MCI ~ Mild Cognitive Impairment

 

Recently, I have been asked questions about Mild Cognitive Impairment (MCI), as more older adults are being diagnosed with it and yet, their families and friends still have lots of questions. Is MCI a mild form of Alzheimer’s Disease? Is MCI a precursor to being diagnosed with Alzheimer’s Disease? How is MCI diagnosed?

Because I am a gerontologist and not a physician, I will not break discipline and author a detailed medical article, as that is beyond the scope of my expertise. However, people are curious about it and my intent is to provide resources and an overview of MCI. In researching articles for this blog post, I found a plethora of inaccuracies and sweeping claims. When educating yourself about any condition, seek out credible, peer-reviewed articles. I have included several below.

A condition that impacts older adults, MCI has been identified as “an unstable transition state between normal aging and dementia” Qian et all, 2019, p. 1). MCI is a syndrome that impacts one or more brain domains but does interfere with daily functioning. For example, fundamental activities such as mobility, dressing, eating, and bathing are not severely diminished. Studies indicate that it is often misdiagnosed in primary care settings and should be followed up with a neurological evaluation (Sabbagah et al., 2020).

Early detection and screening are essential for accurate diagnosing and treatment. As my readers know, memory loss is NOT normal: Cognitive slowing IS normal. The aging brain is slower to retrieve memories and information and that should not be confused with “loss.”

To demystify MCI, I have created case studies of two vastly different approaches and treatment plans. The case studies are composites and not real people. There is no one-size-fits-all approach to MCI, as medical professionals must take into consideration how daily activities and functioning are impacted, severity of symptoms, and lifestyle of the patient.

In creating the two case studies, it is essential to see the common elements in both approaches.

 

-     They did not ignore the changes.

-     Smart and Keen reported the cognitive changes to their primary care physicians without delay.

-     They both followed up with a neurology consult.

-     Smart and Keen have continued with follow-up appointments.

Case #1:

Mr. and Mrs. Smart have been married forty years and they are in their early seventies and semi-retired. Mrs. Smart noticed changes in her husband’s personality including increased agitation and swearing. He lost personal items more frequently and started drinking excessively. She asked her grown children about it, and they noticed these changes, too. Mr. Smart was examined by their physician, and he made a referral to a neurologist, who referred Mr. Smart to a psychologist for a two-day neuropsychological workup. Mr. Smart was diagnosed with MCI, and lifestyle changes included exercising, getting eight hours of sleep, alcohol abstinence, and healthy eating. He returned for reevaluation a year later and Mr. Smart’s condition improved. Mr. Smart is to be reevaluated every other year unless his condition worsens.

Case #2:

Mr. and Mrs. Keen have been married for forty-seven years and both are fully retired and in their seventies. Ten years ago, Mrs. Keen noticed cognitive changes in her husband, although he was only sixty-two years old. His hygiene was slipping, he lost interest in hobbies, and he was unable to remember recent events. They discussed the changes with their physician, who referred Mr. Keen to a neurologist, who ordered brain scans. The imaging showed brain changes and Mr. Keen was diagnosed with MCI. He was placed on medication, he is monitored yearly, and he took an early retirement. Mr. Keen’s condition has been stable.

Resources:

Mild Cognitive Impairment. Cleveland Clinic (2019). Retrieved on July 6, 2022 from https://my.clevelandclinic.org/health/diseases/17990-mild-cognitive-impairment

 

Mild Cognitive Impairment (MCI). Mayo Clinic. Retrieved on July 7, 2022 from https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578

 

Modified Katz Activities of Daily Living (ADL) Scale. Merck Manual Professional Version (2022). Retrieved on July 6, 2022 from https://www.merckmanuals.com/professional/multimedia/table/modified-katz-activities-of-daily-living-adl-scale

 

Staving off dementia when you have mild cognitive impairment. Harvard Health Publishing. Harvard Medical School, 21 March 2021. Retrieved on July 5, 2022 from https://www.health.harvard.edu/staying-healthy/staving-off-dementia-when-you-have-mild-cognitive-impairment

 

Scholarly Resources:

Qian, X., Dai, W., Xu, R., & Ling, H. (2019) One intelligent framework for screening and intervention of Mild Cognitive Impairment (MCI). Journal of Engineering. Retrieved on July 5, 2022 from https://ietresearch.onlinelibrary.wiley.com/doi/pdfdirect/10.1049/joe.2019.1209

 

Sabbagh, M. N., Boada, M., Borson, S., Doraiswamy, P. M., Dubois, B., Ingram, J., Iwata, A., Porsteinsson, A. P., Possin, K. L., Rabinovici, G. D., Vellas, B., Chao, S., Vergallo, A., & Hampel, H. (2020). Early detection of Mild Cognitive Impairment (MCI) in an at-home setting. The Journal of Prevention of Alzheimer's Disease, 7(3), 171–178. https://doi.org/10.14283/jpad.2020.22

 

Sabbagh, M. N., Boada, M., Borson, S., Chilukuri, M., Dubois, B., Ingram, J., Iwata, A., Porsteinsson, A. P., Possin, K. L., Rabinovici, G. D., Vellas, B., Chao, S., Vergallo, A., & Hampel, H. (2020). Early detection of Mild Cognitive Impairment (MCI) in primary care. The Journal of Prevention of Alzheimer's Disease, 7(3), 165–170. https://doi.org/10.14283/jpad.2020.21