MCI, characterized by memory loss abnormal for your age, is often treatable by adopting a brain-healthy lifestyle and addressing underlying health problems.
If you feel your mind slipping in a way that’s truly worrisome, you might be experiencing mild cognitive impairment.
MCI is a form of memory loss far more common than Alzheimer’s, yet most people have never heard of it.
The good news is that mild cognitive impairment, unlike Alzheimer’s, can potentially be treated and even reversed, depending on the cause.
What Is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) is a term doctors use to describe memory loss that’s not normal for your age, but not so severe that it keeps you from going about your daily life.
It’s not a form of dementia, although people with mild cognitive impairment are at higher risk of developing dementia. (1)
There are two types of mild cognitive impairment.
A loss of memory is called amnestic MCI.
When you struggle with other thinking skills, such as executive function or language, that’s nonamnestic MCI.
Either way, these problems are less subtle than the name implies.
People with mild cognitive impairment get by most of the time with little assistance, but the mental “fog” that rolls in and out is by no means mild.
To be standing in a checkout line with people waiting behind you, and suddenly find you have no idea how to pay for groceries, can be frustrating, frightening, and humiliating.
You may also see mild cognitive impairment referred to as “incipient dementia” or “dementia prodrome,” but those are outmoded terms. (4)
If you have MCI, don’t assume you’re going to progress to dementia.
There are many other possible causes of cognitive impairment, and most are treatable.
Who Is at Risk for Mild Cognitive Impairment?
Age is the biggest risk factor for cognitive decline.
An estimated 15 to 20 percent of people 65 or older have mild cognitive impairment, but it can occur in people much younger. (5)
Smoking puts you at higher risk for cognitive impairment.
So do high blood pressure or high cholesterol, if they aren’t treated.
Other risk factors include:
- heavy drinking
- lack of physical activity
- social isolation
- hearing loss
- previous head injury
- having the ApoE4 gene (6)
Symptoms of Mild Cognitive Impairment
We all experience some forgetfulness as we age. (7)
If you can’t find your car keys because you don’t remember where you put them, that’s normal and nothing to worry about.
If you can’t find your car keys because you put them in the refrigerator, that’s a sign of confusion that points to something more serious.
Common warning signs of mild cognitive impairment include:
- experiencing forgetfulness often enough that it worries you
- struggling to understand or remember information you read
- a decline in ability to plan things or solve problems
- forgetting the name of a family member
- losing interest in favorite activities
- getting lost in a familiar setting
- showing poor judgment or struggling to make decisions
- family or friends are expressing concerns about your memory
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Does Mild Cognitive Impairment Lead to Dementia?
About 30 percent of people diagnosed with mild cognitive impairment eventually progress to Alzheimer’s or other forms of dementia. (8)
Other people with mild cognitive impairment remain stable, sometimes for years.
Some may even see their memory return to normal for their age.
Studies show anywhere from 14 to 38 percent of people who are told they have MCI will test normal for memory when they’re evaluated again later.
Yet even they remain at higher risk of developing dementia later on. (9)
Can My Doctor Tell If I Have Alzheimer’s?
The simple answer used to be “no,” but that has changed dramatically.
Until recently, the only way to confirm Alzheimer’s was through an autopsy after death.
However, new tests using a spinal tap or PET scan can measure the level of beta-amyloid “plaque” in the brain, allowing doctors to diagnose Alzheimer’s with near certainty. (10)
These tests have the potential to revolutionize how mild cognitive impairment is treated, giving doctors a better understanding of what the problem is and the right way to address it.
That’s already happening in a small way.
About 18,000 Medicare recipients with mild cognitive impairment are being tested for Alzheimer’s. (11)
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So far, almost 70 percent were put on a different treatment plan after their doctor got the results. (12)
Often, the patient was getting an Alzheimer’s drug “off-label,” and taken off the drug when the test showed they didn’t have Alzheimer’s.
Yet most people with mild cognitive impairment aren’t getting tested.
The tests can be invasive and expensive and typically aren’t covered by insurance, so they’re rarely ordered for people with MCI. (13)
Researchers are working on other simple, inexpensive tests that can detect Alzheimer’s, but those are still a ways off.
Until then, most people with mild cognitive impairment continue to live with the uncertain prospect of Alzheimer’s hanging over them.
Treatment Options for Mild Cognitive Impairment
There’s no cure for MCI, and no sure way to prevent it.
That helps explain why the traditional ways of treating mild cognitive impairment were passive, often to the point of not treating it at all.
A common approach was to merely monitor the patient and see if it got worse.
