Mild Neurocognitive Disorder (mild cognitive impairment)

What is Mild Neurocognitive Disorder (mild cognitive impairment)

Mild neurocognitive disorder is a disorder in which memory does not work as well as it should. This disorder may also affect other mental functions, including thought, communication, behavior, and completion of tasks.

These impairments are noticeable and measurable, but for the most part they do not interfere with daily activities or the ability to live independently.

Mild neurocognitive disorder typically occurs in people older than 60 years but can occur earlier. It is not as serious as major neurocognitive disorder (formerly known as dementia), but it may be the first sign of it. Generally, symptoms of this condition get worse over time. In rare cases, symptoms can get better.

What are the causes?

This condition may be caused by:

  • Brain disorders associated with abnormal protein deposits in the brain, such as:
    • Alzheimer disease.
    • Frontotemporal dementia.
    • Dementia with Lewy bodies.
  • Brain disorders associated with abnormal movement, such as Parkinson disease or Huntington disease.
  • Diseases that affect blood vessels in the brain and result in small strokes.
  • Certain infections, such as HIV.
  • Traumatic brain injury.
  • Other medical conditions, such as brain tumors, under-active thyroid (hypothyroidism), and vitamin B12 deficiency.
  • Use of certain drugs or prescription medicines.
  • Untreated sleep apnea.
  • Heart disease, lung disease, liver disease, or kidney disease.

What are the signs or symptoms?

Symptoms of this condition include:

  • Difficulty remembering. You may:
    • Forget details of recent events, names, or phone numbers.
    • Forget social events and appointments.
    • Repeatedly forget where you put your car keys or other items.
  • Difficulty thinking and solving problems. You may have trouble with complex tasks, such as:
    • Paying bills.
    • Driving in unfamiliar places.
  • Difficulty communicating. You may have trouble:
    • Finding the right word or naming an object.
    • Forming a sentence that makes sense, or understanding what you read or hear.
  • Changes in your behavior or personality. When this happens, you may:
    • Lose interest in the things that you used to enjoy.
    • Withdraw from social situations.
    • Get angry more easily than usual.
    • Act before thinking.
    • Do things in public that you would not usually do.

How is this diagnosed?

This condition is diagnosed based on:

  • Your symptoms. Your health care provider may ask you as well as people you spend time with, such as family and friends, about your symptoms. Questions may include:
    • How often symptoms occur.
    • How long they have been occurring.
    • Whether they are getting worse.
    • The effect they are having on your life.
  • Evaluation of mental functions (neuropsychological testing). Your health care provider may refer you to a neurologist or mental health specialist for a detailed evaluation of your mental functions.

To identify the cause of your mild neurocognitive disorder, your health care provider may:

  • Get a detailed medical history.
  • Ask about alcohol and drug use, including prescription medicines.
  • Perform a physical exam.
  • Order blood tests and brain imaging exams.

How is this treated?

If mild neurocognitive disorder is caused by medicine, drug use, infection, or another medical condition, it may improve when the cause is treated, or when medicines or drugs are stopped. Mild neurocognitive disorder resulting from other causes generally does not improve and may worsen. In these cases, the goal of treatment is to help you cope with the loss of mental function. Treatments in these cases include:

  • Medicine. Medicine helps mainly with memory loss and behavioral symptoms.
  • Talk therapy. Talk therapy provides education, emotional support, memory aids, and other ways of making up for impairments in mental function.
  • Lifestyle changes, including:
    • Regular exercise.
    • A healthy diet that includes omega-3 fatty acids.
    • Intellectual stimulation.
    • Increased social interaction.

Follow these instructions at home:

Lifestyle

  • Exercise regularly as told by your health care provider.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Practice stress-management techniques when you get stressed. If you need help managing stress, ask your health care provider.
  • Stay social.
  • Keep your mind active with stimulating activities you enjoy, such as reading or playing games.
  • Make sure to get quality sleep. These tips can help you to get a good night’s rest:
    • Avoid napping during the day.
    • Keep your sleeping area dark and cool.
    • Avoid exercising during the few hours before you go to bed.
    • Avoid caffeine products in the evening.

Eating and drinking

  • Drink enough fluid to keep your urine clear or pale yellow.
  • Eat a healthy diet that includes omega-3 fatty acids. These can be found in:
    • Fish.
    • Nuts.
    • Leafy vegetables.
    • Vegetable oils.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider. Your health care provider may recommend that you avoid taking medicines that can affect thinking, such as pain or sleeping medicines.
  • Work with your health care provider to determine what you need help with and what your safety needs are.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • You have any new symptoms.

Get help right away if:

  • You develop new or worsening confusion.
  • You have behavioral outbursts that place you or your family in danger.

Summary

  • Mild neurocognitive disorder is a disorder in which memory does not work as well as it should. For the most part, this condition does not interfere with a person’s daily activities or ability to live independently.
  • Mild neurocognitive disorder can have many causes and may be the first stage of Alzheimer disease or other types of dementia.
  • Exercise, healthy diet, getting quality sleep, and keeping your mind active are very important for brain health.
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