Mild Cognitive Impairment

Alzheimer’s, dementia and its precursor, Mild Cognitive Impairment (MCI) workup and management by Dr. Yogesh Shah, M.D.

Most dementias are preceded by mild cognitive impairment (MCI). MCI is a stage between the expected cognitive decline of normal aging and dementia. It can involve one or more of cognitive functions like problems with memory, language, executive function and judgment.

If you have mild cognitive impairment, you may be aware that your memory or mental function has "slipped." Your family and close friends also may notice a change. But generally these changes aren't severe enough to significantly interfere with your day-to-day life, usual activities and independence.

However, it’s important to understand mild cognitive impairment, because it may increase your risk of later progressing to dementia (about 12% per year), caused by Alzheimer's disease or other neurological conditions. Up to 33% of patients with MCI can revert to normal with simple interventions and lifestyle changes.

At Broadlawns Medical Center’s Memory Center, we specialize in MCI and have the following approach to identify MCI and address related issues. If you notice changes in thinking or memory, please call (your primary care physician or) the Broadlawns Medical Center’s Memory Center for evaluation.

Here’s what you can expect at your first visit:

- Bring a close friend or spouse who can help you describe your symptoms and help write down information from the doctor.

- Bring (a list of) all the prescription, over-the-counter, recreational drugs and supplements you currently take. Be honest about drug and alcohol use.

- You will undergo an office-based cognitive screening, that consists of answering questions to determine the extent of your memory loss.

- The doctor will check for depression.

- Routine blood test to rule out any reversible causes of memory loss.

- A neuroimaging (brain scan) may be required, depending on the findings.

Discuss Life Style modification and cognitive function

If you receive a positive diagnosis of MCI, there are some lifestyle choices that can help improve outcomes.

1. Manage chronic medical conditions

2. Build cognitive reserve

i. Take Save Your Brain Quiz and set personal goals

3. Remove offending medications

i. Certain medications, when taken over a long period of time, can contribute to memory problems.

4. Start Rx with antidementia meds/antidepressants

Once your health care provider starts you on a health maintenance plan, it’s time to determine what other resources are needed to support the individual living with Alzheimer’s or dementia and their family.

1. Get all legal documents including wills and Durable Power of Attorney

2. Determine driving status (with physician recommendation)

3. Living arrangements/Level of care

4. Explore participation in research studies through the Alzheimer’s Association’s TrialMatch®

5. Receive referrals to speech therapy, physical therapy, occupational therapy, audiology, outdoor behavioral healthcare, Aging Resources and the Alzheimer’s Association.

Ongoing care:

A. Your physician will track disease progression and monitor response to antidementia medications.

B. The health and wellbeing of caregivers will also be closely monitored for signs of stress, depression or declining health.