Diagnosing and getting treatment for MCI

Getting a mild cognitive impairment diagnosis

Step 1: Seeing a GP 

The GP will ask about a person’s symptoms. This includes when they started and how they are affecting their daily life.

They will review the person’s physical health and any medicines they are taking. They will also briefly test their thinking skills.

If the GP thinks there may be a problem with memory or thinking they will normally refer the person to their local memory service for a specialist assessment.

They will also request some routine blood tests to check for treatable causes, such as physical health problems.

Step 2: Seeing a specialist

A specialist clinician will ask about problems with memory or thinking and how they have been causing difficulties with everyday activities. They may also ask about other health problems or what’s going on in a person’s life. 

They will then ask questions which are designed to test memory and thinking. Once this is done, they will try to explain what they think the cause of these problems could be. 

They may request a brain scan to check that symptoms aren’t being caused by a brain injury or tumour. A brain scan isn’t always necessary, but for many people it can provide useful information to get a more accurate diagnosis.

Sometimes they may ask to do more assessments if they don’t feel able to give a diagnosis. 

A diagnosis of MCI is usually given when a person’s memory or thinking is worse than would be expected for their age but it’s not affecting their ability to do everyday activities.

Benefits of knowing you have MCI

• Many people are relieved when they are told that they have MCI because it means that there is still a good chance that their symptoms won’t get worse.
• A diagnosis of MCI can be helpful for anyone struggling to convince people around them that they have a problem and need help or support.
• It can prompt health professionals to explore treatable causes of MCI. This could be hearing loss, mental health or sleep problems, which otherwise might have gone unnoticed.
• A diagnosis can sometimes help to get access to support such as practical strategies to help with memory and thinking. It can also be an opportunity to make positive changes that could reduce the risk of the condition progressing to dementia. 

Getting treatment for mild cognitive impairment

There are currently no medicines that are licensed to treat MCI or which reduce the chances of developing dementia.

Symptoms can sometimes improve when a health problem that’s contributing to the condition is treated effectively. This might involve a referral to another specialist clinic, such as a sleep clinic or mental health service. 

However, for many people it’s not clear what is causing their MCI and so the best option may be to wait and see. 

Waiting for a diagnosis can be emotional, and lots of people find it affects their wellbeing and day-to-day life. Looking after physical and mental health is especially important during a difficult time like this. 

Once a person has been told they have MCI they will often be referred back to the care of their GP. If their condition gets worse, the GP will refer them back to the memory service for a follow-up assessment.

The memory service should also direct a person with MCI to local sources of support, where these are available. 

Getting regular checkups for MCI

Some memory services ask a person with MCI to come back in 6 or 12 months for a routine follow-up appointment. If symptoms continue to get worse before then, contact the GP.

The GP can refer a person back to the memory service for further assessment. This is particularly the case if their symptoms are making it difficult to do everyday activities without help.

If MCI has developed into dementia, then the memory service may be able to help with medicines and other support.

Do people with MCI always develop dementia?

About one in every seven people diagnosed with MCI by their memory service will develop dementia over the next 12 months. However, around one in two (half) the people diagnosed with MCI will have dementia after five years. 

The risk of progressing to dementia may be greater for some types of people than for others:

• Age: If a person is older, they are more likely to develop dementia. The majority of people with MCI younger than 65 do not develop dementia.
• Symptoms: If a person has problems with their memory, rather than other aspects of thinking, they are slightly more likely develop dementia. This also happens if they have problems with several different types of thinking skills.
• Other health conditions: Some long-term health problems increase the risk of MCI getting worse and becoming dementia. These problems include depression, diabetes, high blood pressure and being very overweight. 
• Frailty: Being frail also increases the risk of MCI becoming dementia. Frailty is when a person is more vulnerable to illness or injury. This is because of a combination of old age, declining physical strength and other long-term health problems.
• Physical evidence of risk: If a scan shows clear evidence of changes to the health of the brain in a person with MCI, this might mean they have a higher chance of developing dementia. Occasionally a person may also have tests carried out on their spinal fluid which can show evidence of brain disease.