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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