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As a neuropsychologist, I often see patients who are concerned about the possibility that they have Alzheimer's disease. When we discuss their test results and diagnosis, I often get questions such as “what's the difference between Alzheimer's disease and dementia?” Or “what's the difference between mild cognitive impairment and dementia?”
Both mild cognitive impairment (MCI) and dementia are umbrella terms, meaning that they are broad or general ways of defining a condition that can have many different, specific causes.
How are they similar?
Both MCI and dementia involve having cognitive skills that are not normal for age. For many people, this is memory impairment. But, other people have difficulty with language functioning, thinking speed, visuospatial skills, problem-solving, or attention. Both MCI and dementia are diagnosed through a series of medical and cognitive evaluations, typically including: bloodwork, brain imaging (such as CT or MRI), neuropsychological evaluation, and a careful history-taking to rule out other causes of thinking difficulty by a physician, psychologist, or both.
Both MCI and dementia can be caused by the following:
- Alzheimer’s disease
- Cerebrovascular disease (including stroke)
- Parkinson’s disease
- Lewy Body disease
- Frontotemporal degeneration
How are they different?
The main difference between MCI and dementia comes down to how folks are functioning in day-to-day tasks. People with MCI are still pretty independent with their daily functioning. They usually are still driving, cooking, paying bills, and taking care of the house. Some are even still working. They may use systems, strategies, or other aides (like a pill organizer) to keep themselves independent.
People with dementia, on the other hand, have cognitive difficulties that have progressed to the point that they interfere with the person being able to be independent in her daily life. Therefore, they may have family members or healthcare assistance who administer their medications to them, do the cooking, and/or provide transportation. A person with dementia typically would not be able to hold down a job.
In addition, people with MCI may have only one area of thinking difficulty (often memory), with normal thinking abilities in other domains. People with dementia usually have global cognitive impairment or problems in multiple cognitive domains.
Chime in - how could healthcare professionals do a better job of explaining the difference between MCI and dementia when providing the initial diagnosis?
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My husband died 12 years ago of metastatic cancer of the spine after denying his cancer had returned. He never was diagnosed with a mental problem because he lied his way through every exam during his five stays in the hospital the year before he died. He told the hospital he didn't live with his wife so they wouldn't tell me anything. He didn't sign the required paper until his last stay in the hospital.
I stayed because I knew no one could care for him so we lived separately in a huge home unreconciled. He was not home very much at all and when he came in at night he aggravated me with outrageous lies just to torment me. I still study to rationalize his crazy behavior so I can find reasons to forgive the whole thing. The community would never believe my story so I heal in silence, but this group is a good place for me to work on considering reasons for it all. I like to think I took care of him for God because no one else could do it. Dorisena.
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5 ReactionsThe picture I get on this web is that dementia patients are concerned about their mental health and look for help from the doctors, or family members take them in and they cooperate with the treatment like good little boys. What about the narcissistic bully who lies and cons his way through life and is supposedly a successful businessman and is mentally abusive to his wife and family? I was advised I would get no help from the courts and was told not to try. He could sell an igloo to an Eskimo and charmed waitresses off their feet. Eventually his dementia progressed so that it was easier to stay ahead of his antics and I was careful not to ride in a vehicle with him because his driving was erratic. The police called the office looking for him because he turned left at the light from the right hand lane, being the farm boy that he was as a child. We said we didn't know where he was and they let it go. He was an alcoholic but was never stopped and charged. The cancer stopped him when he could no longer walk. No medical professional would ever help the poor man. Dorisena
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3 ReactionsYou have gone through a lot and posting is helping you release some stress. It may sound trite but try to be good to yourself. You did your best.
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5 ReactionsThank you so much. This winter I took myself to an extended stay hotel by plane and sat in the sun knitting my granddaughter's afghan. I met new friends and we are planning to get together again next winter at the same place. It has been difficult to allow myself to spend the money on my health and happiness. I am learning to sit in a chair and look outside at the day evolving, with the birds, squirrels, and flowers brightening my life. I never had time for that before. Now I want to remodel the nice storage shed in the corner of the yard into a "playhouse" for me. First I must get rid of the mice. Dorisena
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6 ReactionsHi @dorisena
I agree with @providence1960. You have been through a lot. It also sounds like you'd like to talk about things not related to MCI and dementia. I'd like to direct you to the Groups Directory (https://connect.mayoclinic.org/groups/) so that you can find connection here on Connect to talk with others about things that help you find joy.
