Mild Cognitive Impairment is an intermediate step between an expected cognitive impairment due to normal aging and the most serious deterioration of dementia.
Cognitive impairment is an alteration of intellectual functioning, also known as cognitive functioning. Cognitive function includes processes such as memory, language, and spatial orientation, anything that allows us to know and interact with our environment.
When a person has a cognitive impairment, one or more of these processes are dysfunctional, for example, the affected person forgets things they are supposed to remember or has trouble using words.
This can involve memory, language, thought and judgment issues that are more important than normal age-related changes. However, these changes are not so severe that they interfere significantly with everyday life and routine activities.
Mild cognitive impairment may increase the risk of dementia in the future, caused by Alzheimer’s disease or another neurological disorder. But some people with mild cognitive impairment never get worse and some get better over time.
I – Symptoms of Mild Cognitive Impairment
– Forget things more often.
– Forgetting important events such as consultations or social gatherings.
– Lose the thread of thought or conversations, books or movies.
– Feeling more and more overwhelmed when making decisions, planning steps to complete a task, or understanding instructions.
– Start having trouble locating in a familiar environment.
– Become more impulsive or show a sense of reality more and more deteriorated.
– Family and friends notice all these changes.
If you have a mild cognitive impairment, the following events may occur:
– Irritability and aggression
II – The Causes of Mild Cognitive Impairment
There is no single cause of mild cognitive impairment or a single outcome for the disorder. Symptoms may remain stable for years, progress to Alzheimer’s or other dementia, or improve over time.
Mild cognitive impairment can also be the manifestation of different medical conditions:
– The side effects of some drugs: In this case, stopping the drug would lead to an improvement in cognitive status.
– Depression: It is common for many people with a depressive disorder to have mild cognitive impairment. Depression itself can cause problems with memory and concentration. If depression is the cause and is treated properly, cognitive impairment will improve significantly.
– Different medical conditions: Hormonal disorders, infectious diseases, cerebral vascular alterations, deficiency of certain vitamins, etc. Proper treatment of each of these conditions can help reduce cognitive problems. For example, deficiency of some vitamins may lead to a state of mild cognitive impairment that can dissipate once the vitamin deficiency has been treated and the values have returned to normal.
Current evidence indicates that DCL usually, but not always, develops from a lesser degree of the same types of brain changes as those observed in Alzheimer’s disease or other forms of dementia. Some of these changes have been identified during autopsies of people with mild cognitive impairment.
These brain changes are as follows:
– Abnormal accumulation of beta-amyloid protein (plaques) and microscopic protein accumulations of tau characteristic of Alzheimer’s disease (neurofibrillary degeneration).
– Lewy bodies, which are microscopic accumulations of another protein associated with Parkinson’s disease, Lewy body dementia, and some cases of Alzheimer’s disease.
– Small strokes or decreased blood flow in the blood vessels.
Diagnostic imaging studies show that the following changes may be associated with mild cognitive impairment:
– The narrowing of the hippocampus, a region of the brain important for memory.
– Enlargement of the cerebral spaces filled with fluid (ventricles).
– Reduction of the use of glucose, the sugar that is the main source of energy for cells, in key regions of the brain.
III – Risk Factors for Mild Cognitive Impairment.
– More advanced age
– Have a specific form of a gene called APOE-e4, also linked to Alzheimer’s disease. Although the gene does not guarantee a decrease in cognitive abilities.
Other diseases and lifestyle factors have been associated with an increased risk of cognitive changes, including:
– High cholesterol
– Lack of physical exercise
– Low level of education
– Little participation in stimulating activities mentally or socially.
IV – Complications About Mild Cognitive Impairment
People with mild cognitive impairment are at significant risk – though not certain – of having dementia. In general, about 1 to 3% of older people suffer from dementia each year. Studies indicate that about 10 to 15% of people with mild cognitive impairment develop dementia each year.
V – How to Detect Cognitive Impairments and Why It Is so Important to Do It?
Cognitive impairment is a condition that manifests itself to varying degrees. There are people with mild cognitive impairment, which involves problems, but these do not significantly affect daily life, while others have cognitive impairment so advanced that it already involves the existence of dementia.
