When It's Not Dementia, But More Than Normal Aging

When It’s Not Dementia, But More Than Normal Aging

Memory loss, becoming more impulsive, being easily distracted or overwhelmed...there are many indicators of Alzheimer’s or dementia. But what behaviors are considered normal for the aging process, and what should be considered more serious?

When symptoms aren’t quite dementia, but aren’t normal either, what should you do? What do adult children do when Mom seems rather removed, forgetful, and confused? The first thought of most caretakers is the extreme – Alzheimer’s Disease. It rings in the brain like a ship’s horn as it departs from port.  However, have you considered other things may be at play? For clarity sake, memory loss, forgetfulness and confusion should alarm you. This behavior is abnormal and makes a caretaker question the health of a resident.  

Other causes do exist that can cause seniors to become forgetful or confused.

  • MCI – Mild Cognitive Impairment is a condition which presents much like Alzheimer’s Disease but is something much different.
  • MCI causes memory and thinking problems for 10-15% of seniors.

Mild cognitive impairment causes associated symptoms, diagnosis, and risk factors, as well as plausible treatments.


Healthy people can experience a slow decline in cognitive abilities as a normal part of aging.  This alone is not alarming. It is a slow degradation, but often does not inhibit function. However, mild cognitive impairment is a mid-stage diagnosis. It is between the occasional forgetfulness of normal aging and the serious cognitive decline of dementia.

Mild Cognitive Impairment can cause symptoms such as:

  • Memory loss
  • Language difficulties
  • Thinking challenges, referred to as “foggy brain”
  • Impaired judgment

People diagnosed with MCI are at a greater risk of developing dementia of some type. 

  • About 1 – 2% of seniors develop dementia every year. 
  • Among seniors with MCI, about 10 – 15% develop some form of dementia every year.

The progression of mild cognitive impairment to dementia is not too alarming, and the overall prevalence of dementia is relatively low.  In some cases, mild cognitive impairment doesn’t worsen over time and can improve. Symptoms could also stay the same.  

What makes mild cognitive impairment improve, degrade or stay the same? Numerous things can affect MCI, some of these triggers include:

  • A fall resulting in a hip injury
  • A fall resulting in a head injury
  • New medication with side effects
  • Asymptomatic Urinary Tract Infection
  • Symptomatic Urinary Tract Infection
  • Depression/Anxiety
  • Transient Ischemic Attack (TIA)
  • Stroke

Symptoms Of Mild Cognitive Impairment

Someone with mild cognitive impairment could experience any of these symptoms:

  • Forgetting recent events or repeating the same question
  • Forgetting important events like appointments or social events
  • Being very easily distracted, losing their train of thought, or losing the thread of conversations, books, or movies
  • Feeling increasingly overwhelmed by decision-making, planning, or understanding instructions
  • Taking much longer than usual to find the right word for something
  • Starting to have trouble finding their way around familiar places
  • Becoming more impulsive or showing increasingly poor judgment
  • Difficulty judging distances or navigating stairs
  • Depression
  • Irritability and aggression
  • Anxiety
  • Apathy

Changes listed above may cause the burden of care to increase. Seniors suffering with these symptoms will need help overseeing a household, dressing appropriately, managing appointments and other activities.  

Diagnosing Mild Cognitive Impairment

Proper diagnosis of MCI and the cause of its manifestation are key. It is also imperative for accuracy in managing healthcare. Additionally, diagnosis will help seniors know the cause of their cognitive issues and enable them to take necessary steps to mitigate it. Depending upon the cause of MCI, seniors will also be made aware of the possible increased risk of dementia. This allows for proper monitoring by healthcare professionals, family members or care providers while residing in a residential assisted living home. If MCI begins to progress, proper treatment can be started early. The steps to diagnose MCI are very similar to those used to diagnose dementia.

Process of Diagnosis

Thorough medical history, including current symptoms, previous illnesses and medical conditions, and any family history of significant memory problems or dementia is key for proper diagnosis. As are the following:

  • Assessment of independent function and daily activities, focusing on any changes from the usual level of function
  • Input from family or a trusted friend to get additional perspective on how cognitive function might have changed
  • Assessment of mental status using brief tests that evaluate memory planning, judgment, ability to understand visual information, and other key thinking skills
  • In-office neurological exam to assess the function of nerves and reflexes, movement, coordination, balance, and senses
  • Check for depression, which is common among older adults and can cause some dementia-like symptoms including problems with memory or feeling “foggy”
  • Lab tests including blood tests and brain imaging
  • If needed, neuropsychological testing

Causes and Risk for Mild Cognitive Impairment

The strongest risk factors for MCI are the same as those for dementia:

  • Advanced age
  • Family history of Alzheimer’s or another dementia
  • Conditions that increase risk of cardiovascular disease like high blood pressure, diabetes, or high cholesterol
  • Activities that don’t promote a healthy lifestyle like smoking, lack of physical exercise, being lonely or isolated, lack of mental stimulation
  • Experiencing depression

Treatments for Mild Cognitive Impairment

There are no FDA-approved medications that treat mild cognitive impairment, directly. However, depending upon the cause of the mild cognitive impairment, physicians may prescribe medication to treat that cause and resolve the condition.

If no apparent cause can be traced, drugs that are approved to treat Alzheimer’s disease haven’t shown any benefit in delaying or preventing progression of MCI to dementia. Therefore, caretakers must monitor closely without being obsessive. Allow seniors to live as normally as possible. As with any disease, lifestyle is the major factor impacting it. Therefore, feed seniors well, with food that is very nutritious and supportive of brain function.  

Senior Wellness Plans Should Include:

  • Eating a healthy diet, keeping a healthy weight
  • Exercising regularly to improve cardiovascular and brain health
  • Controlling health conditions that affect the heart and blood vessels like heart disease, high blood pressure, high cholesterol, and diabetes
  • Participating in mentally stimulating and socially engaging activities
  • Treating depression
  • Stopping smoking
  • Limiting alcohol
  • Intake of Omega-3 Oils, Coconut Oils
  • Plenty of green leafy veggies (juicing them with low glycemic fruit is best)
  • Ensure Vitamin B and D levels are optimal

Experts also recommend that a person diagnosed with MCI should be re-evaluated by their doctor every 6 months to assess the symptoms. This will serve as a great marker for improvement, stability or declination.  

Ralna Provides Expert Industry Tips

Regardless of the outcome, residential assisted living staff must make sure seniors are living a full, active and meaningful lives.

The RAL industry continues to thrive despite the stock market, U.S. economy or current pandemic. Remember to visit www.RALNA.com for more information about membership and resources.

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