Understanding Dementia Mild Cognitive Impairment (MCI)

Mild Cognitive impairment (MCI) is not a normal occurrence in aging, neither is it dementia. There is a lot of controversy around MCI but 10-15% of people over the age of 65 experience MCI brain changes and, of that percentage, about 10-15% will develop full blown Alzheimer’s or another type of dementia within a year. Over a lifetime the risk of someone with MCI developing dementia is over 50%. MCI is commonly known for significant memory loss but without other thinking challenges. 

However, other research and studies have found cognitive changes under the MCI type and have defined two types of MCI based on symptoms. The first is Amnestic MCI which primarily affects memory. People experiencing these symptoms will begin to forget things they normally can remember, like important events, appointments and recent conversations. 

The second, Nonamnestic MCI, is when the person has trouble with their thinking skills such as judging the time, sequences of steps needed to complete a complex task and being unable to make sound decisions or even visual perception. These symptoms are the same as early Alzheimer’s or dementia and, if misdiagnosed, a person can be treated for a condition they do not have. Studies have shown that giving MCI patients dementia drugs or even depression drugs has made no significant difference with their condition. Most people do better with memory help aids like notebooks, calendars and smart phones to help them keep track of daily tasks and important information. 

Receiving a diagnosis is challenging but it can be done. According to information from alz.org the list below is helpful with diagnoses:

• Thorough medical history, where the physician documents current symptoms, previous illnesses and medical conditions, and any family history of significant memory problems or dementia.

• Assessment of independent function and daily activities, which focuses on any changes from a person’s usual level of function.

• Input from a family member or trusted friend to provide additional perspective on how function may have changed.

• Assessment of mental status using brief tests designed to evaluate memory, planning, judgment, ability to understand visual information and other key thinking skills.

• In-office neurological examination to assess the function of nerves and reflexes, movement, co-ordination, balance and senses.

• Evaluation of mood to detect depression; symptoms may include problems with memory or feeling “foggy”. Depression is widespread and may be especially common in older adults.

• Laboratory tests including blood tests and imaging of the brain’s structure.

It is highly recommended that a person with MCI be evaluated every six months. It is not clear why people develop MCI or why some people with MCI do or do not develop Alzheimer’s or related dementia. More research is needed. The St Lucia Alzheimer & Dementia Association (SLADA) recommends utilizing brain training tools for increasing the health of your brain and to improve your memory.

–By Regina Posvar

Questions about dementia

Q: I have been dealing with this memory thing for over a year. I am forgetting everything. I have to keep notes everywhere or it will not get done. It is getting worse because now I am forgetting where I put my notes. I am afraid to see the doctor and learning I have Alzheimer’s. What can I do to help my memory?

A: I do recommend you see a doctor. Letting it go on so long is dangerous and puts you more at risk of developing Alzheimer’s or another type of dementia. Even if you have dementia, you are still able to think and choose what you want to do. People with early symptoms could really benefit from brain exercises that can enhance your memory and thinking skills. If it is not dementia, chances are you can reverse the symptoms.

Regina Posvar is the current president of the Saint Lucia Alzheimer’s and Dementia Association and has been a licensed nurse for 25 years. SLADA is supported by volunteers and donations and aims to bring awareness and support by providing awareness public workshops, family support, memory screenings, the Memory Café, counselling and family training for coping skills and communication with persons living with dementia.