Yogesh Shah, Director of Palliative Care, Broadlawns Medical Center
Mild cognitive impairment (MCI) is a stage between the expected cognitive decline of normal aging and dementia. It can involve one or more cognitive functions, including problems with memory, language, executive function, and judgment. There are two different types of MCI: amnestic MCI (aMCI), which is characterized by memory dysfunction, and non-amnestic MCI (naMCI), in which patients present other cognitive deficits.
If you have MCI, 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 are not severe enough to significantly interfere with your day-to-day life, usual activities, and independence.
Mild cognitive impairment may increase your risk of later progression to dementia (about 12 percent per year), caused by Alzheimer’s disease or other neurological conditions; however, some people with mild cognitive impairment never experience a worsened condition, and a few eventually get better. Up to 33 percent of patients with MCI revert to normal mental clarity.
At Broadlawns Geriatric and Memory Center, we use the following three modalities for diagnosis:
• Clinical syndrome to stage the disease: Detail history from the patient and close friend/spouse, and office-based cognitive screening (MoCA, SLUMS, or other Neuropsychological testing).
• Biomarkers to define the disease: Amyloid and Tau levels (in very select cases).
• Biomarkers to stage the disease: MRI atrophy measures (MTA score) and FDG PET (in select cases).
After clinical diagnosis, we discuss lifestyle modification and cognitive function:
a. Manage chronic medical conditions.
b. Build cognitive reserve:
i. Take Save Your Brain Quiz.
ii. Set personal goals.
c. Remove offending medications:
i. Role of Anticholinergic Medications/OTC—refer to PCP for depresecribing if applicable.
Hesham Abboud, MD, PhD, Director of the Multiple Sclerosis and Neuroimmunology Program and staff neurologist at the Parkinson’s and Movement Disorder Center at University Hospitals of Cleveland, Case Western Reserve University School of Medicine