What is mild cognitive impairment?
Mild cognitive impairment, or MCI, means that memory or thinking has changed more than expected for your age. You or the people close to you notice the change, and testing can measure it. But you can still take care of yourself and handle most daily tasks on your own.
There are different types of MCI:
- Amnestic MCI mainly affects short-term memory, such as remembering recent conversations, appointments, or where you put things. It is the type most often linked to Alzheimer’s disease.
- Multidomain MCI affects more than one area, such as memory together with language, attention, or planning and organizing.
MCI is not a single disease. It is a stage, and many different things can cause it. Some causes can be treated, such as a low vitamin level or a medicine side effect. In other people, MCI is the earliest stage of a brain condition such as Alzheimer’s disease.
MCI does not always get worse. Some people stay the same for years, and some get better when a treatable cause is found. That is why a careful evaluation matters.
Common symptoms
- Forgetting recent conversations, appointments, or events more often
- Losing your train of thought, or repeating the same question
- Taking longer to plan, make decisions, or follow steps
- Trouble finding the right word
- Feeling overwhelmed by tasks that used to be easy, like paying bills
- Getting lost in a place you know well
MCI or normal aging?
Some changes are a normal part of getting older. It is common to walk into a room and forget why, or to recall a name a few minutes later. With normal aging, the memory usually comes back, and daily life is not affected.
With MCI, the changes happen more often and are more noticeable. Family members may see them before you do. If you are not sure which one you have, an evaluation can help sort it out.
How we make the diagnosis
The goal is to find out whether there is a real change, how large it is, and what is causing it.
At your visit, we will:
- Talk with you, and with a family member or friend if possible, about what has changed and when it started
- Do a neurological exam
- Do in-office cognitive testing, which uses short tasks to check memory, attention, language, and problem solving
Checking for treatable causes. Several common problems can affect memory and are often treatable. We check for:
- Thyroid problems
- Low vitamin B12
- Poor sleep, including sleep apnea
- Medicine side effects, especially some sleep, allergy, bladder, and pain medicines
- Depression, anxiety, and stress
- Hearing loss
We use blood tests to rule out reversible causes. We may also order a brain MRI to look for strokes, other changes, or problems that can be treated.
Neuropsychological testing. Routine neuropsychological testing is available to track the long-term stability of thinking and memory in patients with mild cognitive impairment or Alzheimer’s disease. Repeating the testing over time helps us see whether things are changing.
Amyloid testing. If we think Alzheimer’s disease may be the cause, we can order testing for amyloid, a protein that builds up in the brain in Alzheimer’s disease. To confirm amyloid, we order an amyloid blood biomarker test, an amyloid PET scan, or a spinal fluid (CSF) test. These tests are done outside our office. Knowing the cause helps you and your family plan and tells us which treatments may fit.
Treatment options
Treatment depends on the cause.
Treating what we find. When a treatable cause is found, such as low B12, a thyroid problem, sleep apnea, or a medicine side effect, we treat it or work with your other doctors to change it. Treating depression and hearing loss is also an important part of care.
Protecting your brain health. Good control of blood pressure, blood sugar, and cholesterol matters for the brain as well as the heart. Regular exercise, good sleep, and not smoking are part of every plan.
Anti-amyloid infusions for MCI due to Alzheimer’s disease
When testing shows that MCI is caused by Alzheimer’s disease, anti-amyloid infusions may be an option. We offer Kisunla (donanemab) and Leqembi (lecanemab) infusions at the infusion center in our building for early Alzheimer’s disease (mild cognitive impairment or mild dementia) with confirmed amyloid. The goal is to slow the decline in memory and thinking. They do not reverse symptoms that are already present.
Not everyone qualifies. We review your testing, brain MRI, health history, and medicines to decide whether these infusions are safe for you. Scheduled MRI scans watch for ARIA, a side effect that can cause brain swelling or small bleeds. ARIA often causes no symptoms, which is why the scans matter. Tell us right away about a new headache, confusion, or vision changes. Genetic (APOE) testing is recommended before starting, because it affects the risk of ARIA. Learn more about infusions at the infusion center in our building.
Follow-up visits. We see you again over time to repeat testing, check how you are doing, and adjust the plan.
Your medication list
Make sure you bring a typed list of medications used to treat mild cognitive impairment that failed or caused side effects. Use BPMedTracker to track your medications and print a list.
When to see a specialist
Consider a memory evaluation if you or a loved one has:
- Memory changes that are happening more often or getting worse
- Family or friends who are worried about your memory
- Trouble managing money, medicines, or appointments
- Changes in mood or personality along with memory problems
- A family history of Alzheimer’s disease and new memory concerns
It is best to come in early. Early evaluation gives the most time to find treatable causes and to plan. Call 940-828-MOVE (6683) to schedule a visit.
Staying mentally active
Staying active in body, mind, and social life is part of healthy living with MCI. These habits are good for your overall health, and they work best alongside your medical care, not in place of it.
- Stay social. Spend time with family and friends, join a club, or volunteer.
- Move your body. Walk, swim, dance, or join an exercise class, as your doctor advises.
- Keep learning. Read, do brain games like Mind Sage, BrainHQ, or CogniFit, learn a new skill, or take up a hobby.
- Keep a routine. Use a calendar, a pill box, and reminders on your phone.
Support and resources
You do not have to face memory changes alone. The Alzheimer’s Association offers free education, support groups, and a 24/7 Helpline for people with MCI and the families who care for them.
