MCI (Mild Cognitive Impairment) or Dementia?

Mild Cognitive Impairment (MCI) is a relatively new diagnosis that is leaving family members of loved ones’ with this medical determination very confused.  This is because MCI is not a diagnosis of dementia.  It is a medical finding suggesting that there are some cognitive impairments that may indicate a precursor for dementia down the road.  Not all MCI’s become dementia; however, all dementias begin as MCI.

A phrase that I often hear from family members of a loved one with MCI is “But mom doesn’t have dementia, she has Mild Cognitive Impairment”, as if the diagnosis is a stagnant one – you get one test and diagnosis and that’s it.  The harm in this way of thinking is that it encourages denial and ignores important help and services that could be beneficial once a dementia diagnosis is reached.  Think of it this way:  MCI is like pre-diabetes and dementia is like diabetes.  If you know that you have pre-diabetes, wouldn’t you want to continue to get tested periodically to be sure that you have not crossed over into a diagnosis of actual diabetes?  With dementia, it is the same.  Once there is a diagnosis of MCI, there should be periodic follow up medical appointments to look for any further signs of dementia.

When does MCI become actual dementia?  According to the Alzheimer’s Association, the definition of MCI is a “noticeable” and “measurable” decline in memory and thinking skills that does not interfere with a person’s normal daily functioning.  This means that MCI becomes dementia when the individual’s cognitive decline begins to interrupt that person’s ability to normally function in his/her typical daily routine.  In other words, someone with MCI may forget what goes into making a spaghetti dinner, but can follow a recipe to make one.  Whereas, someone with dementia will tell you that s/he had a great dinner last night, but couldn’t tell you what it was and you will not be able to find evidence that s/he cooked anything.

The important thing to remember about MCI is that it should not simply be accepted and then disregarded just because it is not a dementia diagnosis.  It is a recognized condition that should be seen as a potential precursor to dementia and it needs to be further monitored, tested, and followed up on regularly.

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