Description

Mild cognitive impairment is an average between typical of the thinking skills and dementia. The condition causes the loss of memory and problems with the language and the trial, but it will not affect the daily activities.

People with mild cognitive impairment, also known as MCI, you can be aware that your memory or mental capacity has changed. Family and friends also may notice the changes. But these changes are not bad enough to impact daily life or affect the normal activities.

MCI increases the risk of developing dementia caused by Alzheimer's disease or other brain conditions. But for some people with mild cognitive impairment, the symptoms may never get worse or even better.

Symptoms

The symptoms of mild cognitive impairment, also known as MCI, which include problems with memory, language and judgment. The symptoms are more serious memory problems that are expected in the elderly. But the symptoms did not affect the daily life at work or at home.

The brain, like the rest of the body, changes with age. Many people notice that they become more forgetful with age. It may take more time to think of a word or remember the name of a person. But if the concerns with the memory of going beyond what is expected, the symptoms can be due to mild cognitive impairment.

People with MCI may have symptoms that include:

  • Forget things more often.
  • Missing appointments or social events.
  • Lose your train of thought. Or not to follow the plot of a book or a movie.
  • Problems to continue a conversation.
  • Difficulty finding the right word or with tongue.
  • Difficulties to make decisions, to complete a task or follow the instructions.
  • Trouble finding your way around places that know you well.
  • Lack of judgment.
  • The changes observed, for family and friends.

People with MCI may also experience:

  • Depression.
  • Anxiety.
  • A genius and aggression.
  • A lack of interest.

When to see a doctor

Talk with your health care professional if you or someone close to you notices of changes in thinking or memory. This can include forgetting recent events or have trouble thinking clearly.

Causes

There's No single cause of mild cognitive impairment. In some people, mild cognitive impairment is due to Alzheimer's disease. But there is not a single result. The symptoms may remain stable for years or can be improved with time. Or mild cognitive impairment will progress to Alzheimer's disease, dementia or another type of dementia.

Mild cognitive impairment, also known as MCI, often involves the same type of brain changes seen in Alzheimer's disease or other dementias. But in MCI, changes occur to a lesser degree. Some of these changes have been seen in autopsy studies of people with mild cognitive impairment.

These changes include:

  • Aggregates of the amyloid-beta protein, called plaques, and neurofibrillary tangles of tau proteins, which are observed in Alzheimer's disease.
  • Microscopic clumps of a protein called Lewy bodies. These groups are related to Parkinson's disease, dementia with Lewy bodies and, sometimes, the disease of Alzheimer's.
  • Small strokes or less flow of blood through the blood vessels of the brain.

Brain imaging studies show that the following changes may be related to MCI:

  • Decreased size of the hippocampus, a brain area important for memory.
  • Increased size of the brain fluid-filled spaces, known as the ventricles.
  • The reduction in the use of glucose in the key areas of the brain. Glucose is the sugar that is the main source of energy for the cells.

Risk factors

The major risk factors for mild cognitive impairment are:

  • Advanced age.
  • Having a form of a gene known as APOE e4. This gene is also linked to Alzheimer's disease. But have the gene, it is not a guarantee of a decline in thinking and memory.

Other medical conditions and lifestyle factors have been linked to an increased risk of changes in thinking, including:

  • Diabetes.
  • The habit of smoking.
  • The high blood pressure.
  • High cholesterol, especially high levels of low-density lipoprotein, known as LDL.
  • Obesity.
  • Depression.
  • Obstructive sleep apnea.
  • The loss of hearing and vision loss are not treated.
  • Traumatic brain injury.
  • The lack of physical exercise.
  • Low level of education.
  • The lack of mental or socially stimulating activities.
  • Exposure to air pollution.

Complications

Complications of mild cognitive impairment, which include an increased risk, but not the certainty — of the dementia. In general, about 1% to 3% of adults develop dementia each year. Studies suggest that around 10% to 15% of people with mild cognitive impairment go on to develop dementia each year.

Prevention

Mild cognitive impairment can't be prevented. But research has found that some lifestyle factors that can reduce the risk of autism. These steps may offer some protection:

  • Do not drink large amounts of alcohol.
  • Limit exposure to air pollution.
  • To reduce the risk of a head injury, as for example the use of a helmet when driving a motorcycle or riding a bicycle.
  • Do not smoke.
  • Manage health conditions such as diabetes, high blood pressure, obesity and depression.
  • See their levels of low-density lipoprotein (LDL-cholesterol) and receive treatment if the levels are high.
  • Practice good sleep habits, and manage any sleep conditions.
  • Eat a healthy diet full of nutrients. Include fruits and vegetables and foods low in saturated fats.
  • Stay in touch with friends and family.
  • Get moderate to vigorous exercise most days of the week.
  • Use a headset if you have a hearing loss.
  • Get regular eye exams and treat any changes in vision.
  • Stimulate your mind with puzzles, memory games, and training.

Diagnosis

There is No one test can diagnose mild cognitive impairment, also known as MCI. A diagnosis is made based on the information that you provide, your medical evaluation and the results of the tests.

