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A person with mild cognitive impairment (MCI) has cognitive problems greater than normally expected with aging, but does not show other symptoms of dementia. The most common sign is trouble with short term memory, but it can be a language problem, or a reasoning problem, etc. The problem is severe enough to be noticeable to other people and to show up on tests, but not serious enough to interfere with their everyday life. MCI is often described as a precursor to Alzheimer’s disease, but whether MCI is really early stage Alzheimer's or a discrete disorder is still unclear. It appears that some people develop MCI but don’t go on to decline further, while it is true that many people who develop MCI do go on to develop dementia. Recent research suggests about 40% of people with MCI go on to develop dementia within three years.
In 2005 there was a large study done on possible treatments for MCI. Patients with MCI were given either 10mg of Aricept (Donepezil, and medication used to treat Alzheimer’s disease), 2000 international units of Vitamin E, or a placebo. The results showed that Aricept could reduce the risk of progressing to Alzheimer’s disease for about a year, but after three years there was not difference between the three groups. Vitamin E was found to be of no benefit at all. (Petersen, R.C., et al. Vitamin E and Donepezil for the Treatment of Mild Cognitive Impairment, New England Journal Medicine, June 9 2005, Vol. 352: 2379-2388.)
Another medication used to treat Alzheimer’s disease, galantamine has also been studied for it’s affect on MCI, but although a marginal clinical benefit has been found, there was also an as yet unexplained excess in deaths. (Loy, C., & Schneider, L. Galantamine for Alzheimer’s disease and mild cognitive impairment. www.cochrane.org). Watch this space.
Mild cognitive impairment can be difficult to diagnose because often a person’s test scores are within the normal range, even though this may represent a decline from their previous level of functioning. Diagnosis is often made six months or a year after the first assessment when a decline over time can be shown. For this reason I recommend that people over the age of 60 have a baseline assessment. Then, if they feel they are declining in the future, a re-assessment will clearly and quickly show the change, meaning that any appropriate treatment can be started straight away. A baseline assessment should be seen as part of a person’s preventative health, just as they see their doctor to check their cholesterol, etc. Early diagnosis is of the utmost importance, but will become even more so in the future as new treatments and preventative measures such as vaccinations become available
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