Are There Risk Factors For The Development Of Mild Cognitive Impairment
Scientists know that the strongest risk factors for the development of mild cognitive impairment are the same as those for dementia: older age, family history of dementia, and conditions that increase the risk of cardiovascular disease including high blood pressure, high cholesterol levels, diabetes, obesity, and stroke.
How Is Mild Cognitive Impairment Related To Alzheimers
Mild cognitive impairment causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimers or another dementia. activities. Approximately 15% to 20% of people age 65 or older have MCI.
Whether mild cognitive impairment has a distinct neuropathological profile that reflects an intermediate state between no cognitive impairment and dementia is not clear.
Mild Cognitive Impairment Vs Alzheimers Disease Five Ways The Diseases Differ
Mild cognitive impairment is a condition where mental decline is more prominent than it should be for the age. Some believe it can be a precursor to Alzheimers disease, but it doesnt have to be. While mild cognitive impairment may progress into Alzheimers in some, others never see a progression.
When MCI is present, senior citizens may worry they have Alzheimers. There are differences between this disease and Alzheimers.
#1 Mild Cognitive Impairment Doesnt Impact Daily Routines
Memory and speech may be affected by MCI. Its usually so mild that people figure its a normal part of aging. Daily activities of living are not impacted. With this condition, seniors wont forget to eat meals and can keep up with grooming and personal care.
#2 Alzheimers Sees Reasoning and Judgment Skills Diminish
Reasoning and judgment skills diminish as Alzheimers progresses. That doesnt happen with mild cognitive impairment. As an example, someone with Alzheimers who is losing these skills might send thousands of dollars to a person after getting an email saying theyd inherited millions from someone in another country.
#3 Mild Cognitive Impairment Doesnt Always Cause Worsening Symptoms
#4 Alzheimers Disease Causes Psychological Changes
#5 Mild Cognitive Impairment May Get Triggered by Anxiety or Depression
There are cases where MCI is the result of extreme anxiety or depression. Once the patient is on a medication that works, cognitive skills improve.
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What Causes Mild Cognitive Impairment
Many factors can cause problems with memory and thinking. There is no single cause of MCI, and it’s more likely to occur as someone ages. Estimates vary, but roughly 10% to 20% of people over age 65 have MCI, with the risk increasing as someone gets older. Other factors like genetics and certain conditions including diabetes, depression, and stroke may affect a persons risk for MCI.
In some cases, memory and thinking problems may be caused by conditions that are treatable. For example, a bad reaction to medication, emotional problems, drinking too much alcohol, blood clots or tumors in the brain, or a head injury can all cause serious memory problems that can be resolved with treatment.
Symptoms Of Mild Cognitive Impairment
The term MCI describes a set of symptoms, rather than a specific disease. A person with MCI has mild problems with one or more of the following:
- memory – for example, forgetting recent events or repeating the same question
- reasoning, planning or problem-solving – for example, struggling with thinking things through
- attention – for example, being very easily distracted
- language – for example, taking much longer than usual to find the right word for something
- visual depth perception – for example, struggling to interpret an object in three dimensions, judge distances or navigate stairs.
These symptoms may have been noticed by the individual, or by those who know them. For a person with MCI, these changes may cause them to experience minor problems or need a little help with more demanding daily tasks . However, MCI does not cause major problems with everyday living. If there is a significant impact on everyday activities, this may suggest dementia.
Most healthy people experience a gradual decline in mental abilities as part of ageing. In someone with MCI, however, the decline in mental abilities is greater than in normal ageing. For example, it’s common in normal ageing to have to pause to remember directions or to forget words occasionally, but it’s not normal to become lost in familiar places or to forget the names of close family members.
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Read about how the signs of dementia differ from normal ageing.
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Facts About Mild Cognitive Impairment
Mild cognitive impairment is a condition that falls somewhere between normal age-related memory loss and Alzheimerâs disease or a similar impairment. Not everyone with MCI develops dementia. And like dementia, MCI is not an illness, but a cluster of symptoms that describes changes in how you think or process information. Memory problems are the most common indicators of MCI. A person with MCI may also experience difficulties with judgment, thinking, and language beyond what one might expect with normal aging. For unknown reasons, MCI appears to affect men more than women.
Family members and friends who notice these problems might not express concern because the early symptoms can mimic normal, age-related changes. People suffering from MCI often recognize they are having trouble but are still able to carry on most of their usual activities and live independently.
