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Mild Cognitive Impairment

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Mild Cognitive Impairment (MCI) is a condition that involves a slight decline in cognitive abilities or memory loss. A treatment plan for mild cognitive impairment can involve lifestyle modifications, such as regular physical exercise, improving sleep habits and developing strategies to help the individual stay organized and on task. Medications may be prescribed to address underlying mental health issues, such as depression or anxiety. It is also important to note that MCI may eventually progress to dementia if left untreated, so getting an early diagnosis and beginning treatment are essential. 
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About one in five older adults has some type of MCI. In a study of nearly 2,000 people about   16 % of dementia-free people over age 70 were suffering from MCI. Men were more likely to suffer than women, although women may simply experience dementia at a later age. In the study, risk factors included being a carrier of the APOE ε4 gene (a known risk factor for late-onset Alzheimer’s disease), never having married and having less than nine years of education. In a 2011 study of nearly 1,300 women age 85 and older, 23 percent were diagnosed with MCI. The researchers recommend that women this age should be screened for cognitive problems.

Diagnostic guidelines for MCI

A person is thought to suffer from MCI if he or she meets the following criteria:
  • A friend, family member, doctor or the person in question is concerned about a change in his or her cognition compared to the previous level.
  • The person is experiencing more difficulties in one or more cognitive areas such as memory, attention and language than would be expected for his or her age or educational background. Difficulty learning and retaining new information is most common in MCI patients who develop Alzheimer’s-related dementia.
  • The person is having trouble performing complex tasks such as paying bills, preparing a meal or shopping. He or she may take more time, be less efficient and make more mistakes than in the past. Still, he or she maintains his or her independence with minimal assistance.
  • There’s no evidence of significant impairment in social or occupational functioning.
  • There should be objective evidence of progressive cognitive decline over time. Cognitive testing can assess the degree of impairment. Scores for people with MCI are usually 1 to 1.5 standard deviations below the mean for their age and education level. Some formal cognitive tests that assess both immediate and delayed recall can help identify MCI patients who are likely to progress to Alzheimer’s dementia within a few years. Other tests can determine impairment in problem-solving, reasoning and language. Doctors may also assess a person’s cognitive function using informal techniques, like asking a patient to learn a street address and then remember it after a delay.
  • Vascular, traumatic and medical illnesses that could explain the decline in cognition must be ruled out. The goal is to increase the likelihood that the underlying cause of MCI is probably Alzheimer’s.
  • If a person is known to carry a genetic defect, such as a mutation in APP, PS-1 or PS-2, he or she most likely has MCI due to Alzheimer’s disease. Most of these carriers develop Alzheimer’s before age 65. A person who meets the diagnostic criteria for MCI and carries a variant of the apolipoprotein E (APOE) gene is more likely to progress to Alzheimer’s dementia within a few years than someone without it.
  • Researchers have discovered that activities such as exercise and computer use may prevent MCI. In a Mayo Clinic study, adults between ages 70 and 90 who participated in moderate physical exercise like brisk walking or biking and used a computer were less likely to develop MCI. Another Mayo Clinic study found that consuming more heart-healthy mono- and polyunsaturated fats reduced the risk of MCI among people age 70 and older. These fatty acids—which are found in olive oil, nuts, seafood and vegetable oils—appear to prevent inflammation and reduce the risk of blood clots, stroke and heart disease.
Many experts believe that MCI may be an early warning sign of memory disorders later in life. Studies show that up to 15% of people with MCI progress to Alzheimer’s disease each year, compared with a rate of 1 to 2 percent a year for the general older population.

From HealthAfter50

At At-Home Test to Detect Signs of Alzheimer's and Dementia

For those interested in determining if they or a loved one has mild cognitive impairment, age-associated memory impairment, perhaps early dementia or the beginnings of Alzheimer's there is now a test to make you aware of the early warning signs.

Take the SAGE (Self-Administered Gerocognitive Exam) at-home test.  It evaluates your thinking abilities and helps physicians to know how well your brain is working.

You do not need special equipment to take SAGE - just pen and paper. There are four forms of the SAGE test. You only need to take one. It doesn't matter which one you take; they are all interchangeable. Click this link to download the test. Print it out and answer the questions in ink without the assistance of others. Don't look at the clock or calendar while taking the test, and if you have questions about an item, just do the best you can. The average time to complete this four-page test is 10 to 15 minutes, but there is no time limit.

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