Finally, a way to define MCI that doesn’t insult you for having it

What is MCI?

That is such a basic question. But it’s been hard to get a really good answer. One that doesn’t needlessly frighten you. Or insult you.

Finally, I think we have one. And that’s what I want to talk about today. Hi, I’m Tony Dearing, of GoCogno.com, the website for people with mild cognitive impairment.

I’ve been writing about MCI for a long time, and one thing that’s always bothered me is how we try to describe it. There’s never really been a good definition.

And that matters. If you can’t even describe it, how do you address it, and overcome it?

The way experts used to describe MCI was just plain wrong. It was often referred to as “incipient dementia” or a “precursor” to dementia.

In other words, everyone who has MCI is going to get Alzheimer’s, probably sooner than later.

OK, we know that’s not the case. For many people who have MCI, the cause isn’t Alzheimer’s. The cause is something else, something that is probably treatable.

So we needed a new, better definition of MCI. But that’s not what we got. Instead, we got this definition, which I see all the time:

Mild cognitive impairment is a form of memory loss that’s not normal for your age, but not serious enough to affect the activities of your daily life.

Well, that’s not true either. It makes MCI sound like no big deal, you just go on more or less about your life the way you always did.

That is an insult to people with MCI. Living with mild cognitive impairment is hard.

We need a way to describe MCI for what it really is. And finally, I think we’ve arrived at that.

So let me lay it out for you. There are two things that define MCI, and the first is the degree of memory loss.

Because there is normal, age-related memory loss, which everyone experiences. And then there’s mild cognitive impairment, which describes memory loss that’s not normal. And we can measure that. Doctors can use a test like the MoCA, or the SAGE or the MMSE, followed by a more thorough evaluation, to say, OK, this is not normal. There is some problem here.

At that point, the next thing doctors need to figure out, and they really need to get this right, is: Is it MCI, or is it dementia?

That is what anyone with MCI really wants to know. What is the line between them? And which side of that line am I on? And how will I know if I cross that line?

There’s some gray area there. It can be hard to explain, and hard to understand.

But really, it boils down to one basic thing. And it’s this. Autonomy.

How autonomously are you able to live? Can you mostly get by on your own? Or do you need other people to help take care of you?

This can be defined too, by this list of what are called “Activities of Daily Living.” If you want to know what these activities are, here’s a list of them:

But those are the two things that accurately describe MCI. The degree of cognitive loss, and the degree of autonomy.

So the proper definition of MCI, the one I’m seeing the really top experts use now, and the one I’m adopting, is:

Mild cognitive impairment is a degree of memory loss that’s not normal for your age, but you can still live in a mostly autonomous way.

I like that definition. I think it’s very accurate. I think it’s very understandable.

It’s good to know. And then it’s good to turn your attention to where it really belongs.

For you, the most important difference between MCI and dementia, is that at the MCI stage, you’ve caught it in time to do something about it. With recent advances in research and treatment, it has become very possible to halt cognitive decline at the MCI stage and prevent it from progressing to dementia.

We know how to do that. In these videos every way, I show you the ways that have been proven to work. I’ll be back next week with more. Until then, as always, be kind to your mind.

 

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