Overview

Mild cognitive impairment (MCI) is the stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It's characterized by problems with memory, language, thinking or judgment.

If you have mild cognitive impairment, you may be aware that your memory or mental function has "slipped." Your family and close friends also may notice a change. But these changes aren't severe enough to significantly interfere with your daily life and usual activities.

Mild cognitive impairment may increase your risk of later developing dementia caused by Alzheimer's disease or other neurological conditions. But some people with mild cognitive impairment never get worse, and a few eventually get better.

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Symptoms

Your brain, like the rest of your body, changes as you grow older. Many people notice gradually increasing forgetfulness as they age. It may take longer to think of a word or to recall a person's name.

But consistent or increasing concern about your mental performance may suggest mild cognitive impairment (MCI). Cognitive issues may go beyond what's expected and indicate possible MCI if you experience any or all of the following:

  • You forget things more often.
  • You forget important events such as appointments or social engagements.
  • You lose your train of thought or the thread of conversations, books or movies.
  • You feel increasingly overwhelmed by making decisions, planning steps to accomplish a task or understanding instructions.
  • You start to have trouble finding your way around familiar environments.
  • You become more impulsive or show increasingly poor judgment.
  • Your family and friends notice any of these changes.

If you have MCI, you may also experience:

  • Depression
  • Irritability and aggression
  • Anxiety
  • Apathy

Causes

There's no single cause of mild cognitive impairment (MCI), just as there's no single outcome for the disorder. Symptoms of MCI may remain stable for years, progress to Alzheimer's disease or another type of dementia, or improve over time.

Current evidence indicates that MCI often, but not always, develops from a lesser degree of the same types of brain changes seen in Alzheimer's disease or other forms of dementia. Some of these changes have been identified in autopsy studies of people with MCI. These changes include:

  • Abnormal clumps of beta-amyloid protein (plaques) and microscopic protein clumps of tau characteristic of Alzheimer's disease (tangles)
  • Lewy bodies, which are microscopic clumps of another protein associated with Parkinson's disease, dementia with Lewy bodies and some cases of Alzheimer's disease
  • Small strokes or reduced blood flow through brain blood vessels

Brain-imaging studies show that the following changes may be associated with MCI:

  • Shrinkage of the hippocampus, a brain region important for memory
  • Enlargement of the brain's fluid-filled spaces (ventricles)
  • Reduced use of glucose, the sugar that's the primary source of energy for cells, in key brain regions

Risk factors

The strongest risk factors for MCI are:

  • Increasing age
  • Having a specific form of a gene known as APOE e4, also linked to Alzheimer's disease — though having the gene doesn't guarantee that you'll experience cognitive decline

Other medical conditions and lifestyle factors have been linked to an increased risk of cognitive change, including:

  • Diabetes
  • Smoking
  • High blood pressure
  • Elevated cholesterol
  • Obesity
  • Depression
  • Lack of physical exercise
  • Low education level
  • Infrequent participation in mentally or socially stimulating activities

Complications

People with MCI have a significantly increased risk — but not a certainty — of developing dementia. Overall, about 1% to 3% of older adults develop dementia every year. Studies suggest that around 10% to 15% of individuals with MCI go on to develop dementia each year.

Prevention

Mild cognitive impairment can't always be prevented. But research has found some environmental factors that may affect the risk of developing the condition. Studies show that these steps may help prevent cognitive impairment:

  • Avoid excessive alcohol use.
  • Limit exposure to air pollution.
  • Reduce your risk of head injury.
  • Don't smoke.
  • Manage health conditions such as diabetes, high blood pressure, obesity and depression.
  • Practice good sleep hygiene and manage sleep disturbances.
  • Eat a nutrient-rich diet that has plenty of fruits and vegetables and is low in saturated fats.
  • Engage socially with others.
  • Exercise regularly at a moderate to vigorous intensity.
  • Wear a hearing aid if you have hearing loss.
  • Stimulate your mind with puzzles, games and memory training.

Mild cognitive impairment (MCI) care at Mayo Clinic

Sept. 02, 2020
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