• image.alt
  • With Mayo Clinic health education outreach coordinator

    Angela Lunde

    read biography
The Mayo Clinic Diet Book, learn more

Free

E-newsletter

Subscribe to Housecall

Our weekly general interest
e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now

  • Alzheimer's blog

  • March 3, 2012

    Alzheimer's, dementia and MCI overlap, but have different meanings

    By Angela Lunde

28 comments posted

Alzheimer's Caregiving

Subscribe to our Alzheimer's Caregiving e-newsletter to stay up to date on Alzheimer's topics.

Sign up now

From time to time it's good to try and sort out the confusion among the terms mild cognitive impairment (MCI), dementia and Alzheimer's.

Cathy and several others asked about this in recent postings. Be assured that it's perfectly understandable if you're confused. The terms are often used interchangeably and can have varying interpretations even by healthcare professionals. Yet, their meanings are distinctly different. Let me attempt to clarify.

As we age, each of us has some changes in our thinking and memory, sometimes coined "senior moments." You may forget a person's name or a word, but recall it later in the day. You might misplace your glasses, keys, or wallet occasionally. Or maybe you find that you need to make lists more often to remember appointments or tasks. These changes in memory are generally minor and don't disrupt your ability to work, live independently, maintain normal activities and a social life.

MCI is used when cognitive changes (generally memory) are more frequent or exceed what's expected for an individual at a particular age. It can be thought of as a stage between normal forgetfulness due to age and the development of dementia.

In MCI, memory problems may be minimal to mild, and hardly noticeable to the individual. Writing reminders and practicing specific strategies can help a person compensate for these mild changes.

Symptoms of MCI can include:

  • Difficulty performing more than one task at a time
  • Difficulty solving complex problems or making decisions
  • Forgetting recent events or conversations
  • Taking longer to perform more difficult mental activities

Maybe most important is that a diagnosis of MCI means you're able to perform your usual daily activities with minimal change and little difficulty. When this is no longer the case, dementia may be the appropriate term to describe the condition.

Dementia isn't a specific disease. Instead, it describes a group of symptoms affecting intellectual and social abilities severe enough to interfere with daily functioning.

Memory loss generally occurs in dementia, but memory loss alone doesn't mean dementia. Dementia implies there are problems with other brain functions as well, and that more than one dementia symptom is present.

Symptoms of dementia can include:

  • Memory loss
  • Language problems
  • Inability to learn or remember new information
  • Difficulty with planning and organizing
  • Difficulty with coordination and motor functions
  • Personality changes
  • Inability to reason
  • Changes in behavior
  • Apathy or loss of interest in activities
  • Paranoia

Dementia symptoms can be due to many things such as an underactive thyroid, vitamin deficiency, brain tumors and depression. Even certain medications can cause dementia symptoms. However, if during a medical evaluation these reversible causes of dementia are ruled out, the probable cause of dementia symptoms may be due to Alzheimer's.

Alzheimer's causes brain changes that gradually get worse. Two abnormal structures called plaques and tangles are prime suspects in damaging and killing nerve cells, causing a steady decline in memory and mental function.

In older folks, Alzheimer's is the most common cause of progressive dementia symptoms. Symptoms are similar to the dementia symptoms listed above, which is why the terms are often used interchangeably. However, dementia is simply a set of symptoms, whereas Alzheimer's describes what is causing the symptoms.

Another reason it gets confusing is because the lines between normal age-related memory loss and mild cognitive impairment are blurred and overlap, as are the lines between MCI and early stage dementia caused by Alzheimer's.

But unlike Alzheimer's — where cognitive abilities gradually decline — persons with MCI may remain stable for years. And while not all persons with MCI go on to develop Alzheimer's, almost all cases of Alzheimer's start with MCI.

It's important to note that persons with MCI do have an increased risk of going on to develop Alzheimer's disease (or another form of progressive dementia).

However, science isn't able to predict whether someone with MCI will progress, remain stable or improve. Current research is focusing on models to predict who will get Alzheimer's and who won't, and on determining which folks with MCI will go on to develop Alzheimer's.

