Mild Cognitive Impairment vs.

Alzheimer's
Disease

Overview
Causes
Progression
MCI vs. Alzheimer’s
MCI vs. Normal Memory Changes

Mild cognitive impairment (MCI) is a decline in cognition, including

concentration, communication, memory, and orientation. These declines
may also impact a person’s ability to conduct activities of daily
living (ADLs) in such areas as dressing, bathing and eating meals

Overview

It’s estimated that about 20 percent of people over the age of 70 have MCI.
Generally, as people age, they are more likely to develop MCI as well as
Alzheimer’s disease.

MCI is often thought of as the period between normal cognition and when
Alzheimer’s disease develops. Others consider it to be an early stage of
Alzheimer's if specific changes in the brain are present, although not
everyone with MCI will develop Alzheimer’s.

The definition of MCI has continually evolved. In the initial guidelines for a
diagnosis of MCI, the only area an individual could demonstrate
impairment in was memory. All other cognitive functioning had to remain
intact.

The definition was then revised and allowed for problems in other cognitive
areas, such as reasoning and judgment. However, a person had to continue
functioning quite well in daily life; if activities of daily living were impacted,
the diagnosis would likely be dementia, or specifically, the early stages of
Alzheimer's disease.

A group of researchers found that this definition was not always fitting with
what they found in their evaluations of those who were diagnosed with MCI
since many people with MCI in their study did indeed demonstrate a
functional impairment.

Because of this, a team from the Alzheimer's Association and National

Institutes of Aging recommended another revised definition of MCI in
2012. This one allowed for mild impairment in activities of daily living in
addition to the cognitive challenges outlined above. While it gives more
flexibility and perhaps is more accurate, the revised definition also blurs the
line between MCI and Alzheimer’s.

Consequently, some have recommended that the term MCI due to AD

(Alzheimer’s disease) be used, unless it's clear that the symptoms of MCI
are related to other potentially reversible causes, such as normal pressure
hydrocephalus or vitamin B12 deficiency.

Causes

The cause of MCI is unknown. It does appear to have similar risk factors to
Alzheimer’s, such as age, education level, and certain brain/body health
factors like stroke, diabetes, cholesterol, heart health, and blood pressure.

Progression to Dementia

People with MCI are at a higher risk of progressing to Alzheimer's disease;

however, despite this risk, not everyone does. One study found that after a
diagnosis of MCI, 40 percent of people "reverted" (that is, their cognitive
abilities returned to normal) for a time, although they were significantly
more likely to develop Alzheimer's within five years when compared with
those who never had MCI.

How MCI Differs From Alzheimer’s

Symptoms of Alzheimer’s disease typically begin with MCI. MCI refers to

relatively minor impairments in thought processes and memory, whereas
Alzheimer’s is a specific disease in which memory and functioning continue
to significantly decline over time.

Some researchers would like to identify MCI simply as a very early stage of
Alzheimer’s, especially because studies have shown changes in the brains of
people with MCI that are similar to those that are present in Alzheimer’s.
However, since some people who are diagnosed with MCI don't continue to
decline or show other symptoms of dementia, this definition is unlikely.

MCI vs. Normal Memory Changes

As people age, it’s normal for them to experience some occasional memory
gaps, such as not being able to remember someone’s name that they haven’t
seen for a while or where they set down their favorite pen. A periodic delay
in being able to access memories is also typical as we age.
What’s not normal, and moves people toward an MCI diagnosis, is the
experience of additional concerns in the areas of language, judgment, and
problem-solving, or when the memory loss is more than just occasional.
Individuals with normal age-related memory changes have less of a chance
of developing Alzheimer’s disease than those already diagnosed with MCI.

Treatment

There is no medication approved for the treatment of MCI at this time.

Some healthcare providers do opt to prescribe Aricept and Adlarity
(donepezil) since it has been researched as a treatment for MCI and has
shown some benefit.

Other healthcare providers recommend general risk-reduction strategies

similar to what is recommended for Alzheimer’s, including maintaining
healthy eating habits, physical activity, an active brain, and regular social
interaction.

While it's normal to feel worried if you see some of the symptoms of MCI in
yourself, it's important to see your healthcare provider for an evaluation
since some cognitive problems are at least partially reversible with
appropriate treatment. It's also possible that your appointment could
provide some reassurance that you're simply experiencing some
normal, age-related memory loss.

It's important to remember that, while some people with MCI eventually
develop Alzheimer's, others do not. Some people with MCI even function
reasonably well and remain stable for many years