Mild cognitive impairment

But red flags should go up if you start forgetting things you typically remember, such as doctor's appointments or your weekly pinochle game. This happens to everyone now and then, but if a pattern develops, it could be a symptom of mild cognitive impairment.

Commonly used criteria for a diagnosis of mild cognitive impairment are:

• Deficient memory, preferably confirmed by another person
• Essentially normal judgment, perception and reasoning skills
• Largely normal activities of daily living
• Reduced performance on cognitive tests, compared with other people of similar age and educational background

People with mild cognitive impairment may also experience:

• Depression
• Irritability
• Anxiety
• Aggression
• Apathy

Causes

Mild cognitive impairment often causes the same types of brain changes seen in Alzheimer's disease or other forms of dementia. The difference is in the extent of these changes, which is limited in mild cognitive impairment. These changes may include:

• Plaques, which are abnormal clumps of a protein called beta-amyloid
• Tangles, which are abnormal clumps of a protein called tau
• Shrinkage of the hippocampus, an area of the brain important for memory
• Strokes
• Lewy bodies, which are abnormal clumps of a protein that's associated with Parkinson's disease

Risk factors

• A specific change in a gene, called apolipoprotein E (APOE), which has been linked to Alzheimer's disease
• High blood pressure
• Diabetes
• Low levels of physical, social and mental activity
• Fewer years of education

Complications

People with mild cognitive impairment are three times more likely to develop Alzheimer's or other dementias than are those without such impairment. In fact, about half the people with mild cognitive impairment will progress to Alzheimer's disease within five years.

Diagnosis

There is no specific test to confirm a diagnosis of mild cognitive impairment. Instead, your doctor will try to rule out other potential causes for your symptoms. Tests may include the following.

Neurological exam

As part of your physical exam, your doctor may also check for signs of Parkinson's disease, strokes, tumors or other medical conditions that can impair memory as well as physical function. The neurological exam may test:

• Reflexes
• Eye movements
• Balance
• Sense of touch

Mental status exam

A short form of this type of test can be done in less than 10 minutes in your doctor's office. You may be asked to:

• Name today's date and your location
• Copy a design, such as intersecting pentagons
• Follow a three-stage command
• Remember a list of three words
• Follow a written direction
• Count backwards by sevens
• Draw a clock

Longer forms of neuropsychological testing can take several hours. Your results are then compared with those of people from a similar age and education level. This can help distinguish normal from abnormal cognitive aging, and may help identify patterns in cognitive functions that provide clues to the underlying condition.

Lab tests

Simple blood tests can rule out physical problems that can affect memory, such as vitamin B-12 deficiency or an underactive thyroid gland.

Brain scans

Your doctor may order an MRI or CT scan to check for evidence of stroke or bleeding, and to rule out the possibility of a tumour.

References

http://www.alz.org/dementia/mild-cognitive-impairment-mci.asp

http://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/basics/definition/con-20026392

http://emedicine.medscape.com/article/1136393-overview

http://www.nhs.uk/ipgmedia/national/macmillan%20cancer%20support/assets/mildcognitiveimpairmentmcs5pages.pdf