Some changes in memory and thinking are a normal part of aging. But experts say a little-known condition called mild cognitive impairment (MCI) is different, and failing to get help for it can hasten dementia.
“If we’re able to identify mild cognitive impairment, we can start to do some interventions to lessen the likelihood one will go on to develop dementia,” said Dr. Ryan Schroeder, a Wichita neuropsychologist who treats MCI.
MCI is the subject of a special report in the Alzheimer’s Association annual report released last month. Some, but not all, cases of MCI are caused by the same changes in the brain that cause Alzheimer’s. About one-third of people with MCI develop dementia due to Alzheimer’s within five years.
According to the report, about 12 to 18 percent of people 60 and older live with MCI. The condition causes changes serious enough to be noticed by the affected person, family members and friends, but not serious enough to prevent everyday activities.
Schroeder, an associate professor at the University of Kansas School of Medicine – Wichita, gave this example of the difference between MCI and normal aging: “A person who’s normally aging, they might periodically — once a week, let’s say — forget to take their medication. Versus somebody with mild cognitive impairment might be missing medication more regularly, but they’re not at the point where they’re just completely forgetting their medication.”
MCI is classified either as amnestic — in which memory problems dominate — or nonamenstic, in which language, visual spatial skills and the ability to complete tasks are affected.
Dr. Ryan Schroeder treats patients with mild cognitive impairment. Photo courtesy of KU School of Medicine-Wichita.
There’s no medical test that gives a definitive diagnosis. Instead, physicians use patient questionnaires and assessment tools to see if it might be present. The Alzheimer’s Association report notes that diagnosis is challenging.
The reason why it’s important to diagnose MCI is because in some cases, it may be possible to reverse or at least stabilize symptoms related to it. For instance, MCI that is caused by a certain medication may disappear when the medication is changed. Depression, anxiety, insomnia and sleep apnea are treatable conditions that can cause MCI. The condition can also arise as part of a stroke or other vascular disease, brain injury, psychiatric and neurologic disorders.
Physicians often recommend lifestyle changes to combat MCI. Schroder said a healthy lifestyle involves exercising your brain and body and eating right.
“For any type of MCI, some of the absolute best things a person can do is exercise,” he said. “As beneficial as it is for the heart, it’s just as beneficial for the brain. People who engage in aerobic exercise in particular are at lower risk of developing dementia.”
Schroeder described that exercise as involving an “elevated heart rate level, more than just a causal walk” and totaling at least 150 minutes per week.
Cognitive exercises, he said, are “activities that stimulate your brain. That could be reading, crossword puzzles. There are a number of brain- training activities that are sometimes recommended.”
A diet high in lean protein and low in saturated fats also lessens the risk of dementia.
Diagnosis in cases where MCI is caused by the same biological changes that cause Alzheimer’s may help the affected patient get early treatment for Alzheimer’s, which has been proven more beneficial in slowing progress of the disease.
A survey conducted by the Alzheimer’s Association found:
• Fewer than 1 in 5 Americans are familiar with MCI, and more than half say it sounds like “normal aging” after hearing it described.
• 85 percent of Americans say they would want to know if they had Alzheimer’s early, including during the MCI stage, for the purpose of planning for the future and taking steps to treat it.
• 40 percent of Americans say they would consult a doctor right away if experiencing symptoms of MCI, with most preferring to see if the symptoms persist.
• Nearly all primary care physicians say it’s important to diagnose MCI but a third say they are not comfortable doing so.
• 72 percent of physicians say the biggest challenge in diagnosing MCI is distinguishing it from normal aging.
• 90 percent of physicians said it’s hard to know where MCI ends and dementia begins.
• 86 percent of physicians say early intervention can slow cognitive decline, and they most often recommend lifestyle changes.
Prevalence of Mild Cognitive Impairment in older adults by age
Age Prevalence
60-64 6.7%
65-69 8.4%
70-74 10.1%
75-79 14.8%
80-84 25.2%
Strongest risk factors for Mild Cognitive Impairment
Increasing age
Having a specific form of the gene that has been linked to Alzheimer’s disease
Medical conditions and other factors such as:
Diabetes
Smoking
High blood pressure
High cholesterol
Obesity
Depression
Sedentary lifestyle
Infrequent participation in mentally or socially stimulating activities
