What is Mild cognitive impairment - Meaning and definition

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: January 11, 2019.

Diagnostic Criteria
A. Evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a mild decline in cognitive function; and
2. A modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits do not interfere with capacity for independence in everyday activities (i.e., complex instrumental activities of daily living such as paying bills or managing medications are preserved, but greater effort, compensatory strategies, or accommodation may be required).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).

May be due to: Alzheimer’s disease, frontotemporal lobar degeneration, Lewy body disease, vascular disease, traumatic brain injury, substance/medication use, HIV infection, Prion disease, Parkinson’s disease, Huntington’s disease, another medical condition, multiple etiologies, unspecified.

It may occur without behavioral disturbance, or with behavioral disturbance.

Adapted from American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Washington, DC. American Psychiatric Association. 2013. p. 605.

Published by Roberto Wenk. Reviewed by Alison Ramsey. Last updated date: January 11, 2019.

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by the individuals experiencing them or to other people, but not severe enough to interfere with daily life or independent function.
A person with MCI does not meet diagnostic guidelines for dementia.

Causes and risk factors: Causes are not yet completely understood. Experts believe that many cases result from brain changes occurring in the very early stages of Alzheimer's disease or other dementias.
The risk factors most strongly linked to MCI are the same as those for dementia:
• advancing age,
• family history of Alzheimer's or another dementia, and
• conditions that raise risk for cardiovascular disease.

Symptoms: experts classify mild cognitve impairment based on the thinking skills affected:
• Amnestic MCI primarily affects memory. For example, a person may forget information that they would previously have recalled easily, like appointments, conversations, or recent events.
• Nonamnestic MCI affects thinking skills other than memory, like the ability to make sound decisions or judge the time or sequence of steps to complete a complex task.

Management: Drugs to treat symptoms of Alzheimer's disease have not shown any lasting benefit in delaying or preventing progression of MCI to dementia.
The following coping strategies may be helpful for those with MCI:
• exercise on a regular basis,
• control cardiovascular risk factors, and
• participate in mentally stimulating and socially engaging activities.

Experts recommend that a person diagnosed with MCI be re-evaluated every 6 months to determine if symptoms are staying the same, improving, or growing worse.

Outcomes: MCI increases the risk of later developing dementia, but some people with MCI never get worse, or may even return to normal.

Alzheimers Organisation. Alzheimers and Dementia. What is Dementia. Mild Cognitive Impairment. Internet. Accessed on April 1, 2013.

Mild cognitive impairment

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