How to Identify Mild Cognitive Impairment in Older Adults, 7 Important Signs, Causes and Treatment

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Mild cognitive impairment may be a precursor to dementia, particularly Alzheimer’s, research suggests.

Cognitive decline in older adults refers to the difficulty with a person’s thinking, memory, concentration, and other brain functions beyond what is typically expected due to aging.

Cognitive decline, also known as cognitive impairment, can come on suddenly or gradually, and it can be permanent or temporary. It can be scary for the person experiencing the symptoms as well as for their family and friends.

If you’re worried about an older person’s cognitive abilities, there often are some underlying health issues affecting the mind’s function.‌ Those need to be detected and treated if possible. Preferably, seek help from your doctor.

People with mild cognitive impairment can still perform their daily activities and have no apparent symptoms of dementia, although some complex tasks may require more effort.

The brain, like the rest of the body, changes as one grows older. It’s common to notice increasing forgetfulness with aging. It may take longer to think of a word or to recall a person’s name. But consistent or increasing concern about  mental performance may suggest cognitive impairment. Some of the most common signs include:

1. ‌Forgetting things more often
2. Forgetting important appointments or social engagements
3. Losing your train of thought or a thread of conversations, books, or movies
4. Feeling increasingly overwhelmed by making decisions, planning steps to accomplish a task, or understanding instructions
5. Experiencing difficulty finding your way around familiar environments
6. Becoming more impulsive or showing increasingly poor judgment
7. Your family and friends notice changes

Challenges with memory, thinking, or other brain processes are often due to more than one cause.

The most common causes of cognitive impairment in older adults

Medication. Sedatives, tranquilizers, and anticholinergic medications are the most common types of medicine that interfere with proper brain function. Anticholinergic drugs block the chemical (neurotransmitter) released by nerve cells to send signals to other cells. This can affect muscle contractions in the body as well as learning and memory in the brain.

Blood chemistry. Kidney or liver dysfunction can cause different types of imbalances in your blood chemistry, sometimes affecting brain function. Unusual blood sodium levels, calcium, and glucose can also affect your blood chemistry, causing cognitive decline.

Problems with hormones. Imbalances in estrogen and other sex hormones may impact cognitive function.

Vitamin deficiency. Low levels of vitamin B12, other B vitamins, and folate often affect brain function.

Delirium. Delirium is a condition that includes confused thinking and reduced awareness of one’s surroundings. It is widespread in hospitalized older adults and can also occur due to infection or other health problems in older people who are not hospitalized.

Psychiatric conditions. Most psychiatric conditions can cause problems with memory, thinking, or concentration. Depression and anxiety, bipolar disorder, schizophrenia, or other forms of major mental illness are the most common contributing factors.

Substance abuse. Overuse of certain substances (such as alcohol, drugs, or even prescription drugs) can impair brain function.‌

Injury. Two main types of injury can cause cognitive decline. For instance, strokes can cause vascular damage to neurons. Head injuries can also create temporary or long-term cognitive decline.

Neurodegenerative conditions. The most common conditions that cause cognitive decline include Alzheimer’s disease, Lewy Body disease, Parkinson’s disease, and frontotemporal degeneration (damage and loss of nerve cells in the brain).

Toxins. Other potential causes of cognitive decline are toxins like heavy metals, air pollutants, contaminants in your drinking water, and pesticides.

Also, keep in mind that other medical conditions and lifestyle decisions may cause an older adult to be at a greater risk of experiencing cognitive change, including:

• ‌Diabetes
• Smoking
• High blood pressure
• High cholesterol
• Being overweight
• Depression
• Lack of physical exercise
• Low education level
• Lack of mental engagement or socially stimulating activities

When the occasional memory lapse begins to become a regular occurrence, but doesn’t impact your ability to continue living your life relatively unchanged, you may have crossed the line into mild cognitive impairment (MCI).

MCI is the stage that can come after age-associated memory impairment, and it sometimes—but not always—leads to dementia. Currently, as many as 15 to 20 percent of Americans ages 65 and older have MCI, according to the Alzheimer’s Association.

Mild Cognitive Impairment and Dementia

MCI is not the same as dementia. In fact, some individuals with MCI remain stable throughout their lives, while others even revert to normal cognition.

According to Alzheimer’s Association statistics, as many as 32 percent of people with MCI may progress to dementia within five years. However, in some cases, people with MCI never progress.

More recently, experts have begun to classify mild cognitive impairment into two different categories based on the skills that are affected:

• Nonamnestic MCI affects thinking skills other than memory, including visual or spatial perception (e.g., finding it more difficult to navigate your way around a once familiar location), the ability to judge the steps needed to complete a complex task (e.g., pulling together your financial information to file your taxes), or language processing (e.g., losing your train of thought mid-conversation).
• Amnestic MCI refers to MCI characterized primarily by memory changes. People with amnestic MCI have more trouble remembering things that once came easily to them. They also may begin to lose or misplace things more frequently. These problems are relatively mild, but people with MCI perform worse on cognitive tests than others of the same age group.

Amnestic MCI is more likely to be caused by underlying Alzheimer’s disease and carries a greater risk of progressing to dementia. Roughly eight out of every 10 individuals with amnestic MCI go on to develop dementia within seven years.

People with MCI can still perform their daily activities and have no symptoms of dementia, although some complex tasks may require more effort or alternative strategies, such as greater use of lists, calendars, etc. People with MCI can live independently and take care of themselves.

Sadness mature woman with bills at her home

How to reduce the likelihood that you’ll develop Mild Cognitive Impairment or worsen existing MCI

• Practice good lifestyle habits, like eating a nutritious diet, exercising, Exercise helps by improving your mood, reducing stress, and reducing other risk factors that can lead to cognitive decline. Eating a nutritious diet may help prevent cognitive decline by providing your body with nutrients that can reduce the risk of high blood pressure, type 2 diabetes, and high cholesterol.
• Manage health conditions that can impair brain function, such as high blood pressure, triglycerides, blood sugar, and LDL (“bad”) cholesterol levels, along with other risk factors.
• Find ways to minimize stress. Research suggests that practices like mindfulness meditation may reduce some of the challenges of MCI. Mindfulness meditation is a mental state in which you focus on “the now,” slow down racing and confusing thoughts, release negativity, and calm body and mind.
• Reduce daily frustration by adopting strategies to help with forgetfulness, such as making lists and keeping calendars of appointments.
• Certain activities can assist older adults in adapting as they age and increasing their capacity to learn. For instance, doing activities like complex memory tests may help mental abilities like vocabulary improve.
• Keep learning. Reading books and magazines, playing board games, going to museums, and playing musical instruments all help reduce the risk of cognitive decline.
• Stay socially active. Research indicates that social activities can help prevent cognitive decline by challenging people to communicate and stimulating the mind.

Whether or not you’ve been diagnosed with MCI, you still should plan and make decisions regarding your future medical care and finances.

When Memory Impairment Becomes More Serious

Memory loss of any degree warrants an evaluation by a healthcare provider. This is particularly true if it seems to be getting worse or is impacting your daily life.

If you are concerned about cognitive impairments like memory loss, avoid self-diagnosis. Your doctor can provide everything from assessment and counseling to treatment. A medical assessment can help identify a cause and create a course of action. Although there is no cure for AD yet, there are many steps you and your support network can take to address symptoms and plan.

(All image above this article is courtesy of Freepik)

How to Identify Mild Cognitive Impairment in Older Adults, 7 Important Signs, Causes and Treatment was last modified: April 7th, 2025 by Vidya Sury

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