Aging today isn't viewed the same as it was 50 years ago. Back then, increased forgetfulness in older people was seen as a symptom of senility, which was thought to be an inevitable part of aging. Decades of research into brain function, however, have improved our understanding of age and memory loss. The type of memory loss once considered normal now may be seen as an early sign of disease, or mild cognitive impairment (MCI).
The line between ordinary forgetfulness in an older person and MCI is vague. MCI is usually defined as a loss of cognitive function in people over age 65 that exceeds an occasional wrong name or misplaced pair of glasses. MCI can be thought of as a precursor to dementia, which is a catch-all word used to describe serious brain dysfunction such as memory loss in older people. Alzheimer's disease is the most common form of dementia, although MCI does not always result in the development of Alzheimer's.
Increased Risk of Dementia
A person with MCI might have difficulty following a conversation, a fairly consistent inability to recall the names of new acquaintances or might frequently lose things. But a person with MCI can also retain the ability to function independently and maintain day-to-day activities such as preparing food, handling finances and maintaining personal hygiene. He or she may use notes, lists and calendars to compensate, and may maintain an independent lifestyle for many years. A person with full dementia would not be able to function independently.
Although there is no exact count of the number of Americans with MCI, a study conducted by the Mayo Clinic found that approximately 10% of people over 70 have the disorder. A person who has MCI has a high risk of developing Alzheimer's compared to someone who doesn't have MCI. As the population ages, the societal burden of dementia grows. As many as 5 million Americans have Alzheimer's, according to the Alzheimer's Association. The Centres for Disease Control (CDC) estimates that by the year 2030, that number may hit 16 million.
About 9% of people with MCI may experience mild improvement in memory over time. This is why it's so important to get medical attention as soon as symptoms are noted. A variety of medical problems -- such as vitamin deficiency, thyroid dysfunction and irregularities in blood pressure -- can cause or worsen dementia. Identifying and treating underlying conditions can help delay further decline. Some medications that are approved for Alzheimer's are prescribed off-label for MCI and appear to slow its progress, though their effectiveness has yet to be scientifically proven.
Diagnosing MCI
Since there's no single, clear-cut test for MCI, an important part of arriving at a diagnosis is excluding other diseases, such as depression, that can have similar symptoms. It can be a big help to bring someone else along, such as a spouse or grown child, to discuss memory problems and offer a more objective view of the symptoms.
Doctors can give a variety of neuropsychological tests to gauge a person's ability to remember. These tests are aimed at figuring out what kind of information the person can or can't hold on to, establishing how long the problem has existed and determining whether forgetfulness is accompanied by a decreased ability to plan or communicate.
Usually, the person is aware of the decline, and may be experiencing fear or even anger about it. But once the extent of the problem is laid out and a support plan is developed, the person with memory problems may find that he or she is not as sick as imagined. Understanding that slightly more than half of people who have MCI do not progress to full dementia may ease anxiety.
When a diagnosis is made, it is a good time to review what services are available and appropriate for the individual. People with MCI should also consider long-term plans for finances, housing and medical care in the event that their condition worsens.
Right now, there is no specific treatment for MCI. But studies of antioxidants suggest that these may help prevent cognitive decline. Staying active mentally by maintaining social contacts and doing things such as learning a new language may also play a role in prevention.
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