What is Mild Cognitive Impairment due to Alzheimer’s Disease?
Mild Cognitive Impairment (MCI) due to Alzheimer’s disease (AD) is one of the earliest signs of Alzheimer’s disease. This is the first stage when symptoms may become apparent to individuals living with AD, their loved ones and their doctors.1,4 These early warning signs can include increasing short-term memory loss, frequent difficulty finding words, and/or losing track of the day or date. Other symptoms of MCI may include a decline in other thinking skills, such as the ability to make sound decisions or to judge the time and steps required to complete a task.1,4
These symptoms may indicate early stage Alzheimer’s disease – but they can be overlooked or dismissed as just part of getting older. Recognising early changes and understanding the possible cause is important for a timely and accurate diagnosis. Your doctor can assess whether symptoms are due to normal ageing or disease.5
What are the symptoms of MCI due to AD?
Symptoms of mild cognitive impairment which may be an early sign of Alzheimer’s
disease include:
Memory
Becoming increasingly forgetful, i.e. having trouble remembering recent conversations, names or important events more than usual1,4
Attention
Losing your train of thought, finding it difficult to stay focused or feeling increasingly overwhelmed1,4
Language
Having increasing trouble finding the right words1,4
Disorientation
Feeling confused about time and place, i.e. losing track of day or date; having trouble finding your way around familiar environments1,4
Thinking Skills
Having increasingly persistent problems with planning, reasoning or completing tasks, i.e. managing money, or cooking a familiar recipe1,4
Mood & Personality
Changes in mood and personality, i.e. becoming uncharacteristically irritable, anxious or low in mood.1,4
Symptoms should have a clearly defined recent onset, which persist and cannot be explained by life events.3
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Read more about early signs and symptoms.
How is mild cognitive impairment due to Alzheimer's disease diagnosed?
General Practitioners (GPs) or Primary Care Providers (PCPs) are often the first point of contact for people having problems with memory or other cognitive functions. The diagnostic process often includes the following steps:1,2,5
- Assessment of past and current symptoms, other important medical conditions and family history.1,5
- Assessment of daily activities. Detection tools, such as questionnaires, are used and a family member or trusted friend may also be asked to provide an additional perspective1,5
- Physical check-ups and laboratory tests, including blood tests, can rule out reversible causes of cognitive decline1,5
People with mild cognitive impairment may then be referred for further tests to a memory clinic, neurologists, or other specialists. The earlier MCI due to probable AD is detected, the sooner the individual affected can be referred for testing to confirm a diagnosis of AD.6
Why is a timely and accurate diagnosis of Alzheimer’s disease important?
Emotional benefits
- A diagnosis of what is causing an individual’s cognitive decline may help to reduce anxiety through a better understanding of the disease, its symptoms, and also what options may be available to maintain quality of life and independence for as long as possible.6
- Individuals and their families have time to develop coping strategies as they better understand the disease, overcome stigma and learn what to expect in the future.6
- It provides time to build a network for support and learn about support programs that are available to help those affected by AD.6
Medical benefits
- Treatment of any AD-related symptoms may be considered by a treating physician as well as any potential co-existing conditions that may worsen brain health or cognitive functioning. Examples include impaired sleep, impaired hearing, high blood pressure, or behavioural symptoms; such as anxiety, depression or agitation.7,13,14
- A combination of a healthy diet, regular exercise, social interactions, and mental stimulation may help to preserve brain health and cognitive functioning.7,8 Cognitive or mental stimulation such as reality orientation, reminiscence therapy, and music therapy are being investigated to determine possible benefits in patients with dementia.9-12
Decision making for the future
- In the early AD stages, the impact on brain function is subtle and most individuals still retain the ability to plan, make decisions and understand all the available options.6
- Early diagnosis of AD can provide additional time to prepare for the future (e.g., disease education, moving closer to members of one’s support, appropriate network, and organise medical/legal/financial/social support).6
WHAT'S NEXT
Brain Health
A healthy diet, regular exercise, social interactions and mental stimulation may help preserve brain health and cognitive functions.
References
1.2021 Alzheimer's disease facts and figures. Alzheimers Dement. 2021;17(3):327-406.
2.Morris JC, Blennow K, Froelich L, et al. Harmonized diagnostic criteria for Alzheimer’s disease: recommendations. J Intern Med. 2014;275(3):204-213.
3.Jack CR, Bennet DA, Blennow K, et al. NIA-AA Research Framework: Toward a biological definition of Alzheimer's disease. Alzheimers Dement 2018;14:535 -562.
4.Alzheimer’s Association: Mild Cognitive Impairment, https://www.alz.org/alzheimers-dementia/what-is-dementia/related_conditions/mild-cognitive-impairment. Accessed January, 2022.
5.Krolak-Salmon P, Maillet A, Vanacore N, et al. Toward a Sequential Strategy for Diagnosing Neurocognitive Disorders: A Consensus from the "Act On Dementia" European Joint Action. J Alzheimers Dis. 2019;72(2):363-372.
6.Dubois B, Padovani A, Scheltens P, et al. Timely Diagnosis for Alzheimer's Disease: A Literature Review on Benefits and Challenges. J Alzheimers Dis. 2016;49(3):617-31.
7.Risk reduction of cognitive decline and dementia. WHO Guidelines. https://www.who.int/mental_health/neurology/dementia/guidelines_risk_reduction/en/. Accessed January, 2022.
8.Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446.
9.Van der Steen JT, Smaling HJ, van der Wouden JC, Bruinsma MS, Scholten RJ, Vink AC. Music-based therapeutic interventions for people with dementia. Cochrane Database SystRev. 2018;7(7).
10.Brioschi Guevara A, Bieler M, Altomare D, et al. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6. Alzheimers Res Ther. 2021;13(1):172.
11.Woods B, O’Philbin L, Farrell EM, Spector AE, Orrell M. Reminiscence therapy for dementia. Cochrane Database Syst Rev. 2018;3(3):CD001120.
12.Spector A, Orrell M, Davies S, Woods B. Reality orientation for dementia. Cochrane Database Syst Rev. 2000;(4):CD001119.
13.Kishita N, Backhouse T,Mioshi E. Nonpharmacological interventions to improve depression, anxiety, and quality of life (QoL) in people with dementia: An overview of systematic reviews. J Geriatr Psychiatry Neurol 2020;33(1):28-41.
14.Savaskan E, Mueller H, Hoerr R, von Gunten A, Gauthier S. Treatment effects of Ginkgo biloba extract EGb 761® on the spectrum of behavioral and psychological symptoms of dementia: metaanalysis of randomized controlled trials. Int Psychogeriatr. 2018;30(3):285-293.