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
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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.
Can Mild Cognitive Impairment Be Reversed
In some cases, MCI may be reversible.
There arent currently any medications that have been approved by the Food and Drug Administration to treat MCI.
But MCI can be treated if its caused by any of the following:
- stroke or vascular disease
- traumatic brain injury like a concussion
- a medication, as a side effect
- depression or anxiety
Changing or stopping medications or working with a therapist or doctor to treat insomnia, depression, or anxiety could reverse or even cure MCI.
In other cases, MCI will advance to dementia or Alzheimers disease, which are progressive conditions. This means that your ability to perform daily activities may worsen over time.
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How Is Mci Diagnosed
Mild cognitive impairment is primarily identified in people who already have concerns about their cognition but, when tested, they dont quite rise to the clinical definition of dementia. Their memory or thinking abilities have declined over time but this does not impact their day-to-day activities.
This cognitive impairment is assessed through the use of standardized memory and thinking tests administered by a health care professional.
When doctors assess a persons mental performance, an MCI patients score may show a mild level of impairment for their age and education level. Medical professionals use tests such as the Mini-Mental State Examination or the Montreal Cognitive Assessment to do these evaluations.
The results for a person with MCI are typically not significant enough to be labeled dementia. It is important to note that a diagnosis of MCI typically requires significant clinical judgment by your doctor and this could include multiple tests of your memory and cognition, images of your brain, and blood tests.
Where Is The Line
According to the NationalInstitutes on Aging, MCI patients exhibit more severe problems associatedwith memory than the average person their age, but they dont displaypersonality changes or difficulties they classify as moderate symptoms ofAlzheimers such as:
- Hallucinations and paranoia
- Angry outbursts,restlessness and agitation
- Trouble with reading, writingand math
- Short attention span
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Is There Treatment For Mild Cognitive Impairment
There is no FDA-approved treatment for MCIs.
However, some of the drugs that are approved for use in Alzheimers disease patients may be helpful. Cholinesterase inhibitors and NMDA receptor antagonists are the two classes of drugs that are approved for use in Alzheimers disease. They typically only work for a short period of time though.
Non-pharmaceutical approaches can demonstrate benefit in the MCI patient. One of the most common suggestions is to exercise regularly as exercise is known to improve brain health.
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.
What Is Alzheimers Disease
Alzheimers disease is a progressive brain disease. Its the 6th leading cause of death in the United States and, as of now, there is no cure.
Alzheimers causes problems with cognitive functions like memory, judgement, decision-making, and behavior.
SymptomsAlzheimers symptoms are unpredictable, but usually develop slowly and worsen over time.
It will get progressively more difficult for the person with Alzheimers to carry on a conversation or perform everyday tasks.
Other common symptoms are confusion, aggression, and mood changes.
In the early stages, memory loss and other symptoms are usually mild.
In later stages, common symptoms include problems with communication, complete dependence on others for care, loss of mobility, incontinence, problems eating, and challenging behaviors like repetitive questions, rummaging, wandering, or asking to go home.
Current FDA-approved treatments may reduce or delay symptoms, but typically work best in the early stages of the disease.
I Heard There Are Two Types Of Mci
MCI that primarily affects memory is known as amnestic MCI. With amnestic MCI, a person may start to forget important information that he or she would previously have recalled easily, such as:
- Appointments, conversations or recent events
- The names of certain friends and/or new caregivers
- Whether a medication was taken on time and in the right dosage
- The way to familiar locations
Nonamnestic MCI affects thinking skills other than memory, such as:
- Ability to make sound decisions
- Ability to judge the time or sequence of steps needed to complete a complex task
- Visual perception
- Executive functioning
The worried well. These are people who seek a medical diagnosis for their memory loss but, upon testing, do not meet the threshold for MCI. That doesnt mean they are not experiencing issues with memory loss but the cognitive issues are due to normal aging, stress, anxiety or other issues. Often the worried well can improve with therapy services and simple memory compensation strategies, such as using calendars and notepads.
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Is There A Conclusive Test That Diagnoses Mci
Not currently. According to the Alzheimers Association, MCI is a clinical diagnosis representing a doctors best professional judgment. There are currently no tests or procedures to demonstrate conclusively that a person has MCI.