But as we’ve developed a better understanding of what causes cognitive impairment and ways to slow or halt it, treatment has become more aggressive.
Doctors can offer a range of options, from medicine and supplements to recommendations for exercise, better nutrition, and other healthy habits.
Here’s a video that summarizes the various mild cognitive impairment treatments.
Prescribing “Off-label” Drugs for Mild Cognitive Impairment
No drug has been approved by the FDA for treatment of mild cognitive impairment. (14)
However, doctors have the latitude to prescribe an Alzheimer’s drugs “off-label” to a patient with mild cognitive impairment.
Alzheimer’s drugs known as “cholinesterase inhibitors” haven’t been shown to reduce the likelihood of someone with MCI progressing to dementia. (15)
Still, a handful of studies suggest that these drugs might offer a slight benefit to some people with MCI. (16)
For that reason, doctors are encouraged to tell patients about the possible risks and benefits and come to a decision based on what’s best for each person. (17)
Unfortunately, these medications can have serious side effects, so your doctor may decline to prescribe one to you for that reason.
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Treatable Causes of Mild Cognitive Impairment
Sometimes, cognitive impairment can look like dementia, but the cause is actually some other treatable medical conditions.
Sleep apnea is one of the biggest culprits.
Up to 50 percent of older adults may have sleep apnea or some other sleep disorder and recent research has shown a link between sleep disorders and cognitive decline. (18)
A study of 83 older adults with mild cognitive impairment and sleep apnea found that, after their sleep problem was treated, they scored better on cognitive tests. (19)
Here’s another growing threat: the overmedication of older adults.
The number of Americans over the age of 65 taking three or more medicines that affect brain function has more than doubled since 2004. (20)
People who take multiple medications are more likely to experience side effects or harmful drug interactions, which can result in cognitive impairment. (21)
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If you’re worried about your memory, it’s a good idea to have a doctor review all your medications to see if you’re on a drug that’s unnecessary or if you’re taking drugs that might react badly with each other.
Memory loss also can result from:
- a deficiency in vitamin B or vitamin D
- hearing loss
- a thyroid condition called “subclinical hypothyroidism”
If one of these is sapping your memory, it can be treated, and memory may improve.
Exercise as a Defense Against Cognitive Impairment
Healthy lifestyle choices can help slow cognitive decline.
A groundbreaking study in Finland found it’s possible to prevent cognitive decline in older adults through a combination of exercise, healthy foods, social activity, memory training, and management of blood pressure and cholesterol. (22)
Healthy habits like these aren’t guaranteed to halt cognitive decline or fend off dementia.
But neurologists say patients with MCI who stay stable the longest tend to be those who embrace a brain-healthy lifestyle. (23)
And that begins with exercise.
The new treatment guidelines for mild cognitive impairment recommend exercising at least twice a week. (24)
Regular exercise has been shown to increase blood flow to the brain, raise the level of chemicals that protect the brain, and reduce the loss of neural connections.
A study involving adults with amnestic MCI found that those who did moderate-intensity aerobic exercise four times a week for six months scored better on cognitive tests, while those who didn’t exercise continued to decline. (25)
Eating with Brain Health in Mind
Food can fuel your brain or foul it.
People who eat a Western-style diet higher in red meat, saturated fat, refined grains, and sugar are more likely to suffer cognitive decline. (26)
On the other hand, a diet featuring fresh vegetables, fruit, fish, poultry, whole grains, and legumes can promote brain health and reduce the risk of cognitive decline or dementia. (27)
No particular food or nutrient has been shown to protect us from getting dementia.
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Instead, experts say, the best defense is to eat a balanced, healthy diet.
Numerous studies point to a Mediterranean-style diet as the best choice for people with mild cognitive impairment. (28)
The MIND diet, which combines elements of the Mediterranean diet and the heart-healthy DASH diet, is another good option.
One study found that people who closely followed the MIND diet had a 53 percent lower risk of dementia. (29)
Addressing MCI Through Other Lifestyle Changes
You can further cut the risk of dementia by keeping your mind engaged and your social calendar full.
Crossword puzzles, Sudoku and “brain games” are a popular choice for people looking to keep their mind active.
But according to neurologists, they are far from the best choice.
Experts say that when you play these games, you get better at the game, but that doesn’t extend to any greater cognitive benefit. (30)
Instead, stoke your brain with activities that are novel and challenging.
Doing volunteer work is one proven way to promote brain health.
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Learning to speak a new language or play a musical instrument are high on the list too.
