Understanding Mild Cognitive Impairment

The majority of people who find their thinking and learning abilities slowing down as they enter their 60s and 70s are dealing with the predictable effects of aging on the brain. Some people, however, have problems with mental function that are more pronounced than normal age-related forgetfulness. When consistent memory problems disrupt daily living, prompting cause for concern, it may be a sign of Alzheimer’s disease or some other cognitive condition. Early diagnosis helps you better plan your future.

However, if these memory deficits are not severe enough to significantly impede everyday functioning—a hallmark of dementia—the problem can be classified as mild cognitive impairment, or MCI, the gray area that falls between predictable age-related cognitive changes and abnormal mental deficits that stem from disease. MCI is not a disease per se, but rather a collection of symptoms and observations. In addition, MCI is a highly variable condition in which a person may either progress into actual dementia, revert to normal cognitive function, or even remain at a stable level, depending on the individual and the conditions underlying the problem.

This guide from Harvard Medical School explores the subtle differences between various forms of
memory problems, break down the different types of MCI, and explains brain function and its role in creating and retrieving memories. You will learn the causes and risk factors for MCI, what doctors look for when diagnosing the condition, and medical as well as natural ways to treat or even prevent it.

Prepared by the editors of Harvard Health Publishing in consultation with Gad A. Marshall, M.D., Assistant Professor of Neurology, Harvard Medical School, Associate Medical Director of Clinical Trials, Center for Alzheimer Research & Treatment, Brigham and Women’s Hospital
Massachusetts General Hospital. (2021)

About guides from Harvard Medical School

Guides Harvard Medical School deliver compact, practical information on important health concerns. These publications are smaller in scope than our Special Health Reports, but they are written in the same clear, easy-to-understand language, and they provide the authoritative health advice you expect from Harvard Health Publishing.

The six cognitive domains

1. Memory and learning: Holding information over the short term while performing a task (working memory); registering new information and storing it for future use (acquisition, also known as “encoding,” and consolidation); accessing information from storage when needed (retrieval).
2. Social function: Interpreting and responding to social signals from other individuals such as facial expressions and direction of gaze.
3. Language: Translating sounds into words; generating verbal output; comprehension of written and spoken language.
4. Perception and motor skills: Recognizing and interpreting sensory stimuli (smell, touch, hearing, etc.); mobilizing your muscles and body; manipulating objects; navigating your environment; perceiving and interpreting visual images and shapes.
5. Attention: Sustaining concentration on a particular object, action, or thought; managing competing demands in your environment.
6. Executive functions: Carrying out goal-oriented behaviors, such as making a plan and executing it. Executive functions include the following:

• flexibility—the capacity to quickly switch to the appropriate mental mode
• theory of mind—insight into other people’s inner worlds (their plans, likes, and dislikes)
• anticipation—prediction based on pattern recognition
• problem solving—defining a problem in the right way to generate possible solutions and pick the right one
• decision making—the ability to make decisions based on problem solving, incomplete information, and emotions (your own and others’)
• emotional self-regulation—the ability to identify and manage your emotions for good performance
• sequencing—the ability to break down complex actions into manageable units and prioritize them
• cognitive control and response inhibition—the ability to withstand distraction and internal urges.

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