In the support groups here at Mayo Clinic, we often say to caregivers and persons with MCI or early stage dementia: Hope for the best but plan for the worst.

My message to you is to prepare for the possibility that things will progress — educate yourself, put plans and wishes in order, remain active and engaged, and get support. The Alzheimer's Association has a great booklet called "Living Well with MCI or Early Dementia."

You can find it at: www.alz.org/mnnd/documents/Alz_LIVING_WELL_Workbook_2011_web.pdf

And remember, planning for the future is not the same as living in the future. Your life is today — the present moment is all any of us have for certain.

28 comments posted

blog index

  • October 30, 2012 1:08 a.m.

    My family history is long on dememntias. PATERNAL: Grandfather & Aunt, Alzheimers, Cousin Parkinson's w/dementia. MATERNAL: Grandmother, Parkinson's, 2 great Aunts dementia, Mom, now showing dementia symptoms. At 59, I have been diagnosed with MCI, early stages, and have been given great hope of holding off further decline for years, due to the new meds on market. I have been encouraged to get more aerobics exercise, keep my brain active by playing cards, board & active games, crossword puzzles, Soduko, etc. Get online to Cognitive Building sites; I have been encouraged to stay socially active, responsible for helping others as well as myself, read and continue learning new skills. Caring for my father-in-law for 6 yrs w/Alzheimer's gave me great insite into learning to love the person he had become, getting past the anger and fear of losing who he had been. Spiritual Faith is the greatest strength I have found! Keeping family and friends close for a tight network of those you love and whom love you is utmost. Educate yourself on your diagnosis and accept the desease, rather than fighting it. Now I can get on with living every day to the fullest and never looking back with regret at what I didn't accomplish. I am a photographer and plan on publishing the book I have had in my mind for years. It will include soothing photos, words of encouragement and scriptures that give hope where dreams have been dashed by diagnoses. When I lose my mind, maybe it will give me

    - Deb

  • April 14, 2012 7:58 p.m.

    The screening test have come along way in the last 2 years. TheBCAT is much more sensitive for MCI/Dementia than is the outdated MMSE. You don't have to be a PHD or Psy.D to use this free tool either. It takes 15 minutes and has an online scoring program. I suggest you take a look at thebcat.com I also worry about the overuse of the term "sundowning" and how little this term contributes to actually solving a behavior problem. www.dementiabehavior.com

    - Matt

  • April 13, 2012 1:05 p.m.

    The environmental cause factor in Alzeimer's Disease: Could living in a house previously owned by a bird collector, many cats and dogs be part of such factor even though they had gutted the house before moving in. The Wife died of brain cancer a couple of years ago and now the husband has alzeimer's disease. The sister is blaming the house being the cause of brain diseases. Please reply. Thanks

    - fanny

  • March 14, 2012 6:55 p.m.

    While I very much appreciate anyone that differentiates the differences in dementia, this blog did not go far enough into describing the DIFFERENT KINDS OF DEMENTIA! As others have posted, it is critical to have the right diagnosis. My Dad had Lewy Body Dementia -- and some treatments for Alzheimers could cause additional problems for LBD. If you or your loved one has symptoms of dementia, please check out info on LBD and other types of dementia. They should not all be treated the same. http://www.lbda.org/content/10-things-you-should-know-about-lbd

    - Lori D

  • March 14, 2012 4:48 p.m.

    I just entered my husband of 56 years into a memory care facility for the 2nd time in 6 weeks. We had the trauma of taking him there, and 2 weeks later he developed pneumonia and spent 10 days in the hospital. Then back to the facility. I am so depressed today, I cannot function, I can see him sitting there so unhappy. He thought we were going home from the hospital. Sad, sad, sad. I have developed health problems from caring for him for 4 years, and have no choice, besides that, where will all the money come from? I will be broke in 3 years. I pray daily for devine intervention. Prayer is all we have as caregivers.

    - Betty

  • March 14, 2012 1:27 p.m.

