Mild Cognitive Impairment

Memory problems usually come with aging. However, if the person starts to frequently forget names, special dates, tasks to do or to misplace things, it is recommended to seek help as soon as possible by reaching out to either your family physician, or a neurologist, or a geriatric.

The physician will perform tests to first eliminate medical and psychological reasons that could lead to memory loss, such as infections, vitamin deficiency or depression.

If the psychological and/or medical reasons for a memory problem are eliminated, the doctor will refer the patient to either a neuropsychologist or a speech language therapist for a full assessment to find out if the patient is having an MCI. 

Symptoms of MCI will be noticed differently by the patient himself and/or his surroundings depending on the person’s lifestyle and the requirements of his/her professional or personal activities.

They will typically be noticed earlier for people having an active professional life, and a bit later for more sedentary and less active people.

But regardless of the person’s lifestyle, if she/he has MCI they will show at least some of the following common symptoms:

MCI is one of many causes behind memory problems in older adults. Some medical and psychological conditions, other than MCI, can also provoke memory problems. It is therefore very important to seek the help of an expert, as soon as you notice your memory problems, in order to get the right diagnosis for you and understand the reasons behind them.

Apart from MCI, below are other causes that could lead to memory problems.

1. Psychological reasons such as:

2. Medical:

When experiencing memory problems it is recommended to rapidly seek the help of a physician in order to first rule out medical or psychological causes. Usually patients refer to their family doctor who will either run the medical tests himself or refer them to a specialist such as a geriatric, a neurologist, or a psychiatrist. There is no single test that will indicate the presence of MCI, it is rather a full evaluation of the patient's physical (clinical assessment, laboratory tests, imaging, etc.) and psychological conditions that will lead to the MCI diagnosis.

Once the psychological and/or medical reasons for a memory problem are eliminated, the physician will refer the patient to either a neuropsychologist or a speech language therapist to do a full assessment and find out if the patient is having an MCI. 

If you have been diagnosed with MCI, it is very important that you get the help of an SLP.

She/he will design a therapy plan relying on evidence based methods that are tailored to your needs and interests. She/he will teach you some strategies to better memorize and recall information when needed.

She/he will help you better cope with your condition and communicate efficiently with your surroundings, and very importantly better track the evolution of your cognitive symptoms over time.

Aside from speech therapy, below are some general recommendations and tips that could help improve your attention and/or memory:

MCI could have some genetic factors. However, studies did not conclude if genetic factors would surely lead to a cognitive decline.

No, MCI is not considered as a normal part of ageing. A certain modest cognitive decline is expected while ageing. However, MCI leads to more severe memory problems along with higher functions problems, such as attention deficit, reasoning difficulties, spatial orientation issues, and processing speed. Typically a person with MCI will experience more challenges in both memory and higher functions than what is expected for a person in a similar age group.

If the symptoms of MCI are related to a medical or psychological problem, then in some cases the memory problems could be reversed if the medical and/or psychological underlying issues are treated.

However, most of the time MCI cannot be reversed and there are currently no medications that have been approved for treating the non-reversible MCI.

However, once the memory problems are diagnosed as part of the MCI, it is strongly recommended to seek the help of an SLP. 

Although speech therapy will not reverse the memory loss or stop its decline in the future, it will help slow the memory loss, along with the cognitive functions loss, by providing the patient with cognitive exercises and adaptation strategies for his daily activities. The speech therapy will stimulate the patient’s cognitive abilities and teach him compensation strategies, in order to maintain his current level of performance for as long as possible, allowing him to remain independent in his work and/or with his family.

The earliest the patient starts his speech therapy, the better the chances are that he will be able to better cope with his difficulties and have a good relation with his surroundings and a better quality of life.

Starting speech therapy as soon as the MCI diagnosis is clear, is highly recommended. Research has shown that the earlier speech therapy is started, the better the outcome, as it allows both the patient and his family to be on the right track and adopt good habits regarding the cognitive challenges they are facing.

Early speech therapy intervention is critical for helping patients maintain their cognitive functioning as long as possible as well as helping their families or caregivers understand very early on the condition and learn how to adapt the patient’s environment to his condition. The speech language therapy treatment will address not only symptoms but will also have environmental, psychological, and behavioral interventions that are essential.

For most patients it will help stabilize their symptoms as long as possible, postponing a steeper decline in cognitive functions. In very few cases, it could help improve their condition by improving their cognitive functioning hence helping them regain their self-confidence. 

If you have MCI, there is a probability that you will start experiencing difficulties and challenges with your daily life activities. Challenges might range from a struggle to maintain a good performance at work to difficulties in being well understood by your surroundings.

It is important for you to know that those challenges are the consequence of an MCI and to be able to identify them as such. Below are some of the commonly identified daily challenges facing patients with MCI:

Talking to your physician or speech therapist will help you and your surroundings better understand your new limitations and cope with them.

In the case of non-reversible MCI, there are currently no approved medications to treat this condition. The symptoms could either remain stable for years, or progress to dementia, or in some very rare cases improve over time.

In the absence of any medical treatment, it is strongly recommended for patients with MCI to start speech and language therapy as soon as possible.

Speech and language therapy provides older adults with explicit training and support for memory strategies. This training will make them more functional in their daily life, hence improving their quality of life.

The speech and language therapy assists both the patients and their family or caregivers. For the patients, it will teach them strategies to compensate for their deficits. This is done using different memory improvement techniques such as spaced retrieval, errorless learning or the use of memory agendas, books and other types of external memory aids. For the families or the caregivers, it will help them understand the patient’s condition and teach them how to modify his/her environment to meet the ongoing cognitive changes caused by their cognitive impairment. This is a crucial step in the therapy process.

Speech therapy will provide individual one-on-one therapy to the patient along with environmental adaptation strategies and recommendations given to the families or caregivers. Both are key in the intervention efforts to improve the quality of life of patients with MCI. 

It can be very frustrating to have MCI and experience memory problems and/or decline in higher functions. This situation can also be very frustrating for the surroundings of the person having MCI.

If you are living with someone diagnosed with MCI or you have frequent interaction with them, below are some tips and recommendations for the best way to deal with them that will avoid extra stress: