming up with the right word to use in a conversation, which is also experienced in the early stages of dementia.
However, whats important to remember about mild cognitive impairment is that this should not affect your ability to live independently, or should only affect it to a small extent. Mild cognitive impairment can make it harder to complete daily tasks, but it doesnt always lead to a diagnosis of dementia. In some cases, however, it can be the transitory stage between normal age-related forgetfulness and dementia.
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Review Articledoes Mild Cognitive Impairment Always Lead To Dementia A Review
We review current research on mild cognitive impairment and its varying clinical outcomes.
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We focus primarily on MCI patients who revert to normal cognition or remain diagnostically stable.
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Rates of reversion and stability are higher than those of progression to dementia.
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Studies on the characterization and predictors of reversion and stability are limited.
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Increased study of these MCI trajectories can have important research and clinical implications.
How Is Mild Cognitive Impairment Diagnosed
Family and friends may notice memory lapses, and the person with MCI may worry about losing his or her memory. These worries may prompt the person to see a doctor about their memory problems.
In some cases, memory and thinking problems may be caused by conditions that are treatable. A doctor can perform tests and assessments to help understand whether the source of memory problems is something treatable or may be MCI. He or she also may suggest that the person see a specialist for more tests.
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Measuring Cognitive Impairment: The 30 Question Cognitive Test Or Mmse
The MiniMental State Examination test is one of the ways that memory is assessed in a clinical space. This is sometimes referred by people as the 30 Question Cognitive Test.
This test is very simple for people who dont have memory and thinking problems. The goal of this test is not to test your intelligence but to test and identify significant cognitive problems.
The Mini-Mental State Examination includes items that assess registration, attention and calculation, recall, language, and orientation.
The MMSE has to be administered by a professional. You cannot self-administer the MMSE. Your friends cant give this memory test to you.
This needs to be done in a clinical space by a professional who has been trained in how to give the test and how to score the test.
There are specific ways in which this test has to be given.
In general, this test is a blunt way of testing someones memory. It functions as a screening test that could result in further assessment if necessary. Neurologists like it because its fast, pretty simple to give and it does a good job of picking out dementia and strong memory problems.
Is There Physical Evidence Of Mild Cognitive Impairment In The Brain Tissue
When you look at the brain of someone who died with a determination of MCI, often times you can see some of the same changes that we see with other degenerative brain diseases that can lead to dementia.
Those include changes that we see with Alzheimers disease , Parkinsons disease, and vascular dementia.
In summary, if you look at the brain of a collection of people with MCI, you would see a whole array of changes that we see in the brain in normal aging as well as in dementia.
These changes may include:
- abnormal clumps of amyloid proteins and tau tangles, characteristic of Alzheimers disease
- microscopic deposits of a protein called alpha-synuclein that can form Lewy bodies, associated with Parkinsons disease and Lewy Body dementia
- small strokes or reduced blood flow in brain blood vessels due to blockages and/or vascular damage
- shrinkage of the hippocampus
- brain ventricle enlargement
And their levels would often range between those seen in normal aging and those found in patients with dementia. It is important to note that these are generalities and each patient may be different.
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How Is Mild Cognitive Impairment Managed
There currently is no standard treatment or approved medication for MCI, but there are things a person can do that may help them stay healthy and deal with changes in their thinking.
Because MCI may be an early sign of more serious memory problems, it’s important to see a doctor or specialist every six to 12 months. A doctor can help track changes in memory and thinking skills over time. Keeping a record of any changes can also be helpful.
People with MCI might also consider participating in clinical trials or studies. Clinical trials are research studies that help test if a treatment, like a new drug, is safe and effective in people. People with and without memory problems can take part in clinical trials, which may help themselves, their families, or future generations.
To find out more about participating in clinical trials for people with memory problems and people without cognitive impairment, visit Alzheimers.gov or call the Alzheimers and related Dementias Education and Referral Center at 1-800-438-4380.
How Fast Does Mild Cognitive Impairment Progress
This is also different for each person, and we dont have good ways of telling how fast MCI is going to progress.
But usually this question is about how long do I have before I get an Alzheimers diagnosis or how long before I recover. Because people with mild cognitive impairment can recover.
Progression to dementia typically takes many years. Research suggests that this number is between 3-5 years for the majority of amnestic MCI patients but it can be shorter and it can be longer than this.
If the MCI is caused by medication use, recovery back to normal can be rapid, occurring during the course of a few months or so. However this can depend on how long one was taking the medication and how long it remains in the body after stopping the last dose.
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Relationship Between Mci & Alzheimers Disease
Sometimes MCI is called early Alzheimers disease, even though MCI does not always progress to Alzheimers. There is some disagreement amongst physicians and researchers about when to diagnose MCI versus an Alzheimers disease diagnosis. The symptoms of the two can be so similar that the same person could get an MCI diagnosis from one doctor and an early-stage Alzheimers disease diagnosis from a different doctor. There is also some disagreement about when a person who was originally diagnosed with MCI, and has worsening symptoms, should be diagnosed with Alzheimers disease instead.
According to the Alzheimers Association, individuals who have been diagnosed with MCI, particularly with memory issues, are more likely to later develop Alzheimers disease or a related dementia. Approximately 32% of individuals diagnosed with MCI develop Alzheimers disease within 5 years.