    Question? I am wondering if Aphasia falls into the early warning signs of Alzheimer's. My father has had 1.5 years of lose of his words. This is progressing to lose of understanding. The doctors still have not given a diagnosis of Alzheimer's but we are all fearing the worst. He also is on dialysis. I wish I knew what path we are on?

    - Becky

  • March 13, 2012 1:59 p.m.

    Great article and advice. We certainly advocate education as a treatment modality for our clients and their family members who are living with Alzheimer's disease. http://bit.ly/wQjMqB

    - Jason

  • March 12, 2012 7:41 p.m.

    To Vicki, My heart goes out to you in your situation. It is very hard being a caregiver and watching your family member have such difficulty. A special nurse explained to me when I was caring for my mom with some type of Dementia that I was mourning and rightfully so. This is because the person that you once knew is no more that same person. Your husband is not the person he once was because of his disease. So you are rightfully mourning the husband you once had, the person he was. As far as your feeling guilty for not caring for him at home, you need to look at what is best for his care. If you continued to keep him at home with your physical situation, would he be cared for as well as where he is now? Yes, you would love him more than the ones who care for him now. But with your limitations now because of your health issues, who would be benefiting from your care for him at home? Probably neither of you. Just continue to show him the love you do when you can go to visit him. Your quality visits are more important to him than your trying to physically care for him 24/7. And it's okay to mourn. It's part of dealing with it. But please don't mourn because you can't do enough for him. You are doing all you can. That's what is needed.

    - Martha

  • March 11, 2012 3:07 p.m.

    Vicky I feel not only for you but WITH you. My darling wonderful husband has (Dementia?) diagnosed at timers as Alzheimer Disease. I too eventually had to place him in a care centre as I could no longer care for him myself as my physical strength would not allow. I visited him every day for 4 years and changed his care centre 4 times until I found where there was real care and kindness. Now I hgave had a motor accident and major surgery and see him only twice a week. This is the "living death". We MUST look aftern ourselves I know. I deprive myself of all sorts of activities as I am so heartsore that he cannot join my in anything. Things do not improve I am afraiod. It is the 'acceptance' of the situtasion that I cannot come to terms with and find we need friends who are in the dsame position as ourselves as others do not have the understanding needed to be companionable. That is why it is important to belong to a Society dealing with care-giving. Just carry on loving as before and te;ll them how much they mean to us. Be ever cheerful in front of them and pay kibnd attention to all they try to say and do. What elese? Go well Vicky, and others like you - there is nothing wrong with feeling guilty - but do try and put it behind you while you are doing all you can for your loved one. Pat. G. Cape Town South Africa

    - Pat

  • March 11, 2012 12:25 p.m.

    This was a great article. I just wanted to add a little insight to the MCI. I have been a caregiver for my Mom since 2/10. When my Dad was still alive, we knew something was not right with Mom. She exhibited some very strange behaviors, did not want to talk much, eating habits changed, and gradually started to not be able to handle the finances which she always had. My Dad took her in to get checked out after prodding from me and she was instantly diagnosed with Alzheimer's. After researching her symptoms on my own, I was not happy with the diagnosis, as she knew everything that was going on (in the present). It just took her awhile to process it. I spoke with a friend who is an Administrator at a facility and she told me where to take Mom to get another opinion. I am extremely grateful to her as Mom actually has Frontal Lobe Dementia, not Alzheimer's. It is very important to have the correct diagnosis so we treat our loved ones in the right way. See Mom does not dwell on the past, she does know what is going on now. Her language is slipping alot (aphasia), even though I have her in speech therapy once a week. Eventually, as time goes on her disease will look more and more like Alzheimer's, but for now, I at least know what I can expect from her FTD. Love and prayers to all of you caregivers!

    - Jackie

  • March 10, 2012 11:11 p.m.

