Mild cognitive impairment
Mild cognitive impairment | |
---|---|
Other names | Incipient dementia, isolated memory impairment |
Specialty | Neurology |
Symptoms | Can include memory impairments (amnestic) or cognitive problems like impaired decision making, language, or visuospatial skills (non-amnestic) |
Usual onset | Typically appears in adults 65 or older |
Types | Amnestic, non-amnestic |
Risk factors | Age, family history, cardiovascular disease |
Diagnostic method | Based on symptoms assessed by a clinical neuropsychologist through observations, neuroimaging, and blood tests |
Mild cognitive impairment (MCI) is a
Mild cognitive impairment has been relisted as mild neurocognitive disorder in DSM-5, and in ICD-11,[5] the latter effective on 1 January 2022.[6]
Classification
MCI can present with a variety of symptoms, but is divided generally into two types.[4]
Amnestic MCI (aMCI) is mild cognitive impairment with memory loss as the predominant symptom; aMCI is frequently seen as a
Nonamnestic MCI (naMCI) is mild cognitive impairment in which impairments in domains other than memory (for example, language, visuospatial, executive) are more prominent.[4][10] It may be further divided as nonamnestic single- or multiple-domain MCI, and these individuals are believed to be more likely to convert to other dementias (for example, dementia with Lewy bodies).[11]
The
Causes
Mild cognitive impairment (MCI) may be caused due to alteration in the brain triggered during early stages of Alzheimer's disease or other forms of dementia.[
Risk factors of both dementia and MCI are considered to be the same: these are aging, genetic (heredity) cause of Alzheimer's or other dementia, and cardiovascular disease.[15]
Individuals with MCI have increased oxidative damage in their nuclear and mitochondrial brain DNA.[16]
Diagnosis
The diagnosis of MCI requires considerable
- Evidence of memory impairment
- Preservation of general cognitive and functional abilities
- Absence of diagnosed dementia
Neuropathology
Although amnestic MCI patients may not meet criteria for Alzheimer's disease, patients may be in a transitional stage of evolving Alzheimer's disease.[3]
Treatment
As of January 2018,[update] there are no
The
According to research conducted in England, people with MCI often do not receive adequate care and support in healthcare settings. This leaves them and their families in a limbo with uncertainty regarding their futures and the fear of possibly developing dementia. The lack of services also fails to point them to effective ways to prevent dementia such as exercise and social contact. Successful dementia prevention services would have to be tailored to people's preferences and backgrounds.[21][22]
As MCI may represent a prodromal state to clinical Alzheimer's disease, treatments proposed for Alzheimer's disease, such as antioxidants and cholinesterase inhibitors, could potentially be useful;[23] however, as of January 2018, there is no evidence to support the efficacy of cholinesterase inhibitors for the treatment of mild cognitive impairment.[4] Two drugs used to treat Alzheimer's disease have been assessed for their ability to treat MCI or prevent progression to full Alzheimer's disease. Rivastigmine failed to stop or slow progression to Alzheimer's disease or to improve cognitive function for individuals with mild cognitive impairment;[24] donepezil showed only minor, short-term benefits and was associated with significant side effects.[25]
Intervention
Current evidence suggests that cognition-based interventions do improve mental performance (i.e. memory, executive function, attention, and speed) in older adults and people with mild cognitive impairment.[26] Especially, immediate and delayed verbal recall resulted in higher performance gains from memory training.
Nutrition
There is currently limited evidence to form a strong conclusion to recommend the use of any form of carbohydrate in preventing or reducing cognitive decline in older adults with normal cognition or mild cognitive impairment.[27] So, more large and higher quality evidence is needed to evaluate memory improvement and find nutritional issues due to carbohydrates.
Outlook
MCI does not usually interfere with daily life, but around 50 percent of people diagnosed with it go on to develop Alzheimer's disease within five years (mainly for people diagnosed with memory impairments). This diagnosis can also serve as an early indicator for other types of dementia, although MCI may remain stable or even remit.[4]
Prevalence
The
Due to the emphasis shifting to the earlier diagnosis of dementia, more people are assessed who report memory problems. In turn this also leads diagnosing more people who might have MCI which is a risk factor for dementia.[21][22] Globally, approximately 16% of the population over the age of 70 experiences some type of mild cognitive impairment.[medical citation needed]
See also
- Menopause-related cognitive impairment – similar symptoms, appears shortly after menopause, and can be treated with hormone replacement therapy
References
- S2CID 3717948.
- PMID 16006668.
- ^ PMID 29092777.
- ^ PMID 29282327.
In patients with MCI, exercise training (6 months) is likely to improve cognitive measures and cognitive training may improve cognitive measures. ... Clinicians should recommend regular exercise (Level B). ... Recommendation: For patients diagnosed with MCI, clinicians should recommend regular exercise (twice/week) as part of an overall approach to management (Level B).
- ^ "ICD-11 - Mortality and Morbidity Statistics". icd.who.int.
- ^ "Event Information - Overview". www.rcpsych.ac.uk Royal College of Psychiatrists. Archived from the original on 24 June 2021. Retrieved 24 June 2021.
- PMID 27042901.
- ^ S2CID 14831757.
- S2CID 221511593.
- S2CID 6618420.
- PMID 16894068.
- ^ Sartorius N, Henderson AS, Strotzka H, Lipowski Z, Yu-cun S, You-xin X, et al. "The ICD-10 Classification of Mental and Behavioural Disorders Clinical descriptions and diagnostic guidelines" (PDF). www.who.int World Health Organization. Microsoft Word. bluebook.doc. p. 61. Retrieved 23 June 2021 – via Microsoft Bing.
- ^ "Mild cognitive impairment (MCI)". Mayo Clinic. Retrieved 30 Sep 2020.
- S2CID 231964648.
- ^ "Mild Cognitive Impairment". Alzheimer's Association. Retrieved July 9, 2017.
- S2CID 23689125.
- PMID 25629415.
- PMID 11255443.
- PMID 17898323.
- PMID 18263627.
- ^ S2CID 241882442. Retrieved 2022-12-05.
- ^ S2CID 220288902.
- S2CID 73512492.
- S2CID 10742472.
- PMID 29923184.
- PMID 21249675.
- PMID 21491398.