Many health professionals to diagnose MCI based on the criteria developed by a panel of international experts:

  • Changes in memory or other mental ability. People with MCI may have symptoms related to memory, planning, following directions, or the taking of decisions. A health professional can confirm these problems with a family member or a close friend.
  • The Mental capacity that decreases with time. This is illustrated with a careful history. The change is confirmed by a member of the family or a close friend.
  • The daily activities are not affected. The symptoms can be cause for concern, but people with MCI are still able to live their lives as usual.
  • State of mind of the tests show mild changes to the age and level of education. These include brief tests such as the Short Test of Mental Status, Cognitive Assessment of Montreal (MoCA) or the Mini-Mental State Examination (MMSE). More detailed testing can show to what extent the memory has changed. The tests can also reveal the types of memory that the majority of those affected, and whether any other mental abilities are affected.
  • The diagnosis is not dementia. The symptoms are not severe enough to be diagnosed as Alzheimer's disease, dementia or another type of dementia.

Neurological examination

As part of a physical examination, a health care professional can check on how your brain functions and nervous system works. These tests can help find conditions that affect memory and other mental abilities, such as Parkinson's disease, strokes, and tumors.

The neurological exam can try:

  • Reflections.
  • Movements of the eyes.
  • Gait and balance.

If the MCI is thought to be due to mild Alzheimer's disease, tests may detect biomarkers. Biomarkers of Alzheimer disease include accumulation of proteins in the brain. These proteins can be found in the samples of blood or the fluid that surrounds the brain and the spinal cord. Biomarkers can also be found in imaging studies of the brain. If biomarkers are present, MCI symptoms can be a sign of mild Alzheimer's disease.

Laboratory tests

Blood tests may help rule out any physical causes of memory loss. This may include very low vitamin B-12 or the thyroid hormone.

Blood tests can also check for protein in the brain that are related to Alzheimer's disease. A sample of the fluid that surrounds the brain and spinal cord can be removed and checked for proteins related to Alzheimer's disease. This test can confirm the Alzheimer's disease as a cause of cognitive impairment.

Images of the brain

An mri or a ct scan can check for a brain tumor, stroke, or hemorrhage. Positron emission tomography (PET) can pursue the accumulation of protein related to Alzheimer's disease.

Mental status testing

Short forms of mental status testing can be done in about 10 minutes. The test to ask the name of the date and follow written instructions.

More ways of testing the way in which a person's mental abilities compare with others of similar age and education. These tests can also be found patterns of change that offer clues about the cause of the symptoms.

Treatment

Treatment for mild cognitive impairment can include drugs for Alzheimer's disease. If the memory of the symptoms are caused by medications or health conditions, the treatment consists in solving the problems.

Mild cognitive impairment, also known as MCI, is an active area of research. Clinical studies are being conducted to better understand the disease and the search for treatments to improve symptoms or prevent or delay dementia.

Alzheimer's disease medications

Your health care professional may recommend medications approved by the Food and Drug Administration (FDA) to slow the decline in thinking and mental skills. Medications can help prevent proteins from clumping and the formation of structures known as amyloid plaques in the brain. Before you start the treatment, the FDA recommends that you do an mri scan of the brain.

The drugs are approved for people with mild cognitive impairment due to Alzheimer's disease and mild Alzheimer's disease. Known as monoclonal antibodies, which include:

  • Lecanemab-irmb (Leqembi). This medication is given as an INTRAVENOUS infusion every two weeks. May cause infusion-related side effects such as fever, flu-like symptoms, nausea, vomiting, dizziness, changes in heart rate and difficulty breathing.
  • Donanemab-azbt (Kisunla). This medication is given as an INTRAVENOUS infusion every four weeks. Side effects may include flu-like symptoms, nausea, vomiting, headache, difficulty breathing, and changes in blood pressure.

These drugs may also have more serious side effects. Lecanemab or donanemab can cause inflammation in the brain or small hemorrhages in the brain. Rarely, an inflammation of the brain that can cause seizures or other symptoms, or even death.

People with a form of a gene known as APOE e4 appear to be at higher risk of serious side effects. The FDA recommends that you perform the test for the gene before starting the treatment. Once you are taking the medication, regular brain Mri monitor brain swelling and bleeding.

Blood thinners may also increase the risk of bleeding in the brain when taking these medications. Talk with your health care professional if you are taking an anticoagulant before you take lecanemab or donanemab. Also talk with your health care professional if you have other risk factors for bleeding in the brain.

The research on other potential side effects of these drugs is in progress.

Researchers are also studying the efficacy of drugs can be for people at risk of Alzheimer's disease. This includes first-degree relatives of people with the disease, as a father or a brother.

If the memory loss is the main symptom of MCI, sometimes cholinesterase inhibitors are prescribed. But these medications are not recommended for the routine treatment of MCI. Have not been found to help prevent dementia, and that may cause side effects.