    Since Alzheimer's is such a painful condition,one should be open to non-conventional methods too of handling it.I specifically refer to spiritual resources.My Nichiren Buddhist spirituality is a valuable resource that motivates me to deal with the possibility of such an illness.Medical professionals must make the effort to remain open about such resources-even though they may strike them as 'unscientific.The cost borne by both the sufferers and his family members is too intense.They need whatever help they can

    - sanjit

  • March 9, 2012 6:02 a.m.

    Dear colleague caregivers Angela you gave a great description of our dilemma. The medical continuum is from MCI to (Presumed) Alzheimer. But the bottom line is caregivers are dealing with a variety of symptoms that do not fit nicely into these diagnoses. The symptoms vary from person to person. My husband has had many doctors but only one (1) who was wise and understood and ordered the proper medications after observing him for 7 days in an inpatient hospice unit. The doctor ordered the medication (tools) to manage my husband at home. Ex of his behavior was just a few hours ago. At 3 AM he is up and wanting me to get up. I tried to suggest he return to bed. The agitation was escalating: he was walking in the hall and pounding his cane. I did get up and offered him a liquid dose of thorazine and within in a half hour he is back to baseline and his usual kind self: apologizing for his disruptive behavior and thanking me for helping him. Of course he is now asleep and I am sharing with you! Marie

    - Marie

  • March 8, 2012 11:11 p.m.

    I am constantly amazed at what my mate is able to do and understand as he has been diagnosed and is being treated for alzhiemers ( aricept 23) in my research I am finding he is falling more in the category of Lewy body. Is the Aricept the right meds for him????. How do we know???? Also a diagnosis of possible hydrosepholis is susepected. How do we know? It is all so confusing. Help if any one knows. Are there tests for each? Or is everything being lumped,into alzhimers?

    - Donna

  • March 8, 2012 10:37 p.m.

    www.alz.org/mnnd/documents/Alz_LIVING_WELL_Workbook_2011_web.pdf To Lydia, It takes a lot of paper! Angela has this book listed at the end of this blog. And to BONNIE, not to say you have problems, but please do not "ignore" and guess at what it is, find a reliable doctor, many things can cause these symptoms..including thyroid, Please educate yourself, your future depends on it. If you had a lump in your breast... would you decrease your sugar, I don't understand why people usually think it annot happen to them. Do yourself a favor. I know Angela, I said I was done blogging, I cannot help it, people need guidence!

    - cathy

  • March 8, 2012 9:39 p.m.

    My husband who is 76 was diagnosed a over a year ago with Alz/Dementia. Looking back he starting showing signs in 2005; which now I know were MCI.This last year it has gotten alot worse to the point where he got too aggressive for me to take care of and I had to put him in placement. It was one of the hardest decisions I have ever had to make and even to this day I get depprest wondering if I did the right thing. I was diagnosed with Breast Cancer 4 years ago and chose to have a mastectomy. Where they took out Lymphnodes and the breast, I have no strength in my right arm; so lifting on him and other things became impossible. Will I always have these feelings of guilt. Even though he is still very much alive; I am grieving as if he had died. Anyone else had this situation? Please send a reply.

    - vicki

  • March 8, 2012 5:32 p.m.

    Thank you... This was a very informative article. I have been worried that I too have some early signs. My daughter suggested that I am ADHD. That did seem to make sense. My mind is every where and sometimes I get lost in thought and others have noticed this too. My mother was never ADHD so maybe there is a chance for me. Thank you Barb~ Your comment about nutrition hit home. Sugar... Made me think. My mother may be a lot better if we can control this part of her diet. Have any of you watched "Forks over Knives". Diet may make us all a lot healthier. Netflix has it for instant download. I think the theory has merit. Take a look.

    - Bonnie

  • March 8, 2012 5:14 p.m.

    i hope everyone with alzheimer's all get well one of these days

    - melissa

  • March 8, 2012 5:01 p.m.

    My mother has been generally diagnosed with dimentia, being the sole caregiver is frustrating at times, but thanks to you and your soo helpful comments I have found comfort and help sorting out this disease, whatever it may be. Thank you! I'm so glad someone pointed to me to the newsletter to which I have been a subscriber for some time. A great resource.

