Mild cognitive impairment

Also called MCI

More memory or thinking difficulty than expected for the age, but not dementia. Some progress, some stay stable, and some improve.

What it is

Mild cognitive impairment sits in a genuinely uncertain space, and pretending otherwise does people no favours.

It means measurable difficulty with memory or thinking that is greater than expected for a person's age, but that does not significantly affect their ability to manage day to day. That last part is what distinguishes it from dementia.

Roughly 10 to 15% of people with MCI develop dementia each year. Which also means most do not in any given year, and a proportion improve, particularly where a reversible cause is found.

Finding those reversible causes is the entire clinical value of taking MCI seriously.

Signs you might notice

Forgetting recent conversations and appointments more than peers do.

Losing the thread in conversation, or struggling for words.

Difficulty with planning and problem solving.

Being aware of it, and being worried about it. Insight is usually preserved in MCI and often reduced in dementia.

Managing daily life independently, which is the defining feature.

How it can affect day-to-day life

The anxiety is the immediate problem. People go home from an appointment having been told they might get dementia, and are given nothing to do about it.

There is something to do. A meaningful proportion of cognitive impairment has a treatable contributor: hypothyroidism, B12 deficiency, depression, sleep apnoea, medication side effects, alcohol, poor hearing or vision.

The Lancet Commission identifies a set of modifiable risk factors including hearing loss, hypertension, physical inactivity, smoking, social isolation and depression. Addressing them is worth doing at this stage rather than later.

Supporting someone well

Get the reversible causes checked. Thyroid, B12, folate, mood, sleep, medication review, alcohol, hearing and vision. Ask for each by name.

Treat hearing loss. It is one of the largest modifiable risk factors and one of the easiest to address.

Stay physically active and socially connected. Both have real evidence behind them.

Manage blood pressure, diabetes and cholesterol.

Use external memory aids now, while learning them is easy.

Ask for review rather than discharge. Repeat assessment in six to twelve months is what distinguishes stable MCI from something progressing.

Fiducia Life gives structure a person can run themselves, my day and all about me, which supports independence rather than replacing it while things are still mild.

Where to get help

A GP can do the initial assessment and blood tests, and refer to a memory clinic.

Alzheimer's Society support line: 0333 150 3456, and they have good material on MCI specifically.

Ask what the follow-up plan is before leaving the appointment.