There’s also a decade of research to show that a certain type of computer-based cognitive training can reduce the risk of dementia by nearly 30 percent. (31)
The key, experts say, is to try things that are new and challenging.
That’s what builds new neural connections, which are believed to help other regions of the brain compensate for whatever cognitive loss is occurring.
The frequency of these activities matters too.
A Mayo Clinic study found that people who did cognitively stimulating activities at least twice a week were less likely to develop mild cognitive impairment than those who did activities like that only once or twice a month. (32)
Doing these activities in the company of others is better yet.
Social isolation puts you at greater risk for cognitive impairment and can hasten the speed at which your mind declines.
One study followed 8,300 adults for more than a decade and found that those who reported feeling lonely experienced cognitive decline 20 percent faster. (33)
It’s common for people with cognitive impairment to begin avoiding others out of fear that they’ll say or do the wrong thing and look foolish.
But that isolation only increases the risk of further decline.
Being in the company of friends or family, or visiting an adult day program or memory café, are ways someone with cognitive impairment can stay social in a setting that feels safe and welcoming.
Good for the Heart, Good for the Brain
Brain health is closely tied to heart health, so dealing with cardiovascular risks can cut the risk of dementia.
That includes high blood pressure, high cholesterol, diabetes, or smoking.
People who take steps to get their high blood pressure under control are likely to have higher cognitive function and a lower risk of dementia. (34)
Having a high cholesterol level, especially higher blood concentrations of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), also can lead to faster cognitive decline. (35)
Type II diabetes represents an even greater concern.
Having diabetes increases your risk of dementia by more than 70 percent. (36)
These health conditions are dangerous, but they don’t doom you to dementia.
All of them can be managed, and if you tackle them, your risk goes way down.
Supplements and Mild Cognitive Impairment
No supplement has been shown to prevent or reverse mild cognitive impairment.
But certain supplements may benefit some people with MCI.
That’s particularly true of supplements that offer an omega-3 fatty acid called DHA.
A study of older adults with MCI found that those who took a DHA supplement showed significant improvement on cognitive tests in just 12 weeks. (37)
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An estimated 70 percent of Americans don’t get enough omega-3s from the foods they eat.
Research has shown that a lack of DHA can cause your brain to shrink and age more rapidly, resulting in worse memory and cognitive function. (39)
DHA is available either in fish oil or an algae supplement called algal DHA.
Many older adults are also deficient in vitamin B12 or other B vitamins that are essential to brain health.
Several studies have shown that vitamin B supplements can improve memory in people with mild cognitive impairment. (40)
Here are two other supplements to consider:
Ginkgo biloba: People with either mild cognitive impairment or Alzheimer’s took Ginkgo biloba along with conventional medicine for 24 weeks and their cognition improved. (41)
Lion’s mane mushroom: A small sample of 30 Japanese patients with mild cognitive impairment who took a lion’s mane mushroom extract saw their memory improve significantly for as long as they were taking the supplement. (42)
Anxiety and Depression in People with MCI
It’s common for people with mild cognitive impairment to experience feelings of lethargy, irritability, anger, sadness, or despair.
These are not signs of personal weakness and they aren’t something you can just “snap out of.”
Often, they signal an underlying problem of anxiety or depression.
People use these terms loosely, but they are distinct medical conditions that can be treated.
Left unaddressed, anxiety or depression can contribute to and even accelerate cognitive decline. (43)
So if you have these feelings, it’s important to seek treatment. (44)
Common signs of anxiety include a deep sense of worry, irritability, feelings of dread, or problems concentrating.
The signs of depression include sadness, hopelessness, a loss of interest in things you used to enjoy, restlessness, sleeplessness, or agitation.
Mild cases of anxiety or depression can sometimes be addressed by self-help methods including exercise, mindfulness techniques, or support groups.
More serious cases may call for counseling, psychological treatment, or medication.
The treatments available today can be surprisingly effective.
But they take a while to work, usually a month to six weeks.
Mild Cognitive Impairment: Take the Next Step
Mild cognitive impairment is a medical term that describes memory loss that’s abnormal for your age.
Being diagnosed with MCI can be frightening, but don’t assume it will inevitably lead to dementia or Alzheimer’s.
There are many possible causes of cognitive impairment, and many are treatable.
By adopting a brain-healthy lifestyle, it’s possible to halt and even reverse MCI, depending on the cause.
About the author
Tony Dearing is the creator of GoCogno.com, the website for people with mild cognitive impairment. His site features MCI Treatment Made Simple for You, a guide to the best and latest care for MCI, explained in simple, everyday language. You can contact him at firstname.lastname@example.org.