Mild Cognitive Impairment

Memory loss has long been recognized as an inevitable part of aging. Everyone experiences a "senior moment" — the inability to recall the name of an acquaintance or the items on a shopping list. With age, these memory lapses become more common.

But a sharp decline in short-term memory could be more than normal "forgetfulness." It could be a symptom of a condition called mild cognitive impairment (MCI). People with MCI tend to retain critical thinking and reasoning skills but experience a significant short-term memory loss. They may experience trouble remembering the names of people they meet or the flow of a conversation. They also may have an increased tendency to misplace things. They may rely more on a calendar, notes and lists but still manage their daily activities.

Mild cognitive impairment may be a signal of a more serious condition on the horizon. It is believed to be a transitional disease between the normal memory loss of aging and conditions such as Alzheimer's disease. MCI has been associated with a higher-than-normal risk of dementia but not all MCI patients develop it.

Cognitive function, or the process of thought, includes abilities such as learning, reading, speaking and writing. Patients with mild cognitive impairment (MCI) retain these important cognitive skills, necessary to manage their everyday activities, but have difficulty remembering recent events or recently acquired information. Long-term memories tend to remain in tact.

In many cases, patients with MCI are aware of the short-term memory loss and compensate with heavy reliance on notes and calendars.

Until recently, doctors didn't associate significance to these complaints. In the past several years, researchers have found possible links between MCI and the future development of dementia such as Alzheimer's disease.

There is no established approach for evaluating individuals with mild cognitive impairment (MCI). At the UCSF Memory and Aging Center, patients undergo a thorough evaluation of their complaints, including a medical history, neurological exam and a neuropsychological evaluation. The medical history usually requires the participation of a knowledgeable close friend or relative, such as a spouse or child.

Depending on the results of this evaluation, further testing may be necessary, including blood tests and brain imaging. This second level of testing is similar to that given to individuals with more severe memory problems and is directed towards better defining the problem and looking for medical conditions that might have an effect on the brain such as autoimmune disorders, infections, nutritional deficiencies and possible side effects from medication.

An important part of this process is screening for depression since memory loss can be a symptom of anxiety and depression.

As a result of these tests, other causes of memory impairment may be discovered such as vitamin deficiency or thyroid disease, which can be treated.

Currently, there is no specific treatment for mild cognitive impairment (MCI). As new treatments for Alzheimer's disease are developed, these treatments may be tested on patients with MCI. If experimental treatments help slow cognitive decline, the early diagnosis of MCI will become increasingly important.

Keep in mind that some drugs may impair memory, especially in the elderly. Examples of these drugs are Valium, Ativan, Benadryl, Tylenol PM and Advil PM that contain Benadryl, Cogentin and many others. A careful assessment of medications is essential.

Other potential causes for memory impairment, such as vitamin deficiencies or thyroid disease, may be discovered and treated in the evaluation.

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Reviewed by health care specialists at UCSF Medical Center.

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UCSF Clinics & Centers

Neurology and Neurosurgery

Memory and Aging Center
1500 Owens St., Suite 320
San Francisco, CA 94158
Phone: (415) 353-2057
Fax: (415) 353-8292
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