Definition

Mild cognitive impairment–amnestic type (MCI-AT) is mild, repeated memory loss. It lies between the normal memory loss of aging and the more serious conditions of dementia and Alzheimer’s disease (AD). MCI-AT only involves problems with memory. Dementia and AD involve loss of other cognitive (mental) abilities, such as learning, reasoning, making decisions, and problems with confusion, language, and attention.

People with MCI who are over age 65 have a higher chance of developing dementia and AD than people with normal memory. Some studies show a progression rate of 10%-15% per year. However, many people with MCI never develop these disorders. Some even revert to normal.

Causes

The causes of MCI are not clear. However, genetic factors may be a cause.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Risk factors include:

• Age: 65 and older
• Family history of MCI, dementia, or AD
• Medical conditions, such as high blood pressure, heart disease, diabetes, stroke, head injury, depression, anxiety, infections
• Overmedication
• Substance abuse

Research also suggests that these may be risk factors for MCI:

• Lack of physical activity
• Lack of social contact
• Low educational level
• Excessive response to stress
• Poor nutrition and lack of vitamins
• Exposure to toxins

Symptoms

The main symptom of MCI-AT is frequent, ongoing memory loss beyond what is normally expected for one’s age. That means having more than small lapses of memory like briefly forgetting someone’s name or forgetting to get something you need at the store. People with MCI remember much less of what they have just read or seen than people who have only the normal memory changes of aging. They may also take longer to recall the information that they can remember.

Diagnosis

The doctor will:

• Ask about your symptoms and medical history
• Perform a physical exam
• Perform tests to measure your cognitive skills, including memory

The doctor may also talk with your family members and any other caregivers. People with MCI should have their cognitive skills tested regularly to check for further decline.

Treatment

Treatment for MCI-AT is focused on preventing, or at least slowing down, further loss of memory and other cognitive abilities and preventing dementia and AD. Researchers are currently studying the effects that several medications may have on slowing cognitive decline. These include:

• Donepezil
• Vitamin E
• Tacrine
• Rivastigmine
• Galantamine

See the prevention section below for strategies that may also help slow cognitive decline once it has started.

Prevention

The following are being studied as ways to reduce the risk of cognitive decline:

• Managing medical conditions that may lead to MCI, especially high blood pressure
• Getting treatment for depression and hypothyroidism, if present
• Staying mentally active by doing things like memory exercises, crossword puzzles, reading, taking classes
• Getting regular exercise
• Participating in social activities
• Reducing stress
• Getting help for emotional problems
• Eating a balanced diet, including fruits and vegetables rich in antioxidants (vitamins C and E and beta-carotene)

RESOURCES:

National Institute on Aging
http://www.alzheimers.org

National Institute on Aging
http://www.nia.nih.gov

CANADIAN RESOURCES:

Alzheimer Association of Canada
www.alzheimer.ca

Seniors Canada On-line
http://www.seniors.gc.ca/

References:

Alzheimer’s Disease Education & Referral Center (Summer/Fall 1999). Connections: News from the ADEAR Center; 8(2).

Birks J, Flicker L. Donepezil for mild cognitive impairment. Cochrane Database Syst Rev. 2006;3:CD006104.

Feldman HH, Jacova C. Mild cognitive impairment. Am J Geriatr Psychiatry. 2005;13:645-655.

Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment. Lancet. 2006;367:1262-1270.

Institute for the Study of Aging and International Longevity Center–USA (March 2001). Achieving and Maintaining Cognitive Vitality With Aging: A Workshop Report. New York, NY.

National Institute on Aging (July 2003). 2001-2002 Progress Report on Alzheimer’s Disease.

Petersen RC, et al. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology. 1999;56(3): 303-308.

Petersen RC. Mild cognitive impairment: current research and clinical implications. Semin Neurol. 2007;27. Available at: http://www.medscape.comn/viewarticle/553257. Accessed on March 23, 2007.

ThirdAge WWW