Mild Cognitive Impairment seems less threatening than its predecessors; such as “organic brain syndrome” and “minimal brain dysfunction.” It sounds more benign than terms that contain the word “brain.” Mild Cognitive Impairment is not an actual diagnostic code, but it is a term used by researchers and clinicians. MCI reflects cognitive changes in the elderly that exceeds normal aging, yet does not meet the diagnostic criteria for Alzheimer’s Disease. It is important to note that people diagnosed with MCI have retained their ability to perform all activities of daily living in an independent fashion.
Mild cognitive impairment has received much attention from the research community in recent years. The interest is focused on what percentage of those with MCI actually convert to Alzheimer’s Disease. This is not merely splitting hairs, as it would be a great asset to know which people in this group will actually manifest Alzheimer’s Disease. Early diagnosis will allow more time for caretakers to plan and prepare. An early diagnosis may also avoid surprises that utilize the emergency room and/or local law enforcement.
Current estimates of those that convert from MCI to AD are under twenty percent, but the percentage varies wildly within this restricted range. Most suspected of MCI are brought to the attention of professionals due to a decrease in verbal memory. Fewer are referred, in this clinician’s experience, from an onset of unusual behaviors. This is important, because many progressive dementia’s initially present with a change in behavior prior to the onset of measurable cognitive deficit(s). Measurable is highlighted because these people may actually exhibit a cognitive decline, but it may not be detectable by the current neuropsychological tests in use. Current lab tests and medical imaging are ineffective at diagnosing MCI, as they are ineffective at diagnosing Alzheimer’s Disease.
There are no particular medications or class of medications that could be recommended for the treatment of mild cognitive impairment. As with Alzheimer’s Disease, exercise and keeping mentally active are likely helpful. The beauty of mental and physical exercise is that even if it does not prevent the onset of AD, at least the person will still retain some benefit. The early data suggests that effortful cognitive activity is more important than the passive variety. For example, watching TV is a passive activity and completing a crossword is an effortful activity.
Once the diagnosis has been established, it is recommended to visit the neuropsychologist at least yearly. Only a neuropsychologist will be able to accurately measure any change in cognitive skills, and differentiate the change from the effects of normal aging. Remember that over eighty percent of people with mild cognitive impairment never manifest a progressive dementia. The unfortunate remainder will require ongoing neuropsychological monitoring and behavioral planning. Report any change in mental or physical functioning to the neuropsychologist and attending physician, as they are in a better position to know what is significant. Nearly all people with mild cognitive impairment will profit from set routines and compensatory strategies. Even though MCI sounds less threatening than its previous designations, it is still wise to monitor the disorder and treat symptoms as they arise.