Recognizing the Signs of Mild Cognitive Impairment Due to Alzheimer’s Disease

Almost everyone can relate to misplacing their car keys or forgetting the name of an actor in their favorite movie. It’s a type of memory lapse that can become even more common with age.

In other cases, though, these incidents can be a sign of mild cognitive impairment (MCI), which can develop into Alzheimer’s disease or another type of dementia.

“As we get older, our bodies and our brains age,” says Monica Moreno, senior director of care and support at the Alzheimer’s Association. That’s why it can be easy to regard problems with memory or reasoning as a normal part of aging. “But there are some symptoms or warning signs that may indicate something more serious is going on,” she says.

MCI and Alzheimer’s: What’s Happening in the Brain

MCI can remain stable or — for 10 to 15 percent of people diagnosed with the condition — progress to Alzheimer’s disease or another type of dementia, according to the Alzheimer’s Association. In this case, the damage to the neurons is due to abnormalities in certain naturally occurring proteins in the brain called amyloid and tau. Neurons eventually stop working altogether, and the connections between them break down.

Early Signs of MCI Due to Alzheimer’s

People with Alzheimer’s disease will often experience more severe memory loss than people who are aging normally. This degree of memory loss leaves them “amnesic” — unable to remember new information. They typically repeat, ask questions over and over, and rapidly forget what was said between questions.

Among the signs of Alzheimer’s are:

Memory Loss That Interferes With Normal Functioning

One of the most common (and earliest) signs of Alzheimer’s disease is an inability to remember information, particularly new information. Over time, this memory loss can start to take a toll on daily life. A person in the early stages of Alzheimer’s may forget about appointments, medications, how to get to a familiar location, or how to pay bills. They may forget what they need at home and buy the wrong things. They may make errors driving or get lost.

Difficulty Doing Familiar Tasks

When Moreno asks people with Alzheimer’s what prompted them to see a doctor, they often say they’ve been having trouble doing activities that they did their whole life. “Tasks that had been so normal and easy for them were now becoming more and more difficult,” she says.

For example, “I met a woman who was a vice president of a bank, and one day she was trying to help her grandsons with their homework and she couldn’t do a simple math problem,” she says. “Then there was an award-winning chef who suddenly forgot how to make an omelet one morning.” In each case, tasks that had been easy for that particular person suddenly became impossible.

Trouble Speaking or Finding the Right Words

Dr. Leavitt says that along with memory loss, people with MCI typically have trouble with language. “It comes across as, ‘I can’t get the words out,’” she explains. “Or, ‘Her name is on the tip of my tongue.’”

“It’s something that’s very common, but [in people with Alzheimer’s], it’s more severe,” she says.

People with MCI due to Alzheimer’s may also have trouble keeping up a conversation. They may stop in the middle of a sentence and lose their train of thought, for example, or repeat themselves. They can also have trouble retrieving words from their brain’s storehouse of information, which is known as “lexical access.”

“Think of your brain as a big warehouse,” Leavitt explains. “You’ve got all these little forklifts, and you send them off to aisle 9, row 47. That requires coordination among areas of your brain to go to the right place, grab the information, and bring it out. … When it falls apart a little bit, that’s normal, healthy aging. But when that starts to fall apart a lot, that tends to be a signifier of Alzheimer’s.”

When to See a Doctor

Moreno encourages people to see a doctor if they (or a loved one) notice even one of the symptoms of MCI or Alzheimer’s. “You shouldn’t wait to experience all the signs,” she says.

A general doctor, neurologist, geriatrician, or psychiatrist can perform tests to evaluate cognitive functioning. The ones that are most often used include:

• The Montreal Cognitive Assessment, which involves memorizing a short list of words, naming certain objects, and copying shapes.
• Mini–Mental State Examination, which requires counting backward, identifying objects, and recalling other facts, such as the date.
• Mini-Cog screening, which involves memorizing and recalling words and drawing a picture of a clock with its hands pointing to a specific time.

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“It can be hard to face the reality of decline that [you or] a loved one is experiencing,” says Leavitt. But, she adds, “You have to put safety above everything else.”