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Tests and diagnosis
By Mayo Clinic staffThere is no specific test to confirm a diagnosis of MCI. Your doctor will make a judgment about whether MCI is the most likely cause of your symptoms based on the information you provide and results of various tests that can help clarify the diagnosis.
Many doctors diagnose MCI based on the following criteria developed by a panel of international experts:
- You have problems with memory or another mental function, such as planning, following instructions or making decisions. Ideally, your own impressions are corroborated by someone close to you.
- You've declined over time. A careful medical history reveals that your ability has declined from a higher level. Again, this change is ideally confirmed by a family member or a close friend.
- Your overall mental function and daily activities are not affected. Your medical history also shows that your overall abilities and daily activities are generally not impaired, although specific symptoms may cause worry and inconvenience.
- Mental status testing shows a mild level of impairment for your age and education level. Doctors often assess mental performance with a brief test such as the Mini-Mental State Examination (MMSE). More detailed neuropsychological testing may shed additional light on the degree of memory impairment, which types of memory are most affected and whether other mental skills are also impaired.
- Your diagnosis is not dementia. The problems that you describe and that your doctor documents through corroborating reports, your medical history or mental status testing are not severe enough to be diagnosed as Alzheimer's disease or another type of dementia.
Neurological exam
As part of your physical exam, your doctor may perform some basic tests that indicate how well your brain and nervous system are working. These tests can help detect signs of Parkinson's disease, strokes, tumors or other medical conditions that can impair memory as well as physical function. The neurological exam may test:
- Reflexes
- Eye movements
- Walking and balance
- Sense of touch
Lab tests
Blood tests can help rule out physical problems that can affect memory, such as a vitamin B-12 deficiency or an underactive thyroid gland.
Brain imaging
Your doctor may order an MRI or CT scan to check for evidence of a brain tumor, stroke or bleeding.
Mental status testing
Short forms of mental status testing can be done in about 10 minutes. Commonly used tests include the following tasks and questions:
- Draw a clock face with the hands showing a time specified by the examiner.
- Name today's date and your location.
- Copy a design, such as two intersecting pentagons.
- Follow a three-step command.
- Remember a list of three words spoken to you by the examiner.
- Follow a written instruction.
- Write down a complete sentence.
- Count backward from 100 by sevens.
Longer forms of neuropsychological testing can provide additional details about your mental function compared with others' of a similar age and education level. These tests may also help identify patterns of change that offer clues about the underlying cause of your symptoms.
- Preventing Alzheimer's disease and cognitive decline. National Institutes of Health State-of-the-Science Conference Statement. April 26-28, 2010. http://consensus.nih.gov/2010/docs/alz/ALZ_Final_Statement.pdf. Accessed June 25, 2010.
- Petersen RC, et al. Mild cognitive impairment ten years later. Archives of Neurology. 2009;66:1447.
- Roberts RO, et al. Subjective complaints in mild cognitive impairment make a difference. Acta Psychiatrica Scandinavica. 2010;21:242.
- Wright JD. Mild cognitive impairment. http://www.uptodate.com/home/index.html. Accessed June 28, 2010.
- Winblad B, et al. Mild cognitive impairment — Beyond controversies, towards a consensus. Journal of Internal Medicine. 2004;256:240.
- Petersen RC. Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine. 2004;256:183.
- Essentials of a diagnostic workup. Alzheimer's Association. http://www.alz.org/professionals_and_researchers_14902.asp. Accessed June 30, 2010.
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