Not all cognitive impairments mean that the person will develop dementia. Some of those presenting with this clinical picture will progress to dementia, others will remain stable and others will improve. Cognitive impairment does NOT mean dementia but increases the risk.
*** Screening Tests to Detect Cognitive Disorders
It is very easy to apply tests that help determine whether there is a change in intellectual functioning depending on the age and level of education of the person. They usually consist of a series of questions or tasks that sometimes involve drawing.
Mini-mental state exam. This is the best known of these tests, commonly called mini-mental.
Mini-Cog. This is another test used in this screening process.
These tests have the problem that they do not detect cases in which the symptomatology is very light and do not give many details on the specific processes affected. To go further, you must contact a specialist, neurologist, or neuropsychologist, who will perform a series of neuropsychological tests, more detailed and more in-depth.
In addition to tests that evaluate intellectual functioning, the doctor will also surely guide other more general tests, such as blood tests, to eliminate other causes of cognitive problems.
It is important to detect cognitive disorders. Detect them and do it early. And it’s important for several reasons. The first, because there are cases in which the deterioration is reversible and may be a sign of a treatable illness, such as depression. Or simply because it is the result of using many drugs.
VI – Treatment of Mild Cognitive Impairment
Since this is a neuro-degenerative process, there is no treatment or therapy that prevents the onset of mild cognitive impairment or resolves the problem when it is detected. But there are a number of measures available that will minimize its consequences and facilitate a reasonable life for the person who lives and their environment, by constantly adapting.
*** Pharmacological Treatment of Mild Cognitive Impairment
No drug completely resolves mild cognitive impairment, although some have shown a delay in symptom progression, protective effects on cognitive and vascular aging, and others remain under study.
Other products, such as ginkgo Biloba, omega-3 fatty acids, or phosphatidylserine, have greater advantages in combination, in particular as protectors of neurological degeneration and play a protective role in the cerebral arteries. In some cases, where cerebral arteriosclerosis is evident, the use of vasodilators such as nimodipine appears to play a beneficial role, but with caution because of the risk of tension dizziness, or headache.
VII – How to Prevent Mild Cognitive Impairment?
*** Mediterranean Diet
Healthy living is a fundamental pillar for achieving optimal physical and mental aging. Thanks to a Mediterranean diet that provides antioxidant effects with fruits and vegetables, omega-3 acids from olive oil and fish also help control cardiovascular risk factors. For these, the appropriate medical checks must be followed and the doctor’s prescriptions must be respected. Again, smoking cessation will be notified in case the habit is taken.
*** Control of Cardiovascular Risk Factors
Aging increases the prevalence of hypertension, diabetes, hypercholesterolemia, and, in addition, for a variety of reasons, a decrease in physical activity is usually associated. Tobacco and alcohol must be eliminated.
– Modify Certain Lifestyles:
You should encourage physical exercise adapted to your abilities. Walking outdoors will not only contribute to desirable physical activity but also prevent falls and associated trauma.
– Social Relations:
In the home environment, it is crucial that all members adapt so that they understand, support, and encourage the older person to cope with the essential changes that are occurring.
It will be important to avoid reproach, to maintain confidence in the activities reserved for the elderly (household chores, handling money for small purchases, etc.), to engage in conversations that are reminiscent of recent events in order to reinforce episodic memory, review photographs of facts or people to enliven memory and other similar actions.
In the same way, the social relations of the elderly should be stimulated with family and friends, encourage their hobbies, and maintain contact with reality through print and audiovisual media. Loneliness and isolation will be factors promoting the progression and development of dementia.
– Cognitive Stimulation Exercises
The educational and cultural levels may play a protective role in the development of the disease. This will compensate for memory loss and other functions. The cognitive reserve will be stimulated. It is a gymnastics brain, which can be exercised by performing crosswords, word searches, games of attention, initiation to the computer. This is to avoid non-mental use.
Therapeutically, many exercises and workshops with professionals – occupational therapy – are offered to the elderly to use the mental faculties permanently and avoid not only the loss of memory but also the transition to a more serious and irreversible process: Madness.