Do you sometimes worry that your brain is not working as well as it should, or as well as it used to? Or have your friends or family noticed that your memory seems to be slipping?
It is normal to become more forgetful as we age. But consistent memory issues, or changes that seem to get progressively worse, may suggest a more serious condition. If those changes in how your brain functions are more significant than what is considered normal for your age, it could be a sign that you have mild cognitive impairment.
MCI may include problems communicating, remembering things, or using language, thinking clearly, or making good decisions.
In the early stage, changes in the way the brain functions are generally not bad enough to affect everyday life. Some people experience enough change to be diagnosed with MCI, but never get worse or develop dementia, while some eventually even get better. But sometimes, MCI gets progressively worse and becomes dementia.
So how can you tell if your memory slips are normal, or might be something else? If the changes are noticeable enough that they are bothering you, your best option is to talk to your health care professional.
Your doctor may recommend that you take one of two tests that are frequently used to assess brain function. Both tests involve answering simple questions, and remembering a variety of items as the test progresses.
The Mini-Mental State Exam has been a popular choice for doctors since it was developed in 1975. It takes about eight minutes to complete the test, which examines orientation, word recall, language abilities, attention and visuospatial abilities.
A newer test, known as the Montreal Cognitive Assessment, was introduced in 1996. This test takes slightly longer, at 10 to 12 minutes, and covers similar topics as the MMSE.
The MoCA is believed to be more sensitive in detecting small changes in brain function. This means that a very mild cognitive impairment that may be overlooked by the MMSE is more likely to be caught by the MoCA.
Researchers also recognize that MMSE results can be affected by a person’s level of education, language fluency, speech disorders or native cultural background. Those factors may also affect which test is more appropriate for your situation.
It is important to know that the researchers who developed the tests expected patients to be nervous about taking them, and adjusted the expected results to compensate for nerves. This means that there is no need to try to study for the test or worry that being nervous will alter your test result.
In fact, studying for the test may actually skew your test result and prevent your doctor from getting an accurate assessment of your cognitive health.
There is no pass or fail in these tests. They are simply a tool your doctor can use to decide the best course of action to help you if cognitive impairment is found. A diagnosis of MCI does not mean that you are stupid or are becoming stupid. It simply means that there are changes in the way your brain is working.
It is also important to note that while these tests can help to determine whether or not you have cognitive impairment, the tests cannot determine the cause or type of impairment. Your doctor will not be able to tell if you have the beginning stages of Alzheimer’s disease or some other type of dementia, based on these tests.
If you are experiencing enough symptoms to be concerned, it is important that you talk to your doctor. The sooner any type of cognitive impairment is diagnosed, the sooner you can take steps to slow or stop the progression, so your impairment does not get worse.
If you have questions about the health of your brain, or about the tests used to assess cognitive function, talk to your health care provider.
The New York Times. Is It Ordinary Memory Loss, or Alzheimer’s Disease? Jane E. Brody. Web. November 23, 2015.
Today’s Geriatric Medicine. MMSE vs. MoCA: What You Should Know. Lindsey Getz. Web. November 23, 2015.
Mayo Clinic. Mild cognitive impairment (MCI). Web. November 23, 2015.
Reviewed November 24, 2015
by Michele Blacksberg RN
Edited by Jody Smith