Mild Cognitive Impairment

What is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) is a condition where an individual experiences a greater decline in cognitive abilities compared to their peers of the same age. These include memory, language, judgement or thinking skills. Family members may notice that the individual requires more time and effort to complete their daily tasks, or makes more errors while doing so, but these changes do not fully impair the individual’s ability to function in their day-to-day activities.

Signs and symptoms
Signs and symptoms of MCI include:

• Forgetfulness (e.g., forgetting conversations or events in the recent months or days)
• Misplacing items (e.g., key, wallet and hand phone)
• Language challenges (e.g., difficulty in finding words or constructing full and coherent sentences)
• Difficulty in planning or problem solving (e.g., struggling with thinking things through)

Risk factors
Some factors can put an individual at risk of developing MCI. These factors include:

• Age
• Family history
• Education level
  
• Lack of physical exercise
• Smoking
• Social isolation
• Excessive consumption of alcohol
• Medical condition (e.g., diabetes, hypertension, hyperlipidaemia, stroke, mood disorders and sleep apnoea)

Causes and outcomes
MCI can be caused by:

• Neurodegenerative conditions (e.g., Parkinson’s disease)
• Conditions which affect the circulatory system (vascular diseases)(e.g., stroke)
• Traumatic brain injuries
• Brain tumours
• Side effects of medications (e.g., painkillers, cough syrup, antihistamines etc.)
• Sleep disorders or deprivation
• Mood disorders (e.g., depression, anxiety)
• Multiple medical problems (e.g., diabetes, high blood pressure, elevated cholesterol)
• Depending on the cause of your MCI, your condition may improve, stabilise or lead to dementia.

Signs that MCI is progressing to dementia

• Worsening memory
• Reduced levels of reasoning and judgement
• Interference with daily activities
• Behavioural changes (e.g., agitation, hallucination and delusion)

Treatment
MCI can be managed by maintaining good health physically, mentally and socially. Being part of a community can create a sense of belonging and help you feel less isolated, and can help to decrease the rate of cognitive decline resulting from MCI. Some examples include:

Physical activities

• Exercise regularly (e.g., walking, swimming, cycling, etc.)
• Have a well-balanced diet for a well-functioning brain (e.g., Mediterranean diet).
  
• Include more whole grains, fruits and vegetables, fish and shellfish, nuts, olive oil and other healthy fats in your diet. Eat less meat and sweets.
  
• Maintain good sleep hygiene by developing and following a sleep routine.
• Keep yourself engaged during the day.
• Consume caffeine only in the morning.
• Ensure a comfortable environment at night (e.g., room temperature, dim lighting etc.)
• Go for regular health check-ups.
• Ensure that medical conditions (e.g. hypertension, hyperlipidaemia and diabetes) are within acceptable levels
  

Mental activities

• Create structured ways to remember things.
• Keep items at regular places.
• Categorising items.
• Use memory aids.
  
• Have notebooks or diaries to record activities of the day, upcoming events and tasks, to-do lists and reminders.
• Place physical calendars in prominent places as a reminder for upcoming events.
• Set reminders through alarm clocks and timers for the activities of the day.
• Participate in cognitive stimulating games and activities (e.g., jigsaw puzzles, word search puzzles, chess, Sudoku, brain games or exercises etc.)

Social activities

• Take part in volunteering.
• Join community club activities (e.g., karaoke, line dancing, cooking, baking, painting etc.)

Family support and help
Family members can support individuals with MCI by:

• Learning and understanding more about the disease through social platforms such as Dementia Singapore or HealthXchange.
• Supporting their loved ones as they cope with the lifestyle changes (e.g., providing visual and verbal cues) brought about by MCI.
• Looking out for signs of dementia.
• Updating the doctor during follow-up visits.