    - Jonathan

  • March 8, 2012 3:37 p.m.

    I have been helping my husband for 4 years with his mother, whom I diagnosed with MCI, as the MD's are so reticent to put a label on her memory malfunction. We have been astounded at what a difference good nutrition makes in her functioning. It's still not perfect, she can't manage her own meds or keep a checkbook, but her functioning is significantly better when she's eating nutritious meals all day every day. When she's 'into the sugar,' it's immediately apparent to us.

    - Barb

  • March 8, 2012 12:39 p.m.

    The importance of nutritious foods should be emphasized in preventing and/or reversing memory loss. I'm sure by now everyone has heard about the benefits of organic Coconut oil. Here's several brain foods that Dr. Ron White suggests: 1-Beets: The amino acid phenylalanine is abundant in beets, and they help to strengthen your neuroconnections (brain cell connections from one cell to another). 2-Blueberries: One of the foods highest in antioxidants and “anthocyanins,” compounds, believed to help in the protecting brain cells from toxins. Antioxidants improve how the brain uses glucose and promotes stronger interaction between neurons (brain cells). 3-Broccoli: Broccoli is full of antioxidants and phytonutrients that help protect the brain tissue from toxins. 4-Carrots: High in beta-carotene help protect brain tissue from toxins. 5-Hot chilies: The fiery-tasting chemical capsaicin is in hot chilies. It stimulates circulation, opens your nasal passages, aids in digestion of food, and sends a feeling of euphoria straight to your brain. 6-Citrus fruits: High in vitamin C and other antioxidants. 7-Wild-caught Fish: the Omega-3 fatty acids help build and maintain myelin sheets in the brain cells. 8-Spinach is concetrated in iron which helps memory. 9-Legumes slow the absorption of extra glucose in the brain and help with concentration and alertness. I would use organic vegetables, fruits, and legumes of course!

    - Holly

  • March 8, 2012 11:54 a.m.

    I am a nurse who cares for Alzheimer's patients. The most challenged I've ever been was caring for my own father who was an MD diagnosed with dementia. My empathy for those caring for family members with Alzheimer's/ dementia is profound. It's made me a better care giver and has made it easier to put myself in my patient's families shoes. Education published with regard to expected personality changes, etc. like we receive from Mayo helps one feel they are doing all the proper for their family members is a life line, even for us nurses.

    - Lisa

  • March 8, 2012 11:32 a.m.

    I am a caregiver for my mom who has ALZ/dementia. Now I know the difference between the 2 terms. Thank you for this info.

    - Brian

  • March 8, 2012 11:13 a.m.

    My wife had an auto accident 2yrs ago and she hasn't really driven since.I don't think she really should be driving. She gets upset with me because we don't have a 2nd car. I am not sure if she that really wants to drive. I try to bluff and keep telling her she has a license, keys and our family car. She said she wants her own car and if I say "let's look for another car" she kind of says "We can't afford one". She feels totally dependent on me and feels she is losing her independence. She goes into periods of crying, upsetment and the atomsphere at home is very disturbing. Any ideas you folks have will be appreciated. Joe K

    - Joe K

  • March 8, 2012 11:12 a.m.

    I am a caregiver, from where I can print the booklet? Cathy is talking about? Love, Lydia

    - Lydia

  • March 8, 2012 10:44 a.m.

    My husband was first diagnoised April 2001 with dementia and has had Alzheimers for many years. He now has "sundowning", but it is all waking hours. There are so many people he sees, children around, etc. and no one is here but me all day. My son comes home after work to help. I slip off to bed for a little sleep, because I know he will have me up 4-5 times a night. He is also now urinating on carpet by bed and other places. Does not remember that he has eaten. Is this called "end stage alzheimers". I plan to keep him at home as long as I can, only care giver durint the day. Give me some pointers please. I do go to a support group that meets once a month.

    - Marva

Post a comment
Next page

  • Page:

  • 1
  • 2
  • Print

  • Share on:

  • Email

Advertisement


Text Size: smaller largerlarger