How Do You Treat Mild Cognitive Impairment
There are no definitive treatments that help mild cognitive impairment. Some physicians prescribe Alzheimers medications for these patients, but research is limited regarding its efficacy. Instead, most people are shifting their focus onto lifestyle changes and therapy, such as:
- Reducing high blood pressure
- Speech and language development
- Problem-solving
As you can see a speech therapists expertise matches closely with mild cognitive impairment signs. The benefit of in-home care for dementia and mild cognitive impairment is that you can use your home as a safe space. It helps develop familiar routines, involves family, and maximizes sessions.
In-home therapy can also reduce stress and worry that you or a loved one may have about driving to a therapy office. The primary benefit is that it uses professional guidance to help with cognitive tasks.
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What Causes Mild Cognitive Impairment
All possible causes of mild cognitive impairment have not been completely discovered. In a small number of cases, another condition may be causing the symptoms seen in mild cognitive impairment. Some of the possible conditions include:
- Depression, stress, and anxiety
- Diseases or conditions that affect blood flow in the brain
- Low vitamin B12 levels or other nutrient levels
- Eye or hearing problems
- Side effects of certain prescription or illegal drugs
- History of alcoholism
Many of these causes of mild cognitive impairment are treatable.
Most cases of MCI, however, are due to a variety of diseases, such as Alzheimers or Parkinsons disease.
Living With Mild Cognitive Impairment
Memory lapses and cognitive decline associated with MCI occur gradually and often do not cause significant troubles for a seniors daily life.
As family members, you can help your elderly loved one make use of notes, reminders, calendars in paper or electronic form to manage their daily activities better. Establishing routine, setting up fixed locations at home for items such as keys and handphones reduce the pressure to memorise things for your elderly. Memory slips happen to everyone every now and then, even with tools and support. Be sure to be extra patient when your loved one is diagnosed with MCI. Do not say things such as How can you forget.. which could be hurtful to someone with MCI.
If you are dealing with MCI yourself, remember that MCI is not a disability. It can be managed and it does not always equate dementia. You can still make the most of your golden years despite having MCI. When you go for MCI evaluation or even being diagnosed with MCI, you are taking your brain health matters in your hands for the best possible outcome.
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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.
How Is Mci Diagnosed
The diagnosis of mild cognitive impairment is relatively complex. No single test can confirm if a person has or does not have MCI. The doctor thus needs to conduct a clinical diagnosis based on the symptoms a patient experiences along with a series of tests and investigations to make the best judgement if MCI is present as well as its possible causes.
5.1. Clinical examination:
- Examination of general health and medical history
- Memory assessment such as interviewing the elderlies themselves and/or their close family members for a view of memory function and how severe memory loss is.
- Evaluation of memory mental functioning compared to age and education, including pen and paper tests to determine the mental status of the patient, such as Mini-Mental state examination or Montreal Cognitive Assessment .
5.2. Neurological examinations such as reflexes, eye movements, walking, and balance are performed.
5.3. Lab tests including blood tests to check for vitamin B-12 deficiency, thyroid functions, and other biomarkers ECG or sleep analysis, etc are performed to rule out other medical conditions and causes.
5.4. Radiological investigations such as specialised Magnetic Resonance Imaging and Positron emission tomography scans are performed to check for brain and blood vessel abnormalities.
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What To Expect From An Initial Evaluation For Cognitive Decline
It may not be realistic to expect definite answers. But that doesnt mean you cant expect some explanations.
Your health provider should be able to explain:
- How substantial the cognitive impairment appears to be, based on the office-based testing and the evaluation so far,
- What was checked for, and what has been ruled out as a cause for the problems youve been worried about,
- Whether any of the medications might be making memory or thinking worse, and what the options are for stopping or reducing those medications,
- What the healthcare team proposes to do next, to further evaluate the issues or follow up on the problems.
So if youve been worried about memory or thinking problems, ask for that medical evaluation. If your health provider skips any of the steps I listed, dont be shy and ask about it.
You probably wont get all the answers and certainty that youre hoping for, but youll have gotten started and thats vitally important.
Of course, you may well be facing the problem of not being able to get your older loved one to go to the doctor. Thats a very common issue, but its too complicated to cover in an article.
In the meantime, especially if its a challenge to see the doctor for some reason, then its all the more important to the most out of your medical evaluation when you do manage to get there.
This article was originally published in 2018, and was last reviewed by Dr. Kernisan in Dec 2022.
Oliver Baumann And Cindy Jones Brain Health Researchers At Bond University In Australia Discuss Memory Loss And The Aging Brain
Youve driven home from work along the same route for the past five years. But lately, youve been stopping at the same intersection, struggling to remember if you need to turn left or right.
Many occasions in everyday life can make us question whether lapses in memory are normal, a sign of cognitive decline, or even the beginning of dementia.
Our first instinct might be that its due to deterioration in our brains. And its true that like the rest of our body, our brain cells shrink when we get older. They also maintain fewer connections with other neurons and store less of the chemicals needed for sending messages to other neurons.
But not all memory lapses are due to age-related changes to our neurons. In many cases, the influencing factors are more trivial, including being tired, anxious, or distracted.
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