Health Library

Mild Cognitive Impairment

Definition

Mild cognitive impairment–amnestic 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 Alzheimer’s disease (AD). MCI-AT only involves problems with memory. Dementia and Alzheimer's involve loss of other cognitive abilities, such as:

Learning
Reasoning
Making decisions
Problems with confusion, language, and attention

People with MCI-AT who are over age 65 have a higher chance of developing dementia and Alzheimer's. However, many people with MCI-AT never develop these disorders. Some even return to normal.

Areas of the Brain

Causes

The causes are not clear. However, genetic factors may be a cause.

Risk Factors

These risk factors increase your chance of developing MCI-AT. Tell your doctor if you have any of these risk factors:

Age: 65 and older

Family history of MCI-AT, dementia, or Alzheimer's

Medical conditions, such as high blood pressure, heart disease, diabetes, stroke, head injury, depression, anxiety, infections
Being overmedicated
Substance abuse

Research also suggests that these may be risk factors for MCI-AT:

Lack of physical activity
Lack of social contact
Low educational level
Excessive response to stress
Poor nutrition and lack of vitamins
Exposure to toxins

Symptoms

The main symptom is frequent, ongoing memory loss beyond what is normally expected for your age. That means having more than small lapses of memory. If you have MCI-AT, you may:

Remember much less of what you have just read or seen than people who have only the normal memory changes of aging
Take longer to recall information

Diagnosis

The doctor will ask about your symptoms and medical history. The doctor may also talk with family members and caregivers. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:
- Lumbar puncture —also called a spinal tap
You may need to have pictures taken of your bodily structures. This can be done with an MRI scan.
Tests of your cognitive skills may be done, including memory.

If you have this condition, you should have your cognitive abilities tested regularly.

Treatment

Treatment is focused on:

Preventing, or at least slowing down, further loss of memory and other cognitive abilities
Preventing dementia and Alzheimer's disease

Researchers are currently studying the effects that several medicines may have on slowing cognitive decline. Examples include donepezil , vitamin E, galantamine (Razadyne), among others. In some cases, low doses of lithium may be prescribed.

Prevention

The following topics are being studied as ways to reduce the risk of cognitive decline:

Managing medical conditions that may lead to MCI-AT, especially high blood pressure

Getting treatment for depression and hypothyroidism
Staying mentally active by doing things like memory exercises, crossword puzzles, reading, and taking classes
Getting regular exercise
Participating in social activities
Reducing stress
Getting help for emotional problems
Eating a healthy diet

American Psychiatric Association

http://www.psych.org

National Institute on Aging

http://www.nia.nih.gov

The Alzheimer Society of Canada

http://www.alzheimer.ca

Seniors Canada

http://www.seniors.gc.ca

Birks J, Flicker L. Donepezil for mild cognitive impairment. Cochrane Database Syst Rev. 2006;3:CD006104.

DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginko biloba for prevention of dementia: a randomized controlled trila. JAMA. 2008;300:2306-2308.

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 Center–USA (March 2001). Achieving and Maintaining Cognitive Vitality With Aging: A Workshop Report. New York, NY.

Mild cognitive impairment. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated January 28, 2013. Accessed February 19, 2013.

National Institute on Aging. 2011-2012 Alzheimer's Disease Progress Report. Available at: http://www.nia.nih.gov/alzheimers/publication/2011-2012-alzheimers-disease-progress-report. Accessed February 19, 2013.

Petersen RC. Mild cognitive impairment: current research and clinical implications. Semin Neurol. 2007;27.

Petersen RC, Roberts RO, Knopmann DS, et al. Mild cognitive impairment: ten years later. Arch Neurol. 2009;66(12):1447-1455.

Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology. 1999;56:303-308.

Last reviewed March 2013 by Michael Woods, MD

Please 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.