Mild Cognitive Impairment

What are the symptoms of Mild Cognitive Impairment (MCI)?

Patients may notice their memory is not as good as it used to be. They may notice a harder time remembering names. They may lose their keys or forget what they went to the store or into a room for more often. However, other intellectual functions and judgment are normal. This has also been called Pre-Dementia. Only about half of these subjects may go on to develop Alzheimer’s disease. Although MCI usually occurs in older adults, it can occur at any age, and even in children (such as following repeated concussions in sports). If memory impairment is accompanied by other intellectual changes such as difficulty organizing, planning, recognition, language, or doing normal activities, this is more likely to be dementia rather than MCI, and the following discussion may not apply.

How is it diagnosed?

Diagnosis of mild cognitive impairment is made by showing impaired memory with normal intelligence through neuro-psychological testing. P300 brain mapping allows assessment of neuro-physiological information processing. In many individuals, the MCI is reversible if the cause can be found. Common reversible causes include depression, sleep disorders (especially Sleep Apnea, but also other causes of Daytime Sleepiness as well as Insomnia), hypothyroidism, Vitamin B12 or folate deficiency, and brain tumors. Genetic testing may be predictive of the chances of getting Alzheimer's. Repeating the neuro-psychological testing and the P300 brain mapping allows us to look at whether the cognitive impairment is worsening. If it is not worsening quite quickly, it may even be normal aging, not dementia or Alzheimer's.

How is it treated?

When a reversible cause is found, treatment involves treatment of this cause. In other cases, worsening of MCI can be slowed or stopped (with good control of hypertension and cholesterol in case of vascular causes, and with exercise, keeping the brain active, and certain medicines when a diagnosis of probable Alzheimer's disease is made). However, use of medicines for Alzheimer's should be avoided unless there is evidence for Alzheimer's. Not only do these medicine not work in the absence of Alzheimer's, they increase the risk of death.

When should I seek help?

When there is a persistent problem with memory in the absence of other intellectual changes or changes in judgment, and this interferes with functioning.