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Aging Issues

Mild Cognitive Impairment (MCI): Symptoms, Causes, and Help

The symptoms of MCI can be subtle, and a formal diagnosis can come as a shock. But learning more about the causes, risk factors, and self-help strategies may help ease your fears.

What is mild cognitive impairment (MCI)?

As you age, some degree of cognitive decline is expected. Names, dates, and details may slip your mind on occasion and, overall, you may not feel as mentally sharp as you used to be. However, if you have problems with memory, language, and thinking that go beyond normal age-related changes, you may be experiencing mild cognitive impairment (MCI).

In some cases, you can think of MCI as the bridge between the normal aging process and Alzheimer's disease or another type of dementia. In other instances, MCI results from another condition, such as a vitamin deficiency or brain injury.

If you're living with MCI, perhaps you've developed a habit of misplacing your wallet, keys, and phone on a daily basis. Or maybe you routinely forget important events like holidays or family get-togethers. These experiences can make you feel embarrassed, anxious, and frustrated. You might feel a sense of despair as begin to question if you can continue to pursue your goals or maintain your independence.

And if a loved one exhibits these symptoms, you might worry about their well-being. Will they need a caregiver soon? How can you offer them the emotional support they need?

These worries are normal, and you're certainly not alone. Roughly 12 to 18 percent of people who are 60 years of age or older experience MCI.

Types of MCI

Once detected, cases of MCI are categorized as either amnestic or nonamnestic.

Amnestic MCI affects a person’s memory. For example, you might have a hard time remembering important dates or recent conversations.

Nonamnestic MCI affects cognitive functions aside from memory, such as decision-making, visual perception, or language skills.

MRI research shows that amnestic and nonamnestic MCI affect different parts of the brain. There is some evidence that nonamnestic MCI is more likely to lead to dementia with Lewy bodies, while amnestic MCI is more likely to lead to Alzheimer’s disease.

There is some good news, though. MCI doesn't always lead to dementia. Research shows that each year about 10 to 15 percent of people living with MCI develop Alzheimer's disease. However, in a study of more than 3,000 people diagnosed with MCI, about 16 percent of participants returned to normal (or close to normal) cognitive functioning a year later.

If you have a neurodegenerative disease, such as Alzheimer's or Lewy body dementia, MCI is more likely to worsen with time. But the progression of cognitive impairment can vary from person to person. Some people remain at the same level of cognitive impairment for several years.

Of course, not everyone who has memory problems has MCI, so it's important to know how to identify the symptoms. And even if you are diagnosed with MCI, there are still steps you can take to slow its progression and manage the symptoms.

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Symptoms of MCI

When you think of cognitive decline, you might imagine someone who gets lost when walking around their neighborhood or someone who has trouble recognizing family members. Perhaps you picture someone who has undergone personality changes or experiences bouts of agitated confusion. These are actually potential signs of Alzheimer's or dementia.

[Read: Alzheimer’s Disease: Signs, Symptoms, Causes, and Stages]

The symptoms of MCI are far more subtle, as the cognitive decline is still in its early stages. Here are some signs that you or a loved one may have MCI.

You frequently lose items. Everyone misplaces keys, hats, TV remotes, and other items on occasion. However, when this habit becomes an everyday occurrence, it may be a symptom of MCI.

You have increased difficulty coming up with the right words. It's not usual to misuse a word in daily conversation or to have a hard time remembering a specific term. However, if you generally have a hard time coming up with words, especially compared to people within your same age range, you might have MCI. Impaired language skills might also make it difficult to follow conversations.

You often forget events, names, or conversations. Forgetting to make a bill payment or water your house plants is a normal occurrence. Forgetting bigger events, such as daily work meetings, could be a sign of MCI. These memory issues might also affect your ability to recall names of new acquaintances or details of recent conversations.

Normal signs of aging vs. possible signs of MCI

Normal agingMCI
You take a pause to remember your new neighbor's name.You consistently forget the name of a long-time neighbor.
You occasionally misplace your keys.You consistently lose your keys and other small items.
You forget bits of a conversation you had several days ago.You can't recall having a conversation with someone.
You forget a difficult word or rarely used term.You have trouble thinking of common words and frequently have to make substitutions.
You have a hard time learning the rules of a new and complex board game.You have a hard time completing familiar activities that require multiple steps.

Because these symptoms are easily mistaken for normal, age-related forgetfulness, it's important to consult a doctor for a professional opinion. A doctor can also help you track cognitive functioning over time to see if it worsens or improves.

