Wednesday, August 24, 2016

Is It MCI, Dementia, or Something Else?

Is It MCI, Dementia, or Something Else?

Does a client, friend or family member who is otherwise normal show these symptoms or express concern about any of them?

The person:

  • Has difficulty remembering important information, or making sound decisions, or finding words that is not normal for the person’s age and education

  • Has memory loss

  • Is disoriented in familiar surroundings

  • Shows increased impulsiveness or evidence of poor judgment

If so, encourage the person to see a doctor for an evaluation.

These symptoms could be signs of Mild Cognitive Impairment (MCI), early dementia, or a psychological condition -- depression, irritability, aggression, anxiety, or apathy.

The key difference between MCI and dementia is that MCI is not severe enough to interfere with the person’s everyday independent functioning and ability to perform the normal six daily activities of living – eating, bathing, dressing, toileting, continence, and walking/transferring (Alzheimer’s Association, n.d.).

At the same time, MCI is a noticeable decline in cognitive functioning that is measurable. Persons with MCI have an increased risk of developing dementia, but not all people with MCI will get worse. Some actually may even improve. According to the Alzheimer’s Association, MCI affects 10 to 20 percent of those 65 or older.

MCI can be hard to pinpoint because its causes are not known, and no tests or procedures definitively diagnose it. MCI is a clinical diagnosis best made by a doctor through a medical workup:

  • The doctor’s professional judgment

  • A thorough medical history -- current symptoms, health history, family history of memory disorders

  • An assessment of the person’s ability to function independently and perform daily activities

  • Input from a family member or reliable friend that gives additional perspective about the changes

  • An assessment of the person’s mental status and mood

  • A neurological exam and neuropsychological testing

Treatment for MCI

There are no medications to stop, treat, or reverse MCI that are approved by the US Food and Drug Administration (FDA). Also, drugs that treat other dementia symptoms do not show any lasting benefits for MCI. Consequently, treatment for MCI focuses on two areas:

  • Slowing the decline in thinking skills

  • Maintaining cognitive function

And uses many of the same strategies for maintaining a healthy brain, including:

  • Limiting smoking and alcohol intake

  • Being socially engaged

  • Doing crossword puzzles and brain teasers

  • Eating foods such as salmon, halibut and tuna; almonds, pecans and walnuts, and blueberries, red grapes and spinach, broccoli and beets.

For more information and practical tips for reducing the risk of MCI or maintaining quality of life with a diagnosis of MCI, see this fact sheet from the Alzheimer’s Association:

 


Sources

Mild Cognitive Impairment,” Alzheimer’s Association.

Society of Certified Senior Advisors, Working with Older Adults: A Professional’s Guide to Contemporary Issues of Aging (2015).

The Working with Older Adults course offered by the Society of Certified Senior Advisors gives professionals a practical, comprehensive understanding of health, social and financial issues that are important to many older adults, including ethical issues specific to aging. For more information, or to enroll in a class, click here.