To talk with others about overcoming living with a narcissist, see discussions in Mental Health https://connect.mayoclinic.org/group/mental-health/
~ Narcissists ~ https://connect.mayoclinic.org/discussion/on-the-subject-of-narcissists/
Healthy Living https://connect.mayoclinic.org/group/healthy-living/
Just Want to Talk https://connect.mayoclinic.org/group/other/ This group covers all sorts of discussions like
- Gratitude Discussion Group https://connect.mayoclinic.org/discussion/gratitude-discussion-group/
- How about a laugh, (hopefully) https://connect.mayoclinic.org/discussion/how-about-a-laugh-hopefully/
- Art for Healing https://connect.mayoclinic.org/discussion/art-for-healing/
and so much more. I hope you'll explore some of the options. Let me know if I can help you find anything on Connect.
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5 ReactionsToday at the Alzheimers Association SW chapter annual research conference I learned that MCI is a condition, and dementia in its different forms is a disease. Works for us! Since there is little research $$ for any condition ......big pharma has no interest!
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4 ReactionsI’m 83 and my spouse is 87. We have our share of arguments but so far love has conquered all. I’m doing my best to be flexible and so is my spouse. If we pass into MCI we might still remember our mutual affection.
My father died at 75 with dementia 10 years after discovering advanced prostate cancer. He was a very pleasant person until his last year when he pulled mother sisters hair but stopped immediately when told he did not want to do that.
Our plan is to support each other until one of us passes and leave enough money to provide for institutional support for the remaining spouse. So far so good.
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7 ReactionsI think it would be very helpful to give a person this printout at the time of diagnosis, and make an appointment to return in 1 month to follow up. That gives them time to think through any info they may read, but not too long for them to worry without getting answers.
Thank you for the opportunity to read this information.
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6 ReactionsIs a five hour exam really necessary to make a diagnosis? My husband was diagnosed with mild memory impairment two years aago. Did ok on the MOCA test. Had an MRI and showed normal brain size for a 85 year old man. His memory is getting worse and repeats questions constantly at times. He does cross words puzzles and plays scrabble. Neurologist suggested meds to slow down process but he was not interested.Should we go for another evaluation?
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2 ReactionsI clearly am at the MCI stage of things. I have had several of the lengthy reading/verbal memory tests (the last was 4 years ago) and always got rated as "exceptional for your age" and was told by two neurologists that I would never get Alzheimer's so I should just ignore my symptoms and do what I like instead of worry. I have after a decade of arguing with doctors, got a brain MRI which suggests chronic microvascular ischemia (CMI) and an amyloid PET scan which also was positive--there was no distinction between my white and grey matter. I stopped driving because of two minor accidents which were caused by poor reflexes and poor cognition. I also am heterozygous on APOE4, a major gene for Alzheimer's risk plus I have had inflammatory illnesses for most of my life. I still haven't gotten a local neurologist to give me a diagnosis that other doctors will listen to. I recently attended an excellent presentation put on by the Alzheimer's Foundation of America (AFA) which was given for caregivers. In one excellent talk by a psychoneurologist, I learned for the first time that if you are highly functional, you can have a perfect score on the 30-question test and still have Alzheimer's. Also he said that MCI and Alzheimer's can occur simultaneously (my mother died of the first and my grandmother died of the second). It was suggested that I contact Synapticure, a virtual medical and caregiving firm that deals with dementia might help. My caregiver and I signed up yesterday and they say after their neurologist reviews my case and has a Zoom meeting with us, he should be able to give me a diagnosis. They give a lot of online contact support re. meals, local groups, etc. IF YOU HAVE MEDICARE A&B, their service will cost you nothing. This might be something others could try. I have tried to go to UCSF and Mayo for diagnosis and treatment but their neurology department seem overwhelmed--I feel I could be dead before getting an appointment and Idaho is a bad place to look for neurological medical care and decisions from the two major hospital chains because of limited staffing.
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