What Is Mild Cognitive Impairment?

Mild cognitive impairment (MCI) may not sound very serious. But this condition, which can affect memory and thinking skills, could be a stealthy danger to many Americans for a few reasons. First, many people are not very familiar with MCI. In fact, more than 80% of Americans know little about MCI or are not familiar with it at all, according to a 2022 report from the Alzheimer’s Association. Simultaneously, with our country’s fast-growing senior population, it’s more important than ever to learn about MCI. The report estimates that 12% to 18% of Americans age 60 and older are living with MCI, which can be an early stage of Alzheimer’s disease. Of those affected, approximately 10% to 15% develop dementia every year. Approximately 1 out of 3 people living with mild cognitive impairment will develop dementia related to Alzheimer’s disease within 5 years. Let’s look a little deeper into this condition, which can have potentially serious outcomes. More than 80% of Americans know little about mild cognitive impairment (MCI) or are not familiar with it at all. But 12% to 18% of Americans age 60 and older are living with MCI, which affects memory and thinking skills.

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MILD COGNITIVE IMPAIRMENT SYMPTOMS AND CAUSES

Many people believe that memory loss and cognitive impairment are simply side effects of normal aging. However those with MCI experience memory or thinking problems that are more pronounced than would be expected for their age. The National Institute on Aging (NIA) notes that there is no single cause of MCI, but there are factors that can increase risk, such as:

• Aging
• Diabetes
• Depression
• Stroke

Though the NIA points out that MCI symptoms are not as severe as those associated with Alzheimer’s or dementia (such as personality changes), they do affect daily life. People with MCI can still function on a day-to-day basis, but they may experience areas of confusion. For example, they may lose items, forget events or commitments, or have trouble finding words when speaking. They may even notice problems with their movement or sense of smell. The Alzheimer’s Association distinguishes between two types of MCI: Amnestic and Nonamnestic.

• Amnestic MCI mostly affects memory, leading to forgetfulness.
• Nonamnestic MCI impacts thinking skills. The person may have a compromised ability to make sound decisions, misunderstand timing or the steps needed to perform a complex task, or have trouble with visual perception.

MILD COGNITIVE IMPAIRMENT MAY LEAD TO DEMENTIA

Given that Alzheimer’s disease now affects an estimated 6.7 million Americans and is the most common form of dementia, understanding mild cognitive impairment can have widespread effects. As a reminder, dementia is an umbrella term that describes a variety of diseases and conditions that develop when nerve cells in the brain die off or no longer function normally. Being on the lookout for early symptoms of Alzheimer’s, such as MCI, can be crucial for starting possible interventions earlier. Certain steps can support and help preserve the memory, and the sooner they begin, the better the outcomes may be. As implied in the statistics above, not all MCI cases develop into dementia. The Alzheimer’s Association points out that MCI can reflect an early stage of neurodegenerative disease development—including Alzheimer’s—if the person experiences the hallmark changes in the brain associated with those diseases. However, some people with MCI can return back to their normal cognition or remain at the same level of impairment without worsening. Diagnosis guidelines for Alzheimer’s and MCI would ideally start at the preclinical stage, which means that noticeable symptoms such as memory loss have not yet occurred. However researchers are still working on identifying the internal biological changes (called biomarkers) that may signal a future issue. In the meantime, medical professionals utilize a variety of tactics to arrive at a diagnosis, such as:

• Medical history
• Assessment of functioning
• Memory tests
• Mood evaluation
• Blood tests

PREVENTION AND TREATMENT FOR MILD COGNITIVE IMPAIRMENT

To get the full picture of a developing case of MCI, it can be helpful to screen for dementia with a brain scan. Functional brain scans are especially helpful in determining early signs of dementia—even before symptoms occur. These tools include:

• SPECT (single-photon emission computerized tomography) scans
• QEEG (quantitative electroencephalogram) imaging
• PET (positron emission tomography) scans

It’s also important to rule out other causes of MCI. In some cases, medication can cause cognitive impairment, leading to a false diagnosis of MCI. In other cases, cognitive problems can develop due to separate health conditions such as:

• Depression, anxiety, or chronic stress
• Conditions that reduce blood flow to the brain
• Substance use disorders
• Sleep apnea
• Thyroid issues
• Nutritional deficiencies
• Infections

Treating these issues can help eradicate the MCI symptoms. In terms of prevention, some research is focusing on decreasing the risk factors for cardiovascular disease, in order to reduce the risk of MCI and dementia. One such study, presented in 2018 at the Alzheimer’s Association International Conference, suggested that “aggressive treatment of high blood pressure (targeting a systolic blood pressure goal of less than 120 mm Hg)” was associated with fewer new cases of MCI and dementia. The study results showed that in one group receiving this blood pressure treatment, 19% fewer people developed mild cognitive impairment. And 15% fewer people developed MCI or dementia (regardless of the underlying cause). Therefore, scientists are interested in studying the overall lifestyle changes that can help with MCI prevention. The two-year U.S. Study to Protect Brain Health Through Lifestyle Intervention to Reduce Risk is currently underway to look more closely at whether various interventions can protect cognitive function in older adults who have an increased risk for cognitive decline. The interventions being studied include:

• Physical exercise
• Nutritional counseling and modification
• Cognitive and social stimulation
• Improved self-management of health

This project follows a 2014 two-year study performed in Finland, which evaluated healthy older adults who had an increased risk of cognitive decline and dementia. This study called the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability, found that certain steps, including diet, exercise, cognitive training, and vascular risk monitoring, “could improve or maintain cognitive functioning in at-risk elderly people.” Currently, treatments for MCI include medications that target the buildup of beta-amyloid plaques in the brain. These have been linked to Alzheimer’s, although this association has been questioned. However other brain changes seen with Alzheimer’s, such as inflammation, shrinkage, and low blood flow, can be evaluated through brain SPECT imaging before symptoms show. It’s important for those with mild cognitive impairment to undergo testing, and to continue to test regularly to track the progression of the condition.

COMBINING INTERVENTIONS FOR BETTER OUTCOMES

As suggested in the Finnish study, staving off dementia including Alzheimer’s after the onset of MCI can likely be best achieved through a multi-pronged approach. MCI may be labeled “mild,” but its impact on our daily lives and loved ones can create serious side effects over time. When we take better care of our bodies and brains through making better health decisions—from as early an age as possible—we increase our chances for improved brain health for years to come. Memory loss and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.