Which clinical history findings are characteristic of mild cognitive impairment (MCI)?

Updated: Apr 22, 2019
  • Author: Sonal Mehta, MD; Chief Editor: Jasvinder Chawla, MD, MBA  more...
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Patients with mild cognitive impairment (MCI) often present with vague and subjective symptoms of declining cognitive performance, which may be difficult to distinguish from the typical performance decline in healthy older individuals. The most common symptom is said to be memory loss, in keeping with the prevalent view that amnestic MCI is the most common type. However, some authorities affirm that the most common form of MCI affects multiple spheres of cognition.

Less common presentations of MCI include language disturbance (eg, difficulty in finding words), attention deficit (eg, difficulty in following or focusing on conversations), and deterioration in visuospatial skills (eg, disorientation in familiar surroundings in the absence of motor and sensory conditions that would account for the complaint).

Dissociating purely cognitive symptoms from those attributable to various degrees of sensory deprivation (eg, hearing loss or loss of visual acuity) that tend to coexist in the same patient population is often difficult and may be compounded by motor deficits that also beset the same individuals.

In any case, the defining element of MCI, as postulated by Petersen, is a single sphere of slowly progressive cognitive impairment that is not attributable to motor or sensory deficits and to which other areas of involvement may eventually be added, before social or occupational impairment supervenes (because this occurrence marks the onset of dementia). [1] Virtually nothing is known about the average duration of these manifestations before they are brought to medical attention (if they ever are).

Clinicians should rely on their own judgment in deciding when safety-related questions that are appropriate for patients with dementia—for example, about weapons, driving, and possible home fires involving cigarettes, stoves, or fireplaces—should also be asked of patients with MCI.

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