The treatment of reversible causes of MCI: suspension of certain medications

The symptoms of MCI can be caused by certain medications that have side effects that affect thinking. These side effects are believed to disappear when the medication is stopped. Discuss any side effects with your health care team. Never stop taking your medication unless your healthcare provider tells you to do so. These medications include:

  • Benzodiazepines are used to treat conditions such as anxiety, sleep attacks and symptoms.
  • Anticholinergics, which affect chemicals in the nervous system to treat many different types of conditions.
  • Antihistamines are often used to manage the symptoms of the allergy.
  • The opioid, is often used to treat pain.
  • Inhibitors of the pump, is often used to treat the reflux or gastroesophageal reflux disease (GERD).

The treatment of reversible causes of MCI: the Treatment of other conditions

Other common diseases, in addition to MCI can make you feel forgetful or less mentally sharp than usual. The treatment of these conditions can help to improve your memory and general mental ability. Conditions that can affect memory are:

  • The high blood pressure. People with MCI tend to be more likely to have changes in the blood vessels in their brains. High blood pressure can worsen these problems and can cause loss of memory. Your healthcare team monitors the blood pressure and may recommend measures to reduce it if it is too high.
  • Depression. Depression can make someone forgetful and mentally "foggy." Depression is common in people with MCI. The treatment of depression may help to improve memory, while making it easier to deal with the changes in your life.
  • Sleep apnea. In this condition, the breathing stops and starts repeatedly during sleep, which interferes with getting a good night's rest. Sleep apnea can make you feel very tired during the day, a forgetful and is not able to concentrate. The treatment can improve symptoms and make you more alert during the day.

Alternative medicine

Some supplements have been suggested to help prevent or delay the mild cognitive impairment. However, more research is needed in this area. Talk with a member of your health care team before taking supplements because they may interact with your current medications.

Lifestyle and home remedies

The study findings have been contradictory about whether the diet, the exercise, or in other healthy lifestyle choices can prevent or reverse the mild cognitive impairment. However, these healthy options to promote general good health and may play an important role in the good health of the brain.

  • Regular physical exercise has well known benefits for heart health. You can also help prevent or reduce a decline in thinking skills.
  • A diet low in fat and rich in fruits and vegetables is another heart-healthy option that can also help to protect the health of the brain.
  • Omega-3 fatty acids are good for the heart. Most of the research on omega-3 that shows a possible benefit to the health of the brain is seen in how much fish people eat.
  • Keep your brain active, you can prevent a decline in thinking skills. Studies have shown that play, playing an instrument, reading books and other activities may help to preserve brain function.
  • Be social and can make life more fulfilling, helps to preserve the mental skills and slow mental decline.
  • The training of the memory and other cognitive training may help improve your symptoms.

Preparing for your appointment

It is likely to start by seeing your health care professional. If you suspect that you have changes in memory, you may be referred to a specialist. This specialist can be a neurologist, a psychiatrist or a clinical neuropsychologist.

Because appointments can be brief and there's often a lot to talk about, it's good to be well prepared. Here are some ideas to help you prepare for your appointment and know what to expect.

What you can do

  • Be aware of any pre-appointment restrictions. Ask if you need to fast for blood tests or if you need to do anything to prepare for the tests.
  • Write down all of your symptoms. Include details about what the cause of your concerns about your memory or mental capacity. The inclusion of the most important examples of the changes in memory. Try to remember when you began to notice changes. Also keep in mind, if you think that your symptoms are getting worse, and why.
  • Take along a family member or a friend, if possible. The input of a trusted family member or friend can confirm that your memory loss is noticed by others. To have someone along can also help remember all the information provided during your appointment.
  • Make a list of your other medical conditions. Let your healthcare professional know if you are being treated for diabetes, heart disease, past strokes or any other condition.
  • Make a list of all your medications and dosages. Include prescription medications, the medications available without a prescription, vitamins or supplements.

Questions to ask your doctor

A list of questions from the most pressing to least important in case time runs out. For mild cognitive impairment, some questions are:

  • I have the memory of the symptoms?
  • What is the cause of my symptoms?
  • What tests do I need?
  • I need to see a specialist? Will my insurance cover it?
  • Treatments are available?
  • There are clinical trials of experimental treatments that I have to take into account?
  • Should I expect the long-term complications?
  • My new symptoms affect how I manage my other health conditions?
  • I need to follow any kind of restrictions?
  • Is there a generic alternative to the medicine you're giving me?
  • Do you have any brochures or other printed material that I can take my house? What sites do you recommend?

Ask any other questions to clarify anything you do not understand.

What to expect from your doctor

Your health care professional is likely to have questions for you, including:

  • What types of memory problems has? When did they first appear?
  • They are getting worse, or are they sometimes better and sometimes worse?
  • Do you feel sadder or more anxious than usual?
  • Have you noticed changes in the way you react to people or events?
  • Have you noticed any changes in how well or how much you sleep? Do you snore?
  • Do you have more energy than usual, less than usual, or about the same?
  • What medications are you taking? You are taking any type of vitamins or supplements?
  • Do you drink alcohol? How much?
  • What other medical conditions are being treated?
  • Have you noticed any shaking or difficulty walking?
  • Do you have any difficulty remembering appointments or when to take your medications?
  • You have had your vision and hearing tested recently?
  • Does anyone else in your family has memory problems? Was once someone is diagnosed with Alzheimer's disease or dementia?
Symptoms and treatment of Mild cognitive impairment (MCI)