Changes in memory, concentration, word finding, or speed can be a normal part of the cognitive aging process. However, at times such changes are more severe than “just” normal aging. Through evaluation with a primary care physician, neurologist, or neuropsychologist, some patients receive a diagnosis of Mild Cognitive Impairment (MCI). Patients diagnosed with MCI have impairment in short term memory or other thinking abilities that is more significant than normal aging, but continue to function reasonably well in daily life. Individuals may find they have to work harder or use compensatory techniques to keep track of important responsibilities, but are still functioning mostly independently. MCI that is specifically a problem with short term memory is called amnestic type Mild Cognitive Impairment. Mayo Clinic provides information on the symptoms, causes, diagnosis and treatment of MCI here.
After a diagnosis of MCI and discussion with their physician, some patients have more questions such as:
It can be difficult to understand that MCI is NOT the same as normal aging. Many of the short term memory complaints from patients with MCI can sound very similar to complaints from one’s age peers. However, objective evaluation, through mental status exam or comprehensive neuropsychological testing, shows memory to be impaired, even considering the normal aging process. So, the answer is no, MCI is not the same as normal aging.
There are currently no FDA approved medical treatments for patients diagnosed with Mild Cognitive Impairment. Doctors sometimes prescribe cholinesterase inhibitors, a type of drug approved for Alzheimer’s disease, but medications are not routinely recommended. You may discuss this individually with your physician.
It is recommended that patients with MCI see their treating physician, either their primary care physician or Neurologist, once per year for follow-up of their MCI. Ideally this includes updated comprehensive neuropsychological testing as requested by your physician.
MCI is often considered the beginning signs of a progressive disorder, such as early stage Alzheimer’s disease. 30%-50% of patients with MCI progress to a diagnosis of dementia, often with an underlying cause of Alzheimer’s disease in 5 years. However, MCI does not always progress to dementia. Some patients experience improvement and some stay stable over time. It is unfortunately difficult to predict at this time for an individual patient if decline will occur, or how rapidly decline will progress.
Driving safety is certainly a concern anytime a patient is diagnosed with some form of cognitive impairment. However, the degree and type of impairment in MCI can vary greatly. So, there is no standard yes or no answer to this question. Some patients have only mild memory impairment, and basic driving skills remain intact. However, other patients have problems with skills such as the ability to divide attention or reaction time. In this case, driving safety may be more of a concern. Thus, driving is a case-by-case decision best discussed with your loved ones (to get their observations), your doctor, and your neuropsychologist. Whether you continue driving for now or not, it is a good idea to have a plan for stopping driving, as MCI often is progressive over time.
If you have concerns about your memory, we encourage you to talk to your doctor and request an evaluation. It can be scary to be diagnosed with MCI, but there are things you can do to manage the symptoms of MCI, maximize your brain health, and plan for the future.
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