The cognitive disturbances and cognitive problems, among them mild cognitive impairment, they are considered an intermediate stage between normal or expected cognitive impairment as a consequence of aging and the development of a more serious decline, dementia (Mayo Clinic, 2012).
Mild impairment of cognitive functions may involve deficits in memory, language, impaired judgment or thinking. Both the person and their relatives may begin to notice these changes; however, they do not reach a level of severity sufficient to interfere with routine activities or daily life (Mayo Clinic, 2012).
Cognitive problems can vary from an almost barely perceptible presence to a more significant presence, sometimes cognitive abilities will progressively decrease, while in other people they may remain stable for years (Memory and Aging Center University of California, 2016 ).
In recent decades, the study of cognitive functions related to age and different pathologies has become a central point, both for the medical and neuropsychological areas, due in large part to the increase in the longevity of the population.
Recently, the medical community has changed its perspective on memory loss in the elderly population. Previously, memory alterations were considered as an inevitable event that was presented in a consequent way to the progressive increase of age (Institute of Cognitive Neurology, 2016).
It is currently known that there are multiple factors that will protect our memory capacity even at very advanced ages and that therefore, cognitive impairment in a mild stage can be considered pathological or indicative of a dementia process rather than an evolutionary event (Institute of Cognitive Neurology, 2016).
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People with mild cognitive impairment may suffer from various more significant or severe impairments in memory, language or executive function than expected for their age, without these symptoms interfering with their daily lives (National Institute on Aging, 2016).
Some of the most common symptoms in mild cognitive impairment are difficulties remembering people's names, losing the thread of a conversation or a significant tendency to lose things (Alzheimer's Australia, 2016).
Normally, people with mild cognitive impairment are able to carry out all the activities of their daily life with varying degrees of efficiency. They often try to compensate for their memory deficits with some external system, such as diaries, notes or calendars (Alzheimer's Australia, 2016).
Mild cognitive impairment is not a type of dementia. In many cases the alterations can remain stable; however, they are more likely to worsen leading to dementia (Alzheimer's Society, 2015)
Different investigations estimate that between 5-20% of people over 65 years of age present mild cognitive impairment (Alzheimer's Society, 2015).
On the other hand, 10-15% of people with a diagnosis of mild cognitive impairment have a high probability of developing Alzheimer's dementia compared to 1-2% of healthy subjects in the same age range (Sánchez-Rodríguez, 2011).
It is not strange that as age increases, forgetfulness episodes occur, it takes more time to find an answer or to carry out a task. But it is possible that when these situations persist, they may indicate the presence of mild cognitive impairment (MCI) (Mayo Clinic, 2012).
Some of the following situations may be experienced (Mayo Clinic, 2012):
Experts usually classify symptoms based on the cognitive area that is affected or altered (Alzheimer's association, 2016):
It mainly affects memory. The person may begin to show significant forgetfulness such as appointments, conversations, events that he normally remembered easily (Alzheimer's association, 2016). In addition, this type can be classified into:
In general, alterations will occur in the following areas (Alzheimer's Society, 2015):
Although normally healthy people begin to experience some signs of decrease or minimal alteration of cognitive functions with age, all these symptoms will present more seriously than in normal aging (Alzheimer's Society, 2015).
It is common that with increasing age pauses are needed to recall data or words; however, becoming disoriented and getting lost in familiar places or forgetting family names can be indicative of mild impairment (Alzheimer's Society, 2015).
Currently there is no specific diagnostic test that indicates the presence or absence of mild cognitive impairment (Mayo Clinic, 2012).
The specialist will make a clinical diagnosis based on the information obtained both from the patient himself and his relatives and from the application of some tests (Mayo Clinic, 2012).
Complaints in relation to the memory area are usually present from the beginning of the symptoms of mild cognitive impairment. They can be manifested both by the patient and by people close to him.
In addition, they frequently describe other symptoms, difficulty finding the correct words when speaking, loss of objects, disorientation in different environments, loss of continuity of thought, conversations and / or daily activities (Sánchez-Rodríguez and Torrellas-Morales, 2011).
In most cases, the following considerations are taken into account (Mayo Clinic, 2012):
Various proposals have been made regarding the essential diagnostic criteria for the diagnosis of mild cognitive impairment, some of them are the following (Sánchez-Rodríguez and Torrellas-Morales, 2011):
No single specific cause for mild cognitive impairment has been identified.
Current scientific evidence shows that mild cognitive impairment can sometimes show some brain changes similar to those found in some types of dementia (Mayo Clinic, 2012).
These changes include (Mayo Clinic, 2012):
In general, the factors most related to the suffering of mild cognitive impairment are the same that have been identified in dementia (Alzheimer's association, 2016):
On the other hand, the Mayo Clinic (2012) also highlights other risk factors:
With regard to drugs, there is currently no specific treatment for mild cognitive impairment. Despite this, there are a wide variety of ongoing clinical and experimental studies trying to investigate the effectiveness of different drugs: cholinesterase inhibitors - used in Alzheimer's, non-steroidal anti-inflammatory drugs or statins (Alzheimer's Australia, 2016).
Apart from this, there is solid scientific evidence on the benefits of neuropsychological rehabilitation and cognitive training. Constantly working on attention, memory, executive function and the rest of the cognitive functions will be essential to achieve the stability of the progress of the symptoms and on the other hand to develop compensatory strategies that provide people with useful and efficient tools to compensate their deficits.
On the other hand, maintaining a healthy diet, exercising regularly, and maintaining optimal health by avoiding the consumption of harmful substances or controlling possible risk factors are variables that can influence the development of symptoms and the progression of mild cognitive impairment.
Mild cognitive impairment is a clinical condition that can cause significant alterations in the cognitive sphere of people, in addition to causing notable discomfort in their day-to-day life.
Despite this, an essential distinguishing feature with dementias is that these deficits will or will not significantly alter both routine activities and daily life of the patient.
An early diagnosis is essential since the early use of cognitive intervention will provide the individual with better compensation strategies for their symptoms of alterations. They must also be monitored to detect more significant changes that indicate the development of an insane process..
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