Early detection of MCI is crucial. An early diagnosis time gives you time to make lifestyle changes that may slow its progression or reverse it when possible. It's also important to note that once MCI progresses to a form of dementia like Alzheimer’s or Lewy body dementia, it can't be reversed or cured, only managed.

Causes of MCI

Various conditions can lead to or worsen mild cognitive impairment. Understanding the specific cause of your MCI can help you assess the most effective ways to manage the problem.

Degenerative brain disease. As previously mentioned, MCI can be an early sign of Alzheimer's disease or another form of dementia.

Vitamin deficiency. A vitamin B-12 deficiency can negatively affect cognitive abilities. The vitamin is often found in meat and dairy products.

Medication. Certain drugs, such as antihistamines, benzodiazepines, and antidepressants, can cause amnestic or nonamenestic MCI. Changes in your medication use may reverse the impairment.

Traumatic brain injury. Events like falls and car accidents cause traumatic brain injuries. Depending on the nature and severity of the injury, cognitive difficulties may follow.

Vascular disease. Problems with the vascular system—also known as the circulatory system—can lead to MCI. For example, a stroke may affect a person's ability to think clearly.

Risk factors

When it comes to your odds of developing MCI, certain risk factors are simply out of your control. Older people are more at risk because brain tissue begins to shrink with age. Genetics can also play a role, so it's worth considering whether your family has a history of dementia.

However, there are plenty of other risk factors that you can control or have treated. Factors that put you at a higher risk of developing MCI include:

Poor heart health. People with coronary heart disease may be at increased risk of cognitive impairment. This could be because heart disease and dementia share common risk factors or because cardiac complications can affect cognitive health. There's also strong evidence that high blood pressure is associated with cognitive decline.

Substance abuse or smoking. Smoking or excessive drinking can come with various physical and mental health complications, including an increased risk of MCI.

Elevated cholesterol. Research suggests that high total blood cholesterol (anything above 240 ml/dL is considered high) may increase your risk of cognitive decline.

Sleep disturbances. People who struggle with conditions that decrease sleep quality, such as sleep apnea or insomnia, seem to be more prone to developing MCI.

Lack of mental and social engagement. Your brain thrives on interpersonal interactions and cognitive stimulation. If you isolate yourself for extended periods or fail to exercise your brain, you may increase your risk of MCI.

Sedentary lifestyle. Physical activity improves cognitive function and helps you manage other risk factors, such as high blood pressure.

Diabetes. This condition may increase your risk of MCI due to its effect on your vascular system.

Untreated mental health issues. When left untreated, conditions like depression and anxiety can put you at a higher risk of developing MCI.

Having multiple chronic conditions, such as asthma, stroke, hypertension, diabetes, depression, and cancer, can further increase your risk of MCI. Taking steps to treat or reduce those conditions can help decrease your risk of cognitive decline.

Assessing the risk of progression

If you or a loved one already has MCI, you'll want to identify which factors increase your risk of MCI progressing to Alzheimer's or dementia. Again, certain genetic characteristics play a role. But other factors, such as diabetes, cardiovascular health, depression, and drug side effects, you have more control over.

Self-help options

Depending on the cause of MCI, you might need to work with a doctor to address the underlying issue. For example, you could swap out certain medications for alternatives or undergo rehabilitation for a traumatic brain injury.

However, there are also simple lifestyle changes you can adopt that may help to lower your risk factors, slow the rate of cognitive decline, or even reverse mild cognitive impairment.

Improve heart health. Heart health is connected to cognitive health. For example, issues like increased arterial stiffness and high blood pressure are associated with worsened memory. Steps to improve your heart health include:

  • Eating more heart-healthy foods, such as fruits and veggies that are high in potassium, a mineral that relaxes blood vessels.
  • Reducing your salt intake and switching to spices like fresh basil and thyme to flavor foods.
  • Using relaxation techniques, such as mindfulness meditation, to decrease blood pressure.

[Read: Blood Pressure and Your Brain]

Manage stress. Aside from increasing your blood pressure, stress can have a more direct effect on your cognitive functioning. Stress can distract you from focusing on tasks in the moment, and chronic stress can accelerate cognitive decline. Activities like meditation, exercise, and journaling can help you ease your stress levels. To handle in-the-moment stress, you can practice grounding yourself in the present using your senses. Hum a song, jog in place, or focus on taking slow, deep breaths.

