Mild Cognitive Impairment
- Mild cognitive impairment (MCI) is defined as significant cognitive impairment in the absence of dementia, as measured by standard memory tests:
- Concern regarding change in cognition
- Preservation of independence in functional activities (ADLs)
- Impairment in ≥1 cognitive domains (attention, executive dysfunction, memory, visuospatial, language)
- Other terms used in the literature relating to MCI: Cognitive impairment not dementia (CIND); mild cognitive disorder. Some of these conditions do not progress to dementia. DSM-5 mentions “mild neurocognitive disorder” (mNCD), which may be a precursor to Alzheimer disease and has many of the same features as MCI.
- Predominant sex: male > female
- Predominant age:
- Higher in older persons and in those with less education
- 12 to 15/1,000 person-years in those age ≥65 years
- 50 to 75/1,000 person-years in those age ≥75 years
- MCI is more prevalent than dementia in the United States.
- 12–18% for those age ≥60 years. ~25% for age 80–84 years. Prevalence increases with age and for those with lower educational level (2).
Etiology and Pathophysiology
- Subtypes of MCI:
- Single-domain amnestic
- Multiple-domain amnestic
- Nonamnestic single-domain
- Nonamnestic multiple-domain
- The amnestic subtype is higher risk for progression to Alzheimer disease.
- Vascular, neurodegenerative, traumatic, metabolic, psychiatric, or a combination
In certain subsets of MCI where the disease will progress to Alzheimer dementia one must consider apolipoprotein (APO) E4 genotype: Various pathways exist leading to amyloid accumulation and deposition thought to be associated with dementia.
- Diabetes; hypertension; hyperlipidemia; cerebrovascular disease
- Sleep apnea
- APO E4 genotype
- Low educational levels
- Sedentary lifestyle
Optimize vascular risk factors and focus on a healthy, active lifestyle.
Commonly Associated Conditions
See “Risk Factors.”
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Domino, Frank J., et al., editors. "Mild Cognitive Impairment." 5-Minute Clinical Consult, 27th ed., Wolters Kluwer, 2020. Medicine Central, im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116980/1.2/Mild_Cognitive_Impairment.
Mild Cognitive Impairment. In: Domino FJF, Baldor RAR, Golding JJ, et al, eds. 5-Minute Clinical Consult. Wolters Kluwer; 2020. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116980/1.2/Mild_Cognitive_Impairment. Accessed June 10, 2023.
Mild Cognitive Impairment. (2020). In Domino, F. J., Baldor, R. A., Golding, J., & Stephens, M. B. (Eds.), 5-Minute Clinical Consult (27th ed.). Wolters Kluwer. https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116980/1.2/Mild_Cognitive_Impairment
Mild Cognitive Impairment [Internet]. In: Domino FJF, Baldor RAR, Golding JJ, Stephens MBM, editors. 5-Minute Clinical Consult. Wolters Kluwer; 2020. [cited 2023 June 10]. Available from: https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116980/1.2/Mild_Cognitive_Impairment.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Mild Cognitive Impairment ID - 116980 ED - Domino,Frank J, ED - Baldor,Robert A, ED - Golding,Jeremy, ED - Stephens,Mark B, BT - 5-Minute Clinical Consult, Updating UR - https://im.unboundmedicine.com/medicine/view/5-Minute-Clinical-Consult/116980/1.2/Mild_Cognitive_Impairment PB - Wolters Kluwer ET - 27 DB - Medicine Central DP - Unbound Medicine ER -