II. Epidemiology
-
Prevalence in U.S.
- Age 65 to 74 years: 21.9%
- Age 75 to 84 years: 24.6%
- Age >=85 years: 22.1%
- Rajan (2021) Alzheimers Dement 17(12): 1966-75 [PubMed]
III. Findings
- See Dementia
IV. Differential Diagnosis
V. Evaluation
- See Dementia (includes screening and diagnostic tools)
- See Dementia Diagnosis (same evaluation tools are used)
- See Mental Status Exam
- Routine screening of asymptomatic older patients is not currently recommended by USPTF
VI. Diagnosis
- See Dementia Diagnosis
- Complaint of Memory Loss and impaired for age
- Significant Forgetfulness
- Does not meet criteria for Dementia
- Normal general cognitive functioning (or mild changes in at least one cognitive domain)
- Normal Activities of Daily Living (Cognitive Impairment does not significantly impact functioning)
- Other conditions are excluded
- See Dementia Differential Diagnosis
- Major Depression screening is negative (See Dementia Diagnosis)
- Consider Consultation (see Dementia for indications)
- Neuropsychiatric testing
- Neurology Consultation
VII. Labs
- See Dementia
VIII. Imaging
IX. Management
- Lifestyle interventions may be helpful
- Encourage mentally stimulating activities
- Unclear efficacy of mentally challenging puzzles (e.g. crossword puzzles, Soduko), but may be helpful
- Encourage social engagement
- Increase Physical Activity
- Address Cardiac Risk Factors
- Avoid medications
- Avoid using Cholinesterase Inhibitors or Nemenda for Mild Cognitive Impairment
- Associated with adverse effects without evidence of benefit
- No evidence for consistent benefit from any herbal supplement (e.g. Ginkgo, coconut oil)
- No consistent evidence for Multivitamin supplementation (although unlikely to be harmful)
- Avoid using Cholinesterase Inhibitors or Nemenda for Mild Cognitive Impairment
X. Course
- Improves spontaneously in up to 26 to 50% of cases
- May ultimately progress with age to Alzheimer's Dementia
- Progresses in 5-10% of patients/year compared with 1-2% without Mild Cognitive Impairment