As we get older our memory and other cognitive functions get a little less acute; this is just a fact of aging. But age related memory loss is not dementia; nor are other minor changes in our intellectual processes. Dementia is a sever loss of one or more cognitive functions that impair one’s ability to complete everyday tasks. In between normal aging and dementia is a condition called Mild Cognitive Impairment.
It is estimated that between 3% and 19% of adults over the age of 65 are affected by Mild cognitive impairment. Mild cognitive impairment is not dementia, as it does not impact a person’s ability to care for oneself. However, as many as half of people with the condition will likely develop some form of dementia within five years. On the other hand, some people with mild cognitive imparement (MCI) remain stable or even return to normal.
Our advice has always been to get a thorough diagnosis if you suspect dementia. This goes for mild cognitive impairment as well. Many of the curable or reversible conditions that can mimic dementia can also create symptoms of MCI. Included on this list of possible culprits:
- depression
- drug side effects and interactions
- infection and neuro-inflammation
- Also see Conditions that Mimic Alzheimer’s

What is MCI, and is it different than Alzheimer’s/dementia?
Mild Cognitive Impairment, or MCI, is a decrease in cognitive functioning that is not clinically significant. It may be considered a risk factor for dementia, just as high blood pressure is a risk factor, but it is not dementia.
MCI is often a precursor to Alzheimer’s disease, like a stage between normal aging and dementia, but it does not necessarily become Alzheimer’s disease or dementia. In fact, only 10% to 40% of the cases of MCI go on to become dementia. Furthermore, by some estimates, as many as 30-40% of people diagnosed with MCI get better, though more recent data has this rate a little lower.
Two Types of Mild Cognitive Impairment
- Amnestic mild cognitive impairment affect memory to a lesser degree than does dementia. Individuals with this type of MCI are generally aware of forgetfulness, as are those close to them. On the other hand, cognitive functions including executive functioning remain relatively unaffected.
- Nonamnestic mild cognitive impairment, by contrast, does affect other cognitive functions like language and attention, while leaving memory untouched, for the most part.Of the two, amnestic MCI is more common and is more likely to progress to dementia of the Alzheimer’s type. In fact, a review¹ in The New England Journal of Medicine estimates that, “more than 90% of those with progression to dementia had clinical signs of Alzheimer’s disease.” Those with the less common form, nonamnestic MCI, who progress to dementia are more likely to develop “dementias that are not related to Alzheimer’s disease, such as frontotemporal lobar degeneration or dementia with Lewy bodies.”
What causes Mild Cognitive Impairment?
Just as there are many causes for dementia, mild cognitive impairment can result from many conditions. In fact, postmortem studies of often find the plaques and tangles of Alzheimer’s disease, the Lewy bodies that cause the dementia that bears that name, or the restrictions to blood flow associated with vascular dementia. It seems reasonable to assume that almost every cause of dementia can potentially cause MCI. I think more important is understanding and controlling risk factors.
Risk Factors for Mild Cognitive Impairment
Risk factors for MCI are much the same as risk factors for dementia. They include:
- Advancing age – probably the most prominent factor
- Having the gene APOE-e4, which is also linked to Alzheimer’s disease; the good news – having the APOE-e4 gene doesn’t
- Diabetes & Hypertension (untreated)
- High serum cholesterol
- Obesity
- Smoking
- Depression
- Lack of physical exercise
Can We Treat or Prevent MCI?
We don’t have a definitive answer for this, but there is a lot we can do to lower our risk for mild cognitive impairment, and even lessen it’s effect, maybe even reverse the condition. Again, these positive risk factors are much the same as positive risk factors for dementia including Alzheimer’s disease. (Positive risk factors decrease our risk for something, as opposed to negative risk factors, which increase our risk.)
Risk factors for MCI are much the same as risk factors for dementia. They include:
- Don’t get older – Okay, that’s not going to happen, but we have two ages: our chronological age and our biological age. It is our biological age that is the real factor, and we can effect our biological age. We can, in fact, reverse it to a degree. How? Begin by reducing or eliminating your negative risk factors:
- Quit smoking
- Moderate or eliminate alcohol consumption
- If you have diabetes or hypertension, be sure it is treated and managed
- Treat high serum cholesterol
- Conversely, do all you can to increase positive risk factors:
- Maintain a healthy weight
- Keep your brain and your body fit – exercise both
- Eat healthy – no junk food, little processed food, limit red meat, etc. One of the best ways to do this is to prepare as much of your food as you can. A Mediterranean diet is one of the best for brain health. Anti-inflammatory foods are recommended. More >>
- Stay socially active
Since symptoms, causes, risk factors, and treatments for mild cognitive disorders are so similar to those for Alzheimer’s disease and many other dementias, I recommend your read also our article Can We Prevent Alzheimer’s Disease.
Related Research
Mild Cognitive Impairment
- Mild Cognitive Impairment(2001). Ronald C. Petersen, M.D., Ph.D.;The New England Journal of Medicine, 2011; 364:2227-34.
Copyright © 2011 Massachusetts Medical Society - Effect of long-term lifestyle intervention on mild cognitive impairment in hypertensive occupational population in China (2018 ). Li M, Liu L, Song S, Shi A, Ma Y, Zhang S, Wang Z, Zhu D, Tian G; Medicine (Baltimore), 2018 Aug;97(34):e11975. doi: 10.1097/MD.0000000000011975.
Related Research: Mild Cognitive Impairment
- This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author’s clinical recommendations.
- The authors studied a group in China experiencing cognitive dysfunction, presumable as a result of hypertension. They found that lifestyle intervention, which included diet, smoke, drink, and exercise intervention, had a measurably positive effect on cognitive performance. Their conclusion: Long-term lifestyle intervention can be used as adjunctive therapy to improve the BP and cognitive function of hypertensive occupational population in China.
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