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Definition
Mild cognitive impairmentamnestic 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 Alzheimers 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 activityLack of social contactLow educational levelExcessive response to stressPoor nutrition and lack of vitaminsExposure to toxins SymptomsThe main symptom of MCI-AT is frequent, ongoing memory loss beyond what is normally expected for ones age. That means having more than small lapses of memory like briefly forgetting someones 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 historyPerform a physical examPerform tests to measure your cognitive skills, including memoryThe 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. TreatmentTreatment 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:
DonepezilVitamin ETacrineRivastigmineGalantamineSee 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 pressureGetting treatment for depression and hypothyroidism, if present Staying mentally active by doing things like memory exercises, crossword puzzles, reading, taking classesGetting regular exerciseParticipating in social activitiesReducing stressGetting help for emotional problemsEating a balanced diet, including fruits and vegetables rich in antioxidants (vitamins C and E and beta-carotene) RESOURCES: National Institute on Aginghttp://www.alzheimers.org National Institute on Aginghttp://www.nia.nih.gov CANADIAN RESOURCES: Alzheimer Association of Canadawww.alzheimer.ca Seniors Canada On-linehttp://www.seniors.gc.ca/ References: Alzheimers 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 CenterUSA (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 Alzheimers 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. Last reviewed March 2008 by J. Thomas Megerian, MD, PhD, FAAPPlease be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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