If you or someone you know is experiencing these changes in memory or thinking, please discuss it with a health care provider. Your provider might evaluate your blood pressure, cholesterol and vitamin B12 levels.
Your physician may also order imaging tests and neuropsychological testing. These are a series of written or computerised tests that assess your thinking skills.
Symptoms
If you or a loved one have been experiencing subtle memory or thinking changes, you should speak to your physician who could diagnose you with Mild Cognitive Impairment (MCI).
It is currently accepted that, though the boundary is somewhat arbitrary, MCI lies between the changes predicted by healthy ageing on the one hand, and those typically associated with dementia – the progressive cognitive decline linked to conditions such as Alzheimer’s disease – on the other. The type of symptoms most commonly observed in individuals diagnosed with MCI include repeated episodes of misplacing items, momentary forgetfulness, and the gradual loss of being able to recall names or places (or hard numbers such as phone numbers) or the ability to find the right words. Trouble initiating or performing familiar movements, as well as a diminution in the sense of smell – are MCI symptoms also.
The changes associated with MCI may be progressing toward dementia and could last for a lengthy period, but despite the many unanswered questions, it’s never certain if things will proceed to dementia. They called it mild cognitive impairment because it’s not quite as serious as dementia. But it is a reflection that your brain is changing. It could be plaque building up in your brain, or shrinkage of the hippocampus, which is a part of your brain, or it could be fluids building up in fluid-filled sacks in your brain (ventricles). Some symptoms are a lack of interest and having difficulty paying attention.
Diagnosis
While some forgetfulness is a normal part of ageing, someone who is having a greater degree of trouble thinking or remembering than other people their age might be experiencing MCI: the changes are greater than would be expected for someone of their age and education, but are not yet enough to rise to the threshold for dementia.
You might notice that your memory slips a little, or family members and/or friends might notice that you have been forgetting things more often than usual, but it’s just slight. It’s not really interfering with your life. It’s subtle. But if you have these kinds of symptoms or have noticed them in a loved one, you should tell your health care provider.
Even so, a basic workup will help to rule out potentially treatable aetiologies such as thyroid disease or cobalamin deficiency, and it can help both you and your physician pinpoint the aetiology of your cognitive decline, which, if untreated, typically progresses to dementia.
Treatment
The good news is that these changes to memory and thinking are not necessarily due to MCI or dementia; they commonly reflect normal ageing or other illnesses.
If you experience any change in memory or thinking, it will be helpful to see a doctor, who should ask questions about your own and your family’s history of dementia or other significant memory problems, and to perform a physical exam. The doctor might also perform blood and urine tests, in addition to tests for vitamin B12 and thyroid hormones, to rule out infections or other conditions.
There is no treatment for MCI, but treating any reversible underlying cause might be helpful, such as changing medications causing cognitive side effects, improving sleep habits, eating right with a heart-healthy diet, and staying mentally stimulated by playing word games, reading or engaging socially. Getting exercise regularly can lower the risk for Alzheimer’s disease, and help keep blood flowing to the brain.
Prevention
If you’ve noticed some memory changes, the first step is to discuss them with your healthcare professional. He or she can determine why you’ve experienced memory or thinking problems – whether it’s related to normal changes of ageing, MCI or dementia; or the result of underlying medical conditions, like bad reaction to medication, blood clot or head injury. Usually, the professional will use two tools to do this – imaging (CT scan or MRI) and neuropsychological testing of mental capacity.
Even though MCI is not a harbinger or a preclinical form of Alzheimer’s disease or other forms of dementia, it is a risk factor for developing dementia. And you may have something for the doctor to treat by finding out whether you have an underlying condition that is causing your MCI – side effects from a medication, lack of sleep, vitamin B12 insufficiency or an infection.
Here are some measures you can take to minimise your risk: maintaining a healthy weight and keeping fit through regular exercise as well as avoiding smoking, perhaps augmented with activities to keep your brain engaged, such as doing crossword puzzles and reading. In general, the idea is that we can ‘use it or lose it’.