The demarcations between normal cognition and MCI, and between MCI and Alzheimers, are difficult to define. Clinical judgment and cognitive testing over time is needed. Therefore, experts recommend that a person diagnosed with MCI be re-evaluated every six months to determine if symptoms are staying the same, improving or growing worse.
The Mayo Clinic web site has a good overview of MCI Tests & Diagnosis.
The Alzheimers Association and the National Institute on Aging have convened expert workgroups to update the diagnostic criteria and guidelines for MCI.
Does Everyone With Mci Eventually Develop Alzheimer’s Disease
No, not everyone with Mild Cognitive Impairment will develop Alzheimers disease or dementia.
Here is the good news:
- 1 out of 5 people diagnosed with MCI will go back to normal cognitive functioning within 3 4 years of their MCI diagnosis
- Many people with MCI remain stable for several years without progressing to Alzheimers disease or dementia
Some other facts:
- Long-term studies suggest that 10-20% of people aged 65 and older may have Mild Cognitive Impairment
- As many as 15-20% of these individuals progress from MCI to exhibiting the symptoms of dementia each year. This is compared with 1-2% of the general adult population.
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Mild Cognitive Impairment Defined
How MCI is defined has evolved over the years. Its commonlythought of as the period between healthy cognitive function and the onset ofAlzheimers.
Initially, guidelines for MCI diagnosis only allowed forsomeone to show impairment in terms of memory. Other cognitive functionshad to continue as normal. That definition was altered to allow for problems inreasoning and judgment, but a person had to continue functioning as theynormally would in their daily life. If their activities of daily living changedradically, the diagnosis was typically dementia or the early stages ofAlzheimers disease.
Research teams from the Alzheimers Association and National Institutes of Aging then supported a revised definition of MCI which allowed for mild impairment in activities of daily living as well as some of the cognitive challenges outlined above. As a result, drawing a clear line between Alzheimers and MCI continued to prove difficult.
What Happens In Mci
Typically, memory complaints include trouble remembering the names of people they met recently, trouble remembering the flow of a conversation and an increased tendency to misplace things or similar problems. In many cases, the individual will be quite aware of these difficulties and will compensate with increased reliance on notes and calendars. These problems are similar but less severe than the neuropsychological findings associated with Alzheimers disease. In some cases, the patient may have mild difficulties with daily activities, such as performing hobbies.
The medical evaluation should include a thorough exploration of the memory complaints, including what type of information is being forgotten and when, the duration of the problem, and whether other cognitive complaints are occurring . The physician should be aware of the patients medical history, the medications prescribed, etc. As subjective memory complaints can be associated with depression, screening for depressive symptoms is always warranted. Depending on the results of this evaluation, further testing may necessary, including blood-work and brain imaging. This evaluation is similar to that given to individuals with more severe memory problems and is directed towards better defining the problem and looking for medical conditions that might have an effect on the brain . The medical history usually requires the participation of a knowledgeable informant.
Abnormal Clumps Of Proteins
If you looked at three groups of people, normal aging, mild cognitive impairment and, lets say, Alzheimers disease patients. And we looked at hundreds of peoples brains in each of those groups, the average level of amyloid plaques would be low in normal aging, high in the Alzheimers disease group and somewhere in the middle for MCI.
Can Memory Loss Ever Be Reversed
Yes! There are a number of conditions that produce symptoms similar to dementia which can often be treated:
- Vitamin and hormone deficiencies
- Brain tumors
It is essential that a medical diagnosis is obtained at an early stage when memory loss symptoms first appear to ensure that a treatable condition is diagnosed and treated correctly.
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Vascular Risk Factor Control
Current pharmacological and non-pharmacological modifications of vascular disease and its risks have been found to have only a marginal effect on reducing dementia prevalence in the general population . Indeed, most strategies, whether pharmacological or non-pharmacological, are ineffective in the prevention of dementia and are potentially harmful. With regard to MCI, while pharmacological and lifestyle modifications have been found to be effective in ameliorating cognitive impairment in selected older cohorts , no consistently positive results have emerged from randomised controlled trials for such manipulation in the prevention of MCI or future dementia progression in older people in the general population . Where the primary prevention of VCIND has been considered, physical activity has been found to reduce the risk of VCIND in women, but not men . Why gender differences emerged in this study is unclear but is thought to be linked to gender reporting bias in physical activity levels or to statistical error due to the small number of male cases. However, before recommendations based on this result can be made, it must be replicated in population-representative samples using objective measures of physical activity.