The following excerpt from our book, “Does My Mom Have Dementia” discusses what Mild Neurocognitive Impairment is and how this term relates to Dementia.
There is another related term that you may hear thrown around in doctors’ offices called “mild cognitive impairment,” or MCI. This refers to impairment that is greater than expected for someone’s age level but not bad enough to meet criteria for dementia. This means that the person may have some degree of impairment in memory or other important thinking skills, but their level of impairment is not severe enough to cause a major functional impact in their daily life. For example, a person with MCI might have a hard time finding the word they are looking for, but they are typically able to find it when given enough time to think, whereas a person with dementia may never come up with the word. Another individual with MCI may forget a recent conversation or ask for clarification on the date for an upcoming event, whereas an individual with dementia may forget the event entirely and claim they were never told about it. MCI has become a very important term in the past 20-30 years because it is generally considered to be a transitional stage between normal thinking abilities and dementia. Therefore, there has been an increase in focused treatment during this stage with the hope of preventing dementia.
It is currently estimated that about 5–25 percent of older adults have MCI, and the incidence increases as they age. Their chances of transitioning into dementia also increase each year that they continue to struggle with MCI. MCI represents an important warning sign because it lets us know that something seems to be wrong and should at least be monitored if not treated outright. Currently the MCI population has become a major focus of drug research, as the goal is to stave off dementia before it fully develops. Regarding the terminology that we described above from the DSM V, mild cognitive impairment can also be called “mild neurocognitive disorder.” Again, the “mild” part of that diagnosis acknowledges the impairment is not currently causing serious limitations in the person’s daily living activities. Just remember dementia = major neurocognitive disorder and mild cognitive impairment (MCI) = mild neurocognitive disorder.
A. Evidence of modest cognitive decline from a previous level of performance in one or more cognitive domains (complex attention, executive function, learning and memory, language, perceptual motor, or social cognition) based on:
1. Concern of the individual, a knowledgeable informant, or the clinician that there has been a mild decline in cognitive function; and
2. A modest impairment in cognitive performance, preferably documented by standardized neuropsychological testing or, in its absence, another quantified clinical assessment.
B. The cognitive deficits do not interfere with capacity for independence in everyday activities (i.e., complex instrumental activities of daily living such as paying bills or managing medications are preserved, but greater effort, compensatory strategies, or accommodation may be required).
C. The cognitive deficits do not occur exclusively in the context of a delirium.
D. The cognitive deficits are not better explained by another mental disorder (e.g., major depressive disorder, schizophrenia).
