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My doctor thinks I have mild cognitive impairment - what does it mean?

Many people with concerns about their memory may come across the term ‘mild cognitive impairment’ (MCI) when they visit a clinician. Here we explain what is meant by MCI, how common this condition is and what it may mean for the future.

As we get older our memory and other types of thinking may become less reliable. These thinking skills are collectively known as ‘cognitive’ abilities. When they get worse than expected for a person’s age, but aren’t severe enough to make daily life difficult without help, this is known as ‘mild cognitive impairment’ or MCI.

What are the symptoms of MCI?

A person with MCI might have more difficulty remembering what they have done recently. They might take longer to work things out than they used to, or be less able to do more complex mental tasks, such as handling household finances or solving problems. They may also have difficulty staying focused on a particular task or conversation.

MCI is not a specific disease or condition. It’s just a term which indicates that something may be making your memory or thinking worse than it should be for your age.

It could be caused by a treatable problem, such as anxiety or depression or a more serious and progressive condition like Alzheimer’s disease

If you’ve been told that you have MCI then your doctor may not yet know for sure what’s causing your cognitive problems. This can be frustrating for people who want a more definite answer, particularly if they are worried about potentially developing dementia.

Does MCI always lead to dementia?

Some people worry that having MCI means they will inevitably develop dementia. However, the chances of a person with MCI progressing to dementia during the course of a year is somewhere between a 1 in 7 and 1 in 20 – so it’s far from inevitable. 

People who have particular difficulty with memory tend to be more likely to progress to dementia compared to those who have more general cognitive problems, such as having difficulties concentrating or solving problems. 

But it’s important to remember many people with MCI get better over time or at least stay at roughly the same cognitive level for several years.

My clinician says I have MCI – what next? 

If your clinician has told you that you have MCI, they are likely to ask you to come back in 6 –12 months for another appointment to review your condition. They may also advise you to come back in the meantime if you or others feel your symptoms are getting worse. 

Your doctor may review the medication you may be taking which could be affecting your cognitive abilities. This could include antidepressants, antihistamines, and incontinence drugs, as well as many others. 

We don’t yet have strong evidence that lifestyle changes can prevent or delay the progression of MCI to dementia. However, we do know that making certain changes can in general protect against cognitive decline.

Things you can do to help reduce your risk of mild cognitive impairment include:

  • stopping smoking
  • reducing the amount of alcohol you drink
  • being more physically active
  • eating more healthily
  • keeping your brain stimulated through a variety mental and social activities. 

Why is MCI a tricky issue for clinicians? 

The term ‘Mild Cognitive impairment’ was not originally intended to be used as a formal diagnosis for patients. For several years it was only used by researchers who wanted to identify people at risk of dementia as early as possible. They hoped that the earlier they caught people, the greater the chances of new drugs being effective in preventing dementia. 

More recently doctors have started using the term in clinical practice when a patient has some cognitive problems, but they’re not so severe as in dementia. However, because there is currently no official guidance for doctors about how to manage a patient with MCI, patients can end up with a very variable service.

Being told you have MCI

Being told you have MCI could be helpful as it confirms something may be wrong. It allows clinicians to monitor you closely and ensure you can access support services. 

However, some clinicians feel telling someone they have MCI can leave them in ‘limbo’. It may cause them to worry about developing dementia which may never happen.

Better MCI tests are needed

Alzheimer’s Society is supporting a number of research projects to improve the diagnosis of diseases causing dementia at the very earliest stages. 

New tests are being developed such as lumbar punctures, which look for tell-tale chemicals in the person’s spinal fluid, and sophisticated brain scans, which can show disease happening in certain regions of the brain. 

Together, these should give us a better understanding of whether the cognitive problems experienced by a person are caused by a disease that can ultimately lead to dementia, such as Alzheimer’s disease, vascular disease or Lewy body disease. Some of these tests are now starting to be used in clinical practice, although many remain very much at the research stage.

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Do you want to take part in research about dementia?

Join Dementia Research helps people with dementia, their carers, or anyone interested in dementia research to be matched to studies taking place in their area.

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17 comments

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I am really struggling, my partner has vascular dementia

Hi Catherine,
Sorry to hear you're struggling - it sounds like you're going through a difficult time.
If you'd like to talk to somebody about your situation, please do call one of our Dementia Advisers who can give you some information, advice or emotional support. You can call on 0300 222 11 22, and find more details and opening hours here: https://www.alzheimers.org.uk/get-support/national-dementia-helpline
Hope this helps,
--
Alzheimer's Society blog team

Interesting article re MCI. It has made me realise that my, sometimes, forgetfulness may not be something serious. One good thing though, I am getting lots of exercise as I often have to go upstairs a few times when I am going out as I realise I have left things in the bedroom I might need, Come to think of it, I know people much younger than myself who often do that anyway or seem rather disorganised.

