Mild Cognitive Impairment Doesn't Always Lead to Alzheimer's Disease

Dorian Martin Health Guide
  • In 2002, my mother was admitted to the hospital when she was having difficulty breathing due to her chronic obstructive pulmonary disease (COPD). A few days later, the doctor who was assigned to her caught me and said, “Your mother has dementia.” Unfortunately, he didn’t give me specific examples of why he was making this diagnosis and I was so worried about Mom’s breathing issues, I didn’t have the wherewithal to ask him more questions about her cognitive abilities. After she was released, Mom refused to even think about going to a doctor about her memory loss.


    However, in 2004 Mom finally agreed to be assessed by a neuropsychologist to try to determine what type of memory loss she was experiencing. The doctor ran Mom through a three-day battery of tests. I still remember the doctor telling us that Mom had mild cognitive impairment (MCI), but she didn’t have Alzheimer’s. That eased my mother’s mind, but about a year later, Mom had developed full-blown Alzheimer’s disease. So that brings me to the question – does a diagnosis of MCI mean that a person will automatically develop Alzheimer’s disease or another type of dementia?

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    Before we try to answer that question, let’s determine what MCI is. The University of California San Francisco's Memory and Aging Center reported that MCI “is defined by deficits in memory that do not significantly impact daily functioning. Memory problems may be minimal to mild and hardly noticeable to the individual.” The diagnosis of this condition is based on whether the person is able to successfully perform their usual activities without more assistance than he or she usually has had in the past.

     

    MCI is actually a clinical diagnosis based on the doctor’s judgment of symptoms shown. There are two types of MCI. The first is amnestic MCI, and involves forgetting information such as appointments, conversations or recent events. The second type is nonamnestic MCI, which affects decision-making, judgment of time, visual perception or complex decision-making. There are no tests or procedures that conclusively determine that a person has MCI.


    So what does a diagnosis of MCI mean? Is it downhill cognitively from there? Researchers from Germany are exploring this question. Their newly published study involved 357 people who were 75 years of age and above who had been diagnosed with MCI. The researchers continued to interview these participants over the course of three years.


    The researchers found that 41.5 percent of the participants had returned to normal cognitive function between 1-1/2 years to 3 years from the start of the study. Twenty-two percent had progressed to dementia while 21 percent of the participants had fluctuating cognitive abilities. The remaining 14 percent had stable MCI symptoms.


    The analysis also found that participants were more at risk for advancing to dementia if they had symptoms of depression, were impaired in more than one cognitive domain (recent memory, language, visuospatial ability or executive function), had more severe cognitive impairment or were older.  Furthermore, an assessment of a test in which the participants were asked to learn and then recall new material 10 minutes later was the best way of determining whether a person had progressive MCI or a type that would eventually fade and allow normal cognition.


  • Researchers aren’t sure what causes MCI.  The Mayo Clinic stated that MCI often comes about due to changes in the brain. These changes can include clumps of beta-amyloid protein plaques and protein clumps, clumps of protein known as Lewy bodies, small strokes, reduced blood flow through the blood vessels of the brain, shrinkage of the brain’s memory region (the hippocampus), enlargement of the brain’s fluid-filled spaces and reduced use of glucose. However, some people who have MCI show no changes in their brain structure.

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    Based on the lack of a firm understanding about MCI’s underpinnings, it’s not too surprising that there isn’t one specific treatment for this condition. Instead, doctors often prescribe medications for Alzheimer’s disease as well as treatments for conditions such as sleep apnea, high blood pressure and depression that can result in MCI. Additionally, people with mild cognitive impairment can benefit from regular physical exercise, a low-fat diet that’s also rich in produce and omega-3 fatty acids, regular social interactions and intellectual stimulation (such as puzzles, reading and hobbies).


    So if you or a loved one is experiencing memory loss and receives a diagnosis of MCI, know that it’s not a sign that a diagnosis of dementia is next. However, you need to work closely with the doctor to address the situation and find ways to improve cognitive functioning.

    Primary Sources for This Sharepost:


    Alzheimer’s Association. (ND). Core cognitive domains.


    Alzheimer’s Association. (ND). Mild cognitive impairment.


    Kaduszkiewicz, H., et al. (2014). Prognosis of mild cognitive impairment in general practice: Results of the German AgeCoDe Study. Annals of Family Medicine.


    University of California San Francisco Memory and Aging Center. (ND). Mild cognitive impairment.

Published On: March 14, 2014