Mild cognitive impairment (MCI)

As you age, a decline in your brain’s cognitive function – such as your attention and memory – is to be expected. When you experience a slight but noticeable decline in your mental abilities that is not a part of normal aging, this is known as mild cognitive impairment (MCI).

If you're experiencing symptoms of MCI, they may not impact your daily life significantly. However, it’s important to speak with your doctor since MCI can be an indicator of other neurodegenerative disorders like Alzheimer’s disease. Sometimes MCI symptoms can be improved, depending on the cause, so it’s vital to take a proactive approach.

What is mild cognitive impairment?

Mild cognitive impairment, also known as mild cognitive dysfunction or cognitive deficit, falls between the expected aging process after age 65 and more serious neurodegenerative conditions. The changes that happen in the brain with MCI are similar to changes seen with other neurodegenerative conditions such as dementia, but to a lesser degree.

Other neurodegenerative conditions include:

• Alzheimer’s disease
• Parkinson’s disease
• Vascular dementia
• Lewy body dementia
• Frontotemporal dementia

Changes in your brain that may be associated with MCI include:

• Decrease in the size of your hippocampus, which plays a major role in your learning and memory.
• Lack of glucose in the brain, which is the main source of energy for your cells.
• Abnormal enlargement of your brain’s ventricles, which puts pressure on your brain.
• Lack of sufficient blood flow through your brain’s blood vessels, which may cause small strokes and eventually lead to vascular dementia.
• Build-up of protein clumps called Lewy bodies in the brain, which is also associated with Lewy body dementia, Parkinson’s disease and Alzheimer’s disease.
• Increase in tau proteins or beta-amyloid proteins, which are also associated with Alzheimer’s disease.

These changes within your brain affect your cognitive function. With MCI, you might have trouble finding words or struggle with complex tasks, but you’re still able to take care of yourself and enjoy your normal activities. Symptoms may remain the same or get better.

Other types of brain disorders that damage your cognitive function have a more severe range of symptoms that impact your daily living. Symptoms usually get worse over time.

Causes of MCI

There are several possible causes that lead to the brain changes found in mild cognitive impairment. Sometimes, these causes can be treatable.

Causes of MCI include:

• Blood clots or tumors in the brain
• Head injuries
• Thyroid, kidney or liver problems
• Depression and anxiety
• Sleep disorders like sleep apnea
• Side effects of certain prescription medications
• Infections like a urinary tract infection (UTI)
• Excessive alcohol use
• Vitamin B12 deficiency

MCI risk factors

Genetics, age and certain conditions are the strongest risk factors for developing mild cognitive impairment.

Other risk factors for MCI include:

• Age 65 or older
• Family history of dementia
• Stroke
• High cholesterol levels
• High blood pressure
• Diabetes
• Depression

Can you recover from mild cognitive impairment?

Yes, if your cause of mild cognitive impairment is reversible – meaning it was due to factors that can be changed – it can be treated and your MCI symptoms should improve. Reversible causes include medication side effects, vitamin B12 deficiency and sleep disorders.

With treatment, your cognitive function may return to a similar function level as unaffected people in your age group.

How fast does mild cognitive impairment progress?

Having mild cognitive impairment puts you at risk of developing Alzheimer’s disease or another type of dementia. MCI can also be the early stage of these conditions. A study showed 15% of people 65 or older with MCI developed dementia within two years of their diagnosis.

Symptoms of MCI

Mild cognitive impairment symptoms can be divided into two types of cognitive changes – primarily affect memory (amnestic MCI) or primarily affect areas of thinking other than memory (nonamnestic MCI). The most common type is amnestic MCI.

Amnestic MCI symptoms include:

• Forgetting important information like appointments
• Misplacing items frequently
• Repeating the same questions or stories

Nonamnestic MCI symptoms include:

• Problems with decision making
• Trouble completing complex tasks
• Difficulty coming up with the right words
• Losing attention easily

Movement problems and the loss of your sense of smell can also be symptoms of MCI.

Diagnosing MCI

Since several conditions share similar symptoms with mild cognitive impairment, it can be difficult to confirm a diagnosis. However, it’s vital to properly diagnose MCI to avoid complications.

First, your doctor will want to discuss your family history, current medications and symptoms. If a family member noticed your symptoms, it may be helpful to bring them along. Your doctor will then order a series of tests to provide a diagnosis, rule out other conditions and find an underlying cause of MCI.

Tests may include:

• Neurological exam: Tests your eye movements, reflexes and balance.
• Cognitive testing: Includes verbal and written testing that evaluates your mental abilities.
• Blood or urine tests: Checks your thyroid levels and looks for vitamin deficiencies.
• Spinal tap (lumbar puncture): Checks your cerebrospinal fluid (CSF) for neurodegenerative diseases.
• Imaging tests: A CT or MRI scan looks for brain tumors, signs of stroke or bleeding in the brain.

MCI treatment

Your mild cognitive impairment treatment will be personalized to you. Treatment depends on multiple factors, including your age, any known cause of MCI and your medical history. You’ll need to stay in close contact with your doctor, including visits every few months to track symptom progression.

Reversible causes such as medication side effects or sleep apnea are usually treatable. Your doctor will work with you closely to manage your treatment while avoiding other side effects.

Researchers are studying new ways to treat MCI. One possibility is with Alzheimer’s disease medications. Learn more about research opportunities through the Advocate Memory Center.

Preventing MCI

If you’re at risk of developing mild cognitive impairment, staying in good cognitive health is important. This includes exercising regularly, maintaining a healthy diet rich in Omega-3 fatty acids and keeping your brain active. Studies have shown that playing word games, being social and reading books helps preserve your brain function.