• Mild Cognitive Impairment

    Definition

    Mild cognitive impairment–amnestic type (MCI-AT) is mild, repeated memory loss. It lies between the normal memory loss of aging and the more serious conditions of dementia and Alzheimer’s disease (AD) . MCI-AT only involves problems with memory. Dementia and Alzheimer's involve loss of other cognitive abilities, such as:
    • Learning
    • Reasoning
    • Making decisions
    • Problems with confusion, language, and attention
    People with MCI-AT who are over age 65 have a higher chance of developing dementia and Alzheimer's. However, many people with MCI-AT never develop these disorders. Some even return to normal.
    Areas of the Brain
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    Causes

    The causes are not clear. However, genetic factors may be a cause.

    Risk Factors

    These risk factors increase your chance of developing MCI-AT. Tell your doctor if you have any of these risk factors:
    Research also suggests that these may be risk factors for MCI-AT:
    • Lack of physical activity
    • Lack of social contact
    • Low educational level
    • Excessive response to stress
    • Poor nutrition and lack of vitamins
    • Exposure to toxins

    Symptoms

    The main symptom is frequent, ongoing memory loss beyond what is normally expected for your age. That means having more than small lapses of memory. If you have MCI-AT, you may:
    • Remember much less of what you have just read or seen than people who have only the normal memory changes of aging
    • Take longer to recall information

    Diagnosis

    The doctor will ask about your symptoms and medical history. The doctor may also talk with family members and caregivers. A physical exam will be done.
      Your bodily fluids may be tested. This can be done with:
    • You may need to have pictures taken of your bodily structures. This can be done with an MRI scan.
    • Tests of your cognitive skills may be done, including memory.
    If you have this condition, you should have your cognitive abilities tested regularly.

    Treatment

    Treatment is focused on:
    • Preventing, or at least slowing down, further loss of memory and other cognitive abilities
    • Preventing dementia and Alzheimer's disease
    Researchers are currently studying the effects that several medicines may have on slowing cognitive decline. Examples include donepezil , vitamin E, galantamine (Razadyne), among others. In some cases, low doses of lithium may be prescribed.

    Prevention

    The following topics are being studied as ways to reduce the risk of cognitive decline:
    • Managing medical conditions that may lead to MCI-AT, especially high blood pressure
    • Getting treatment for depression and hypothyroidism
    • Staying mentally active by doing things like memory exercises, crossword puzzles, reading, and taking classes
    • Getting regular exercise
    • Participating in social activities
    • Reducing stress
    • Getting help for emotional problems
    • Eating a healthy diet

    RESOURCES

    American Psychiatric Association http://www.psych.org

    National Institute on Aging http://www.nia.nih.gov

    CANADIAN RESOURCES

    The Alzheimer Society of Canada http://www.alzheimer.ca

    Seniors Canada http://www.seniors.gc.ca

    References

    Birks J, Flicker L. Donepezil for mild cognitive impairment. Cochrane Database Syst Rev . 2006;3:CD006104.

    DeKosky ST, Williamson JD, Fitzpatrick AL, et al. Ginko biloba for prevention of dementia: a randomized controlled trila. JAMA . 2008;300:2306-2308.

    Feldman HH, Jacova C. Mild cognitive impairment. Am J Geriatr Psychiatry . 2005;13:645-655.

    Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment. Lancet . 2006;367:1262-1270.

    Institute for the Study of Aging and International Longevity Center–USA (March 2001). Achieving and Maintaining Cognitive Vitality With Aging: A Workshop Report . New York, NY.

    Mild cognitive impairment. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/ . Updated January 28, 2013. Accessed February 19, 2013.

    National Institute on Aging. 2011-2012 Alzheimer's Disease Progress Report . Available at: http://www.nia.nih.gov/alzheimers/publication/2011-2012-alzheimers-disease-progress-report. Accessed February 19, 2013.

    Petersen RC. Mild cognitive impairment: current research and clinical implications. Semin Neurol . 2007;27.

    Petersen RC, Roberts RO, Knopmann DS, et al. Mild cognitive impairment: ten years later. Arch Neurol . 2009;66(12):1447-1455.

    Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology . 1999;56:303-308.

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