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When Mild Cognitive Impairment Becomes Early Stage Alzheimer's

by Carole Larkin, Alzheimer's & Dementia Expert
May 01, 2015

Question: What changes can one expect when mild cognitive impairment becomes early stage Alzheimer’s?

Answer: It’s an excellent question, and one that is not easy to answer.  First, did you know that mild cognitive impairment does not always progress to Alzheimer’s disease? Research to date has shown that only a minority of people with mild cognitive impairment continue on to full blown Alzheimer’s. About 20% will go on to develop Alzheimer’s. That means 80% won’t! Of course, these percentages are modified by the various definitions of mild cognitive impairment and early stage Alzheimer’s. Expect more changes in definition of these terms and maybe of the percentages as we learn more about the disease.

Let’s go on to the heart of your question. Well, the first problem in answering is that it’s tough to generalize because in truth, each person is their own unique individual always, with the disease or not. So it stands to reason that each person will progress in the disease in their own unique way. That said, generally deficits begin showing up in mild cognitive impairment in some or all of the following areas of cognition:

•    Executive functions such as logic and reasoning, impulse control, awareness of self in regards to deficits in thinking, empathy, initiation of ideas and actions, attention to task and personality.
•    Memory especially short term or recent memory, but even some long term memory
•    The ability to learn new things, taking more and more repetitions or practice to learn
•    Muscle Memory like control of body functions such as shuffling of feet while walking or increasing episodes of “not making it in time” to the bathroom.

In mild cognitive impairment people develop what I call “work arounds”; that is methods or tricks to help them accomplish things they used to be able to do in everyday life.   Probably the most common example of a work around is sticky notes everywhere reminding the person what he or she has to do. In mild cognitive impairment, people pay attention to the sticky notes and may even carry the notes with them during the day to make sure they do the things that are on the notes. Early stage Alzheimer’s would be in this example, people write the notes, but then don’t think to consult them or forget to consult them and they don’t do the things the notes say to do.  That’s about the best example I can think of to show the difference between mild cognitive impairment and early stage Alzheimer’s. The “work arounds” no longer consistently work, and the person begins losing the ability to function in many areas of their daily lives.

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Carole Larkin MA, CMC, CAEd, QDCS, EICS is a geriatric care manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. Her company, ThirdAge Services LLC, is located in Dallas, TX.

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