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Dementia Aware  

Is MCI a type of dementia?

What you need to know about a diagnosis of mild cognitive impairment (MCI)

Some people experience mild changes in memory and thinking abilities that are noticeable to the person affected, and to family and friends, but do not affect the individual’s ability to carry out every-day activities.

It is a neuro-cognitive disorder, but not severe enough to warrant a diagnosis of dementia. It is called mild cognitive impairment (MCI) and affects approximately 15-20 per cent of people 65 or older.

The term mild is used in comparison to the more severe functional impairments of dementia. The difficulties experienced by a person with MCI varies, however most people show cognitive decline greater than expected for their age and education level.

People with MCI  may have difficulties with:

  • Memory
  • Language
  • Attention
  • Processing visual/spatial information
  • Complex thinking

Diagnosis

Diagnosing mild cognitive impairment (MCI) requires a careful and comprehensive medical and cognitive assessment including family and medical history, medication review, and blood tests, to rule out other causes of cognitive impairment e.g. depression, familial Alzheimer’s Disease, nutritional deficiency, endocrine problem.

The following criteria* is used by doctors to determine if a person has MCI:

  • Memory complaint, preferably supported by another person
  • Memory impairment detected with standard tests of cognitive function
  • Intact activities of daily living
  • Decline in one or more cognitive skills
  • Failure to satisfy criteria for dementia

There are two types of MCI:

Amnestic

  • Memory impairment
  • Most common form of MCI
  • May progress to Alzheimer’s disease

Non-amnestic

  • Memory usually not impaired
  • Other cognitive skills such attention, language, or problem solving is most impaired
  • May progress to Lewy body dementia or temporal frontal love dementia

Treatment

While there is no specific treatment for MCI, research indicates that following a healthy lifestyle and keeping the brain active is associated with a lower risk of cognitive decline.

A person with MCI will be regularly monitored and assessed for any changes in cognitive abilities. Counselling will also help support the person with MCI and caregiver to adjust to the diagnosis and plan for the future. Lifestyle strategies that are likely beneficial to people with MCI include:

  • Brain training: participating in mentally stimulating activities is associated with lower risk of cognitive decline which may help people with MCI
  • Physical exercise: studies indicate cognitive decline is reduced in people with MCI who walk daily
  • Healthy diet: following the Mediterranean diet has been associated with a lower risk of progression from MCI to dementia
  • Social activity: continue to work, volunteer, participate in meaningful activities, meet with friends
  • Management of any pre-existing medical conditions e.g.  diabetes, high blood pressure, high cholesterol which can contribute to cognitive decline
  • Stop smoking and/or controlled substance use
  • Reduce alcohol intake
  • Manage weight: obesity also increases risk of cognitive decline

Studies have shown that people with MCI are more prone to depression, anxiety, increased stress and sleep disorders. This is thought to be related to the uncertainty of whether or not the MCI will resolve or become dementia (Lautenschlager and Kurz, 2010).

Will I get dementia?

Mild cognitive impairment (MCI) is often thought of as a transitional state between normal aging and early dementia, and research does indicate that people with MCI are more likely to develop dementia, especially Alzheimer’s disease.

However, MCI can develop for many reasons and does not always lead to dementia e.g. medication, thyroid deficiency. Therefore, it is important that anyone experiencing memory problems see his/her doctor for an assessment and possible treatment.

The conversion rate from MCI to dementia is around 10-15 per cent per year. For example, if 100 people are diagnosed with MCI this year, 10-15 of them will have dementia next year.

In 10 years, 65-81 of them will have dementia. But this also means that most of them will not have dementia next year; and even in 10 years between 19 and 35 of them will not have dementia (Hughes, 2011).

Some people with MCI, primarily those without memory problems, experience an improvement in cognition or revert to normal cognitive status.

It is unclear why some people with MCI develop dementia and others do not. Therefore, identifying which individuals with mild cognitive impairment are more likely to develop Alzheimer’s disease and other dementias is a major goal of current research.

*Ward A., Tardiff S., Dye C., & Arrighi HM. (2013). Rate of conversion from prodromal Alzheimer’s disease to Alzheimer’s dementia: a systematic review of the literature. Dementia Geriatric Cognitive Disorder Extra 2013; 3: 320-332. 13



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About the Author

Tracey Maxfield, RN, BSN, GNC(c), DDS, is a dementia educator, consultant and advocate with over 35 years working with dementia populations in the U.K. and Canada.

She has worked in a variety of heath-care settings: acute care, palliative care, community care, residential care, physicians offices and community health centres.

Tracey has appeared on the U.S. radio shows Caregivers With Hope and Alzheimer’s Speaks, and has a dementia column in an on-line medical and holistic magazine, The Scrutinizer. 

She is a the Purple Angel Dementia Ambassador for the Central Okanagan, and sits on the board of directors for Seniors Outreach Society, and is a committee member of the Better At Home program.

She can be reached at [email protected].



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The views expressed are strictly those of the author and not necessarily those of Castanet. Castanet does not warrant the contents.

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