Caring for Dad, from near and afar – Simon’s story
Simon, who has lived in New Zealand for two decades, discusses how he cares for his dad who has Alzheimer’s disease and lives alone in the UK.
Mild cognitive impairment, or MCI. refers to small deteriorations in cognition (mental abilities) that, while noticeable, do not interfere too greatly with your everyday life. The changes are greater than would be expected with normal ageing.
The symptoms of MCI include:
- difficulty remembering dates and times
- difficulty finding names and words
- leaving tasks unfinished, such as cooking and DIY
- easily losing concentration, eg when reading or paying for shopping
- losing track of what you want to say
- changes in social behaviour, eg becoming more subdued or extroverted
- changes in mood and emotions
- changes in judgement, eg judging when it is safe to cross the road
- getting lost or feeling more anxious when out and about
- losing the confidence to go out and do the things you used to enjoy
Your family, friends and colleagues may notice these changes and comment that you seem different from how you usually are.
Not everyone experiences all of the symptoms of MCI, and you may feel the effects more on some days than on others, for example if you are tired or stressed.
The changes associated with MCI can have many different causes, and there may be more than one. These include:
- vitamin deficiency
- underactive thyroid
- infections
- lack of sleep
- medication side effects
- menopause
- stress, depression or anxiety
- heart disease
- some autoimmune conditions, such as rheumatoid arthritis, lupus, Crohn’s disease, type two diabetes and multiple sclerosis
MCI and dementia are not the same. Unlike MCI, which may be temporary and can often be improved with the right interventions, dementia is caused by permanent damage to the brain and will worsen over time. However, in some cases MCI can be an indicator