What Is Mild Cognitive Impairment?

As diagnostic criteria for Mild Cognitive Impairment (MCI) has become more widely embraced by the medical community, more and more patients are receiving a diagnosis and then asking the obvious question: what is it? This is generally followed by: does this mean I have (or will have) Alzheimer’s disease (AD)? These are important questions, which we will explore today.

What is MCI?
The first step in diagnosis for most people is to take an early test. This could be an at-home test like the ALZselftest, or a paper and pencil test in your physician’s office, perhaps the MMSE. On either test the maximum possible score is 30. An individual could score in the 28 – 30 range and still be considered to have normal levels of cognition. In the 26 – 28 range we would typically expect to see a diagnosis of MCI. One the score drops below 26 you see individuals with dementia and would not receive a diagnosis of MCI.

An individual with MCI typically complains of difficulties with memory. Mary came to see me last week. She complained that she was not able to follow recipes as well as she has in the past, and said that she has started misplacing kitchen utensils. Her husband, Jim, told me that Mary has reasonably good computer skills but recently seems confused and unable to perform some basic functions. These reports are very common for someone with MCI. Another issue people present with is inability to balance a checkbook. It is often helpful if a spouse recognizes the mild memory difficulty, as this provides independent verification there is a memory problem.

One critical issue with understanding MCI is that one’s professional or social activities are NOT impaired to the point of problems. The deficit tends to be so mild that it doesn’t disturb practical functioning.

I have MCI. Will I get Alzheimer’s disease?
Not necessarily. While many consider MCI to be a pre-cursor to dementia, it’s important to look at it by the numbers. One year after an MCI diagnosis, 40% of people are unchanged, or do not have worsening symptoms, 20% actually improve. Only 8 – 9% of those convert to AD. One reason for this is MCI can be caused by a number of things: thyroid dysfunction, B12 deficiency or depression.

We are just beginning to understand some new ways to test and measure an individual with MCI, in order to determine who will convert to AD later. This is groundbreaking research in the field of Alzheimer’s disease and we will talk more about it in upcoming posts.

For now, please write us if you have questions about AD or dementia which Dr. Dougherty can answer. For an early warning screen you can take in the privacy of your own home, please visit ALZselftest online.

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