Mild Cognitive Impairment (MCI): When to worry
8/17/2020 by Brandon Verdoorn, MD, CMD
Changes in cognition (e.g., thinking) are a natural part of aging; everyone will likely experience some form of change in cognition as they get older. Peak cognitive performance may occur from late teens for processing speed to 40s and 50s for measures of emotional intelligence. Once past these peaks, it is common to notice some cognitive changes, which typically fit into one of three categories:
- Normal aging
- Mild cognitive impairment (MCI)
Cognitive changes seen with normal aging may be a nuisance, but they are generally minor, do not disrupt one's daily activities, and cannot be detected on formal cognitive tests. Common examples include forgetting names, telling stories repeatedly, relying more on written lists rather than memory, or forgetting tasks.
On the other end of the spectrum, dementia is a progressive decline in cognition that is more severe and leads to impairment in daily activities such as the ability to drive, manage finances, or cook a meal, and in more advanced cases even dressing, bathing, or toileting.
MCI lies between normal age-related cognitive changes and dementia. MCI is a decline in cognition more significant than that expected with normal aging but not yet severe enough to affect one's daily activities. It is significant enough to be detected on formal cognitive tests. MCI is common and affects 10 to 20 percent of adults age 65 and older. Risk increases with age, and men appear to be at higher risk than women. Anywhere from 5 to 20 percent of people with MCI progress to dementia annually, though not everyone with MCI eventually develops dementia.
When you notice cognitive changes in yourself or a loved one, it is important to notify your health care team. If you are diagnosed with MCI, your provider will help determine the underlying cause.
While MCI commonly represents a precursor to dementia — most commonly Alzheimer's dementia — it may have other causes like depression or medication side effects. There are no drugs to treat MCI directly, but, depending on the cause, treatment of an underlying condition may help (for instance, if depression is causing MCI, treatment with an anti-depressant may help). Aerobic exercise, mental activity, social engagement, and management of cardiovascular risk factors (blood pressure, cholesterol, etc.) all may help reduce risk of further cognitive decline.
With early detection, your health care team can help you manage MCI and optimize your function and quality of life.
Dr. Brandon Verdoorn is an Assistant Professor of Medicine in the Mayo Clinic College of Medicine and a consultant in the Division of Community Internal Medicine, where he practices mainly in nursing homes and other similar venues. He is the medical director of two nursing homes and holds several education leadership roles.