Many who later develop significant memory disorders and dementia start with mild changes that are difficult to distinguish from the normal changes of aging. Ronald Peterson at the Mayo Clinic described such cases as Mild Cognitive Impairment in about 2000. A number of factors may cause Mild Cognitive Impairment: Alzheimer’s disease, vascular disease (i.e., small strokes), Parkinson’s disease, Lewy Body disease, Primary Progressive aphasia….

The important word is mild. Persons with Mild Cognitive Impairment are not demented. They live independent lives. Many do not become demented. However, the risk of becoming demented is much greater for those with Mild Cognitive Impairment than those who never show these changes as they age. The new diagnostic criteria for Alzheimer’s disease include Mild Cognitive Impairment. Accordingly in Mild Cognitive Impairment:

• The person or family members express concern about changes in memory or thinking. They are worried.
• The changes, as measured by standardized assessment, may affect more than one mental skill such as reasoning, planning, judgment, language, attention, visuospatial skills, and/or memory.
• Persons with prominent and early decline in short-term memory are more likely than others to later be diagnosed with Alzheimer’s disease.
• Persons with prominent and early decline in expressive language skills may later be diagnosed with Primary Progressive Aphasia.
• Persons with prominent and early decline in motor skills, inconsistent memory, and slow response initiation may later diagnosed with Parkinson’s or Lewy Body disease.
• Individuals with Mild Cognitive Impairment are independent. They may take more time, make more errors, or be less inefficient with complex tasks than they used to. For example, they may show changes in skills such as using a computer, paying bills, balancing a checkbook, or preparing a meal.
• Persons with Mild Cognitive Impairment are not demented. Furthermore, not all persons with Mild Cognitive Impairment will become demented. However, the risk is much greater.

Mild Cognitive Impairment can only be reliable determined by rigorous cognitive evaluation by a memory expert – usually a neuropsychologist. Screenings cannot reliably detect Mild Cognitive Impairment.

Why would I want to know if I fit the criteria for Mild Cognitive Impairment? Simply because a person with Mild Cognitive Impairment is in control of his or her own life. This is the time to take control of your future. A person with Mild Cognitive Impairment needs to make a proactive plan in case there will be further decline. The plan is like an insurance policy to cover bad outcome. You will be glad you had it if you need it but you hope never to use it. The plan needs to include repeated evaluations and periodic revisions in light of findings from the evaluations. The plan should include family members and an open discussion of desired outcomes should there be future decline. Create a personalized plan based on your unique interests and skills.