An MCI diagnosis doesn’t always lead to dementia — and Alzheimer’s isn’t always the cause. Neurologists say identifying and addressing underlying health conditions can lead to better outcomes and, in some cases, total recovery.
Table of Contents
- An MCI diagnosis doesn’t always lead to dementia — and Alzheimer’s isn’t always the cause. Neurologists say identifying and addressing underlying health conditions can lead to better outcomes and, in some cases, total recovery.
- What exactly is mild cognitive impairment?
- When MCI can be reversible
- What to do after an MCI diagnosis
In 2020, 66-year-old business executive Mike Zuendel noticed something was amiss. “Someone once said, ‘Don’t worry if you misplace your keys, as long as you know what they’re for,’” he recalled. But after an incident where he looked all over his house for his cell phone — it had been in his hand the whole time — he realized, it was time to see a neurologist. After some cognitive testing, he came home with a diagnosis: mild cognitive impairment (MCI).
MCI is often misunderstood as an early stage of Alzheimer’s disease, but according to neurologists and neuropsychologists, the reality is more complex.
“There are a lot of reasons why people have cognitive impairment,” Dr. Sarah Kremen, a neurologist at the University of California Los Angeles told Being Patient. “You can’t jump to the conclusion that ‘I have mild cognitive impairment, I must have Alzheimer’s disease.’”
While MCI can be an early sign of a neurodegenerative condition, many people with MCI do not go on to develop dementia. In some cases, cognitive changes are caused by treatable or even reversible conditions such as sleep disorders, depression, or medication side effects.
What exactly is mild cognitive impairment?
Lori Golden-Stryer recalls the subtle yet troubling signs that preceded her husband Bob’s diagnosis of vascular-MCI, particularly their struggles managing finances.
“It was always somebody else’s fault, but we weren’t paying our bills… That was one of the first signs I saw,” Golden-Stryer explained.
This realization prompted the couple to seek medical advice, eventually leading to a clear diagnosis and management plan.
But experts say symptoms like these demonstrate how MCI can be a bit confusing.
“MCI is really defined by a mild level of cognitive impairment, where you can still function independently,” Dr. Emily Paolillo, neuropsychologist at the University of California, San Francisco told Being Patient. “It’s a gray area.”
MCI is when someone suffers from a mild decline in cognitive abilities that isn’t part of normal aging, but also isn’t bad enough to interfere with independent function. It’s a common condition that affects millions of people around the world.
Research indicates that around 10 to 15 percent of individuals with MCI progress to dementia annually, meaning the majority of MCI patients do not experience rapid cognitive decline.
MCI arises from various causes, which can include neurodegenerative diseases like Alzheimer’s or vascular issues. But it can also be caused by:
- sleep disorders
- hormonal shifts
- medication side effects
- toxins
- thyroid dysfunction
- vitamin B12 deficiency
- high blood pressure
Managing these factors through comprehensive medical evaluations, addressing treatable conditions, adopting healthy lifestyle habits, regular monitoring, and seeking community support can significantly influence outcomes.
When MCI can be reversible
Some forms of MCI are entirely reversible if the underlying cause is promptly identified and treated.
For example, cognitive issues stemming from sleep disorders, such as sleep apnea, can dramatically improve once proper sleep hygiene or medical treatments are implemented. Nutritional deficiencies, particularly vitamin B12 deficiency, can also mimic cognitive decline, and are often fully reversible with appropriate supplementation.
Depression, anxiety, and medication side effects are other common factors contributing to reversible MCI. Cognitive impairment linked to depression, often termed pseudodementia, can be alleviated through counseling, lifestyle changes, and antidepressants. Similarly, adjusting or discontinuing medications causing cognitive side effects can lead to significant cognitive improvement.
These cases emphasize the importance of thorough medical evaluation following an MCI diagnosis to identify treatable conditions, providing hope and clarity to those affected.
What to do after an MCI diagnosis
Mike Zuendel’s MCI, ultimately, was due to Alzheimer’s disease. Early detection gave him more options.
Meanwhile, Leah Fisher, a former psychotherapist living with MCI, found comfort and clarity once her symptoms were recognized upon formal diagnosis, allowing her to advocate effectively for herself and others: “I have this expression that has served me well, and it is, ‘I know what I know.” she said.
For both Zuendel and Fisher, shock came after receiving an MCI diagnosis. But according to experts (and individuals who have experienced an MCI diagnosis themselves) the journey with MCI is manageable. And sometimes, the symptoms may not be related to Alzheimer’s at all. It could be the result of some other underlying health issue… and if that’s the case, it may be treatable, and even reversible.
Neurologists remind patients and care providers that an MCI diagnosis doesn’t necessarily mean dementia’s next. Instead, they say, it’s a cue to take action. Recommended next steps might include:
- obtaining a thorough medical evaluation
- addressing reversible issues like sleep, depression, and nutritional deficiencies, and
- embracing brain-healthy lifestyles.
- scheduling cognitive assessments every six to 12 months
- participating in supportive communities.
Neurologists also agree that the most important thing a person with an MCI diagnosis can do to help stave off dementia is work with a healthcare specialist to explore and determine the underlying causes of their MCI. Some are indicative of neurodegenerative processes in the brain; others are reversible. That’s why a trip to the doctor can be so crucial when MCI symptoms start appearing — you can find out what’s really going on. And can take proper action, according to Paolillo. “You’re in control of your healthcare,” she said.