Thank you your symptoms are exactly what I am experiencing I now have a name for it,

My Father was diagnosed with Alzheimer’s disease. However, he didn’t show signs of dementia until he was in his early 90’s. It has also been slow to progress and until recently only affected his memory. Our family wondered if we could have some of Dad’s brain cells sent for research after his death to confirm if he had Alzheimer’s or LATE. Also we feel Dad would like to help with research after his death. We have power of attorney for his health and well-being.

I have had this announcement' after an MRI scan of the brain, I am interested in further information and how to adjust/manage all this in addition I am experiencing severe headaches linked to with ...in my view loss of the sight in my left eye. Since ,the headaches begin in the eye sockets and goes to the left side of my brain and down my neck sometimes .This week I will have a further consultation with my GP as the pain is sometimes affecting my sleeping patterns.

I was told I had MCI by the local consultant psychiatrist for olde people, but it was nothing to worry about; that the stroke (lateral medulla syndrome) suffered in 2010 where two or three cells were destroyed would have caused some of my memory loss, though I gather the kind of memory loss that I increasingly suffer from is perfectly normal for people of my age. I've recently taken a memory test at the clinic and scored 97%, which I'm assured is really good? I am just 82. So though I do suffer from memory problems, speech and language problems, and confusion and am easily muddled, my cognitive abilities are excellent still.
What worries me are the confusion,the muddle I get in when trying to describe or explain; the edginessand grumpiness, the over reaction and short fuse I sometimes exhibit when irritated by someone. Some of this is down to depression, as is the total lethargy, lack of energy or motivation or enthusiasm, and despite a lively mind, the desire to rest. I don't think Sertralene works any more as an antidepressant, as it just makes me sleepy and lethargic. I worry about not being able to tell whether I'm just! depressed (enough traumas in the last two years) or fading like many of my contemporaries who share my "independent living" development, into full blown dementia . My consultant says it may or may not but if Alzheimer's is possible it won't be for a good long time.
In the meantime I can no longer exercise in a meaningful way because of mobility problems, have little interaction with others, and these are said to be essentials for avoiding the onset of Alzheimer's

was probably the start of it

We are in the process of getting a diagnosis for my husband. Our gp arranged the blood tests, MRI scan and heart trace and yesterday, a CPN came to the house and tested him and spoke to us both. We now await a consultant appointment for a diagnosis. There were quite a few things that he couldn’t answer. He was asked the name of the US President and even I couldn’t bring it to mind!!!!! I will be back when we have seen the consultant xx

It seems to me that a lot of effort is made to hELP CARERS BUT NO EFFORT TO HELP THE suffer of mental loss
They are written off
I believe the brain can be improved and repaired in time if one could find the trained person
Can you help
Eustace

Bilateral asymmetrical movements a d coordination exercises can improve cognitive skills and replace lost pathways for every day function

Please see this article https://healthland.time.com/2012/02/08/why-a-new-definition-of-cognitiv… which points out the blurry line between MCI and 'mild dementia' and that whilst 'not all patients with MCI go on to develop alzheimers; almost all cases of alzheimers start with MCI'.
It also highlights that for those whose impairment is likely due to alzheimers, it may do the patient and the family a disservice to call it MCI. My mum was diagnosed with MCI and the symptoms progressed very quickly, but she had been given a 12 month period for review. That was obviously too long. The article also points out that there should be more in depth interviews with patients' family members who can point out changes in behaviour and mental functioning. Early intervention is supposed to be best practise and therefore the reclassification of mild dementia to MCI (as discussed in this article) appears to be the exact opposite of that and quite possibly more to do with reducing the financial cost of providing help and support!

I live in Australia and decided to subscribe to the Alzheimer’s Society in UK. I have found it extremely interesting and very informative.
Thank you .
Louise French.

Can you please expand on how and which incontinence drugs can effect cognitive ability

Hello Mrs Mawdsley. Thank you for getting in touch.
Research has shown that some anticholinergic drugs seem to increase risk of dementia when used over an extended period.
You can read our full comment on this research via the link: https://www.alzheimers.org.uk/news/2019-06-24/commonly-prescribed-drugs…
We hope that's helpful.
-
Alzheimer's Society research communications team

Studies indicate that the prevalence of MCI is about 18,5% for people older than 65 years. Other studies indicate that 30,2% of these patients can heal to healthy aging. That means that prevention make sense...the goal is to make an early MCI diagnose...we are developing a companion robot for that...

My wife has been diagnosed with MCI and her neurologist has her on Donepezil (20Mg/day) and Memantine (20Mg/day). What is the success record of this treatment? She is 79 years old.

Hello James, thank you for getting in touch.
We’re sorry to hear about your wife being told she has MCI.
Unfortunately, we’re unable to advise on individual cases. We recommend talking to the clinician to address any concerns about the drugs being used to treat your wife's condition.
You should always feel free to ask the physician to outline their reasons for prescribing them and also to have a full and frank discussion about what options are most suitable at this stage.
If you would like to speak with one of our dementia advisers about your situation, please call 0333 150 3456. They're available seven days a week to give you support. You can find opening hours here: https://www.alzheimers.org.uk/dementiaconnect
Wishing you all the best, James.
-
Alzheimer’s Society blog team

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