Mild cognitive impairment is a decline in memory or thinking that is greater than expected for age but still lets the person manage daily life on their own. Some people stay stable or improve, while others progress to dementia, so follow-up matters.
Key symptoms
- Forgetting recent events or conversations more often
- Losing items or repeating questions
- Trouble finding words or following complex tasks
- Still independent in daily activities
What you find on exam
- Cognitive screen such as the Mini-Cog or MoCA
- Neurological exam for focal signs or parkinsonism
- Mood screening for depression
- Hearing and vision check
Tests
- Vitamin B12, thyroid tests, metabolic panel and blood count
- Review of medicines that affect thinking, such as anticholinergics and sedatives
- MRI brain to look for stroke, tumor or hydrocephalus
- Neuropsychological testing for detailed assessment
Treatment basics
- Treat reversible causes and stop harmful medicines
- Regular exercise, social contact and mental activity
- Control blood pressure, diabetes and hearing loss
- Repeat cognitive testing about once a year
- Plan ahead: driving safety, finances and advance directives
Red flags
- Rapid decline over weeks to months
- Sudden confusion suggesting delirium
- New focal weakness, falls or gait change
Practice it in Making Synapses
Making Synapses cases
Related guides
Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations; AAMC Core Entrustable Professional Activities (Core EPAs). Written by Making Synapses. Making Synapses is not affiliated with these organizations.