Introduction

Mild cognitive impairment (MCI) is an impairment in memory, language, thinking or judgement which is more than forgetfulness in normal aging, however not to the extent of affecting the activity of daily living and independence of the older person.

Risk factors

Major risk factors for cognitive decline are:

1. Older age
2. Lower level of education

However, other risk factor related with dementia has result for mild cognitive impairment.

Signs and symptoms

The signs and symptoms of mild cognitive impairment are:

1. Repeat same question and statement
2. Trouble finding words
3. Trouble with number related task such as paying bills
4. Difficulty planning or organizing
5. Inability to follow multi-step directions or instruction
6. Lack of initiative in activities in absence of depression
7. Lack of focus during activities or conversation

However, the signs and symptoms above are in milder form and the individual still independent in his/her daily function.

Diagnosis

Diagnosis of mild cognitive impairment is made if the person fulfil the following criteria:

1. Self or informant reported cognitive complaint
2. Objective cognitive impairment through neuropsychological test
3. Absence of impairment in daily function
4. Not demented

Blood tests and imaging of the brain’s structure may be conducted to exclude cognitive decline due to brain lesion or medical causes.

Implication of being diagnosed with MCI

People diagnosed with mild cognitive impairment would be at an increased risk of 10% to 15% per year of developing Alzheimer’s Disease Dementia.
In some individuals, mild cognitive impairment does not always lead to dementia as it can revert to normal cognition or remains stable.

Treatment

Treatment for mild cognitive impairment is focus on interventions without medication. The interventions include:

1. Cognitive stimulating activities such as reading, playing Sudoku, chess or mahjong and interaction with others
2. Physical exercise which is age appropriate

Currently, there is no recommended medication for mild cognitive impairment.

Prevention

Even though evidence on the prevention of mild cognitive impairment showed mixed result, healthy lifestyle would promote better cognitive health and should be encourage for older person. Examples of healthy lifestyle that can promote good cognitive health are:

1. Regular physical exercise – age appropriate
2. Healthy diet – low fat, balanced diet, fruits and vegetables
3. Cognitive stimulating activities
4. Social engagement

Strategies to compensate the mild cognitive impairment

These are some strategies to help the individuals cope with mild cognitive impairment:

1. Appointment and daily task
   • Write a to do list and keep in a visible place
   • Mark calendar  or use reminder in hand phone for appointments and important dates or events
2. Medication management
   • Keep medications organized and in a visible location
   • Label the medication
   • Use the pill box to organize medication by day and time
   • Put the pill box at the bed side for easy access and as a reminder.
3. Household responsibilities
   • Keep bills and important documents or papers in a visible place
   • Write reminders notes on notebook or hand phone and put in your favourite place
4. Communication
   • Use the same hand phone and avoid switching to new one
   • Put frequently used number in the speed dial application
   • Use tape recorder to save important matters

What family members should do if someone in the family has mild cognitive impairment?

Individuals with mild cognitive impairment are still able to function independently.

Family members should encourage and help individuals with mild cognitive impairment to stay independent

The family members should:

1. Accept that cognitive impairment is real
2. Learn to recognize the signs and symptoms of mild cognitive impairment
3. Allow the individual with mild cognitive impairment to complete their activity of daily living at their own pace
4. Encourage usefulness by suggesting suitable household task or responsibility for the individual to complete
5. Avoid becoming overprotective
6. Include the person with mild cognitive impairment in social events and community activities
7. Give simple instruction and not too many at a time
8. Simplify speaking style if the person with mild cognitive impairment has difficulty understanding.