Eat a diet with brain benefits. Some research suggests that certain foods may contribute to brain health. For example, switching to a Mediterranean diet, which is low in red meat and sweets but high in fruits, veggies, legumes, and seafood, could be beneficial.

Stay mentally and socially engaged. Engaging in social activities and cognitive training activities can have a beneficial effect on brain health. So, take time to connect with friends and family members on a regular basis. Encourage them to join you in learning new skills or playing games. You can also enjoy solo activities, such as puzzles and brain teasers.

Get active. Results of a six-month study suggested that regular aerobic (cardio) exercise could significantly reduce age-related cognitive problems. When paired with a healthy diet aimed at reducing hypertension, exercise led to even greater cognitive improvements. Aim for at least 150 minutes of moderate aerobic activity each week.

Get enough sleep. Sleep deprivation is known to reduce cognitive performance, including decision-making and long-term memory. To achieve better sleep:

  • Maintain a consistent sleep schedule, even during weekends.
  • Avoid caffeine late in the day and avoid bright screens before bed.
  • Develop a relaxing routine before bedtime, such as taking a warm bath or reading a book.
  • Limit daytime naps to 15 or 20 minutes.

Drop unhealthy habits. If you're a heavy smoker or drinker, consider ways to break those habits. Overcoming addiction isn't an easy process, but with the right guidance you can do it.

Supporting a loved one living with MCI

If a loved one is living with MCI, encourage them to take all of the steps listed above. Keep in mind that you can't force them to adopt the strategies, but joining them in their efforts might help motivate them.

Prep healthier meals together. Go for daily jogs with them. Work on puzzles together or challenge them to brain-teasing games. You'll also get to reap the benefits of these healthy habits.

Coping with an MCI diagnosis

If you're diagnosed with MCI, you might feel shocked, scared, sad, or even angry. You might feel stripped of your future and fearful of losing your independence or self-identity. Denial is also a common reaction, and it may eventually give way to depression and anxiety. You might feel helpless right now, but there are still steps you can take to move forward with your life.

Allow yourself to feel whatever emotions arise. Attempts to suppress negative emotions can have emotional and physical consequences later, raising your blood pressure or steering you towards unhealthy coping mechanisms. A healthier approach is to acknowledge and accept your emotions, even if they are intense or surprising. Know that these feelings will eventually pass. Writing your feelings down or confiding in a loved one can help.

[Read: Coping with a Life-Threatening Illness or Serious Health Event]

Practice self-compassion. Resist the urge to blame yourself for your condition. It's also important to remember that MCI doesn't have to define you as a person. Challenge negative inner monologue with more positive and realistic views. For example, you might find yourself thinking, “I'm going to be a burden on my family.” Challenge that view with, “I still have an important role to play in the lives of those around me.”

Learn more about MCI, Alzheimer's, and dementia. Researching these conditions might feel scary at first, but knowledge can be empowering. Find out how cognitive decline progresses and what can slow or speed up that progression.

Take part in research. Consider participating in research studies or clinical drug trials to help doctors learn more about MCI and uncover new ways to treat it.

Adapting to MCI symptoms

Rather than ignore your symptoms, take steps to adapt to these new challenges. This can help reduce stress, manage symptoms, and give you a sense of control.

  • Follow a consistent routine and keep items that you use daily, such as a laptop, phone, and keys, in easy-to-remember places.
  • Use memory aids, such as calendars, electronic organizers, or sticky notes to help you recall important details or dates.
  • Automate important tasks such as bill payments. You can also use automatic plant watering systems, pill dispensers, and pet feeders.
  • Get rid of unused items that clutter your living space. Items such as boxes of old décor or unnecessary documents make it harder for you to locate items that you actually need.
  • Remove safety hazards, such as cords or throw rugs that could lead to tripping.
  • Increase lighting throughout your home and install safety devices, such as hand railing and smoke detectors where needed.

Helping a loved one cope with a diagnosis

If a friend or family member has received an MCI diagnosis, they will likely need some degree of emotional support. Encouraging them to practice self-compassion, learn more about MCI, or take part in studies may help empower them. You might even want to help guide them through the process of adapting to their symptoms.

It's important to continue to respect their sense of independence, though. People living with MCI can still function without relying on others. They may not want to be treated differently or made to feel as if they're incapable of completing tasks on their own. Put yourself in their shoes. Recognize that they have plenty of time to make their own decisions and chart their own path through life.

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Last updated or reviewed on February 5, 2024