Mild cognitive impairment: What questions to ask the neurologist?

It might be helpful to learn more about coping strategies whatever the diagnosis. I have 2 extended family members who use a paper notebook/ logbook to help track things (ideas, to do's, phone calls, etc) during the day.

"Mild cognitive impairment" is a euphemism. I carry the diagnosis, and it means only that my cognition is somewhere between where it should be for my age, 73, and where it would be if I had full-blown dementia: there are no other intermediate classifications like moderate and severe cognitive impairment.

If you're tempted to ask exactly where you fit on the scale from normal cognition for you (and your age, if you're older, and dementia, don't waste your time. Neurology has lumped lots of levels of impaired cognition under "mild cognitive impairment" for 2 reasons: 1) it's impossible to make finer determinations of impairment and 2) even if more accurate determinations were possible, neurology doesn't have sufficient tools to remediate impairment based on its degree--other than normal (for age), dementia, and everything in between!

Good luck.

Depending on one's degree of cognitive impairment, there are LOTS of things that can be done. As noted below, I am mildly cognitive impaired (MCI) and the overriding rule is to unburden my cognition. We MCIs have no cognition to spare. So, everything goes on MY table next to the kitchen: books, notes, mail that I want to look at again, and--in a basket--key fobs, my wallet, extra eyeglasses, and lots of other small things. On this table are a charging cord for my phone and one for my chromebook. I keep 3 $150 chromebooks thru the house and I ALWAYS put them back by remembering to connect them to their chargers.

The chromebooks and phone raise the issue of notetaking. I use Google Notes for everything--grocery lists, pool chemicals, and more. I rely on Google Calendar for appts. I lose paper notes and always have my phone (or a chromebook), so I always have my notes. (I am unaffiliated with Google.)

Household and yard clutter are prohibited. The table and basket spare me the frustration of looking for something. (With my impairment, I can't see pliers if they are on the opposite side of the drawer where they are kept.) Clutter raises the lost-item issue, but more importantly draws cognition just in living with it and navigating thru it. It bears repeating, we MCIs have no cognition to lose.

Cognition is learning, recalling, reasoning, problem-solving and attending--the last being the precondition to the rest. For the MCI, attention precludes multitasking, pressured conceptual processing, and distracting or overstimulating settings. Reading instead of tv. Prayer, meditation or well-written poetry instead of the news. Humming and singing (which promote the rest-and-relax parasympathetic nervous system over the fight-or-flee sympathetic nervous system). We MCIs must find the joy of sensory vs conceptual processing, the right brain instead of the left brain all the time.

Hope this helps.

Ask about the HABIT Program at Mayo. HABIT is short for Healthy Attributes for Independence and Thinking. I have been in this program for approximately 2 years. Very helpful as you meet by zoom with others who are dealing with MCI issues. There are groups for the spouse (care taker) also.

@sb4ca Mild Cognitive Impairment is indeed a diagnosis that means there has been a change in cognitive functioning that is different from normal aging but is not dementia. Not everyone who is diagnosed with Mild Cognitive Impairment goes on to develop dementia. @tallguy provided very helpful suggestions on how to reorganize your environment at home to support you. Do you have someone at home that will help you with this?

According to your initial post about two days ago you may have already met with your neurologist. Have you had or did your neurologist refer you for neuropsychological testing? This specialized testing will help you to know which cognitive processes are affected and which are not. Neuropsychologists or someone on their team may also be available to you for cognitive rehabilitation. These are the professionals who can look at your test results and help you to figure out the best ways to compensate for what has become more difficult for you over time. A speech-language pathologist who also will be on the time can help you with word retrieval and strategies to help you through those moments where you have forgotten where you were in your conversations.

I am wishing you a good weekend as you prepare for your next steps. What did you learn at your neurology appointment?

I agree with everyone's comments. I was diagnosed with MCI over 2yrs ago and completed the HABIT program. The most important things are: 1) learn to manage it so as not overburden yourself (multitasking is a no-no for me); 2) exercise your body and brain; 3) eat as healthy as you can; 4) get good sleep; 5) organization and note taking are very important; 6) don't be afraid to tell others...they can help.

Thank you for this informative response. I meet with my neurologist on Monday. Losing tract of days is apparent here, lol. I've never heard of neuropsychologists and will ask my neurologist about it. I had white matter changes in my brain starting in my 40's and the new MRI says that has progressed due to small vessel disease. I know this because I already have the MRI report. They are in the front of my brain and in the parietal lobes for whatever that's worth. The main 2 errors on the simple cognitive test were the inability to draw a 3-D box and retrieval of the 7 words I was supposed to remember but that is self-evaluation because I knew I failed those. He didn't tell me what specific tests I failed. I am now 64 years old so unclear how much cognitive decline is normal for my age.

Is it “normal” for a neurologist to ask for an MRA before one has even met the guy? Carolyn Uhing/Omaha

Thank you for this great information. I use notes on my apple devices all the time and also calendar. The thing about calendar is knowing when to set the alerts. If I do it the day before, I don't get reminded before the appt and can miss it. I also started putting reminders to self on the calendar. Should I not use it for that? I am not a TV watcher and mainly read to begin with. I love the sensory process you bring up and I will strive to find more of that in my life. Thank you

@sb4ca. In my view the simple cognitive testing that the neurologist gave you in the office is a screening test. This is like getting your blood pressure checked, you find out your BP is high, and so your doctor does more investigation into why it is high. Your MRI results are very helpful in ruling out what may or may not be an explanation for the cognitive symptoms you’ve described, but more cognitive testing will provide you with more detailed information.

Here is a description of a neuropsychologist and what this specialist does:

Clinical Neuropsychology
— https://www.apa.org/ed/graduate/specialize/neuropsychology#:~:text=Clinical%20Neuropsychology%20is%20a%20specialty,and%20the%20design%20of%20effective

What you have described with word retrieval problems, spelling, and forgetting where you are in your sentences is not a sign of normal aging. A neuropsychologist can help you to sort that out.

Is there a memory diagnostic center or memory clinic near you? These are the clinics that specialize in the questions that you are asking about yourself. By the way, even though many clinics have the word « dementia » or « Alzheimer » in the title does not mean that a person who goes there for evaluation has dementia. Their mission is to sort out what is normal aging, what is mild cognitive impairment, and what is dementia (there are several different types).

Here is an example of a group of University of Wisconsin affiliated clinics. Many academic medical centers have a memory clinic.

UW Memory Clinic Network List

— https://wai.wisc.edu/memory-clinic-network-list/

Does this information help you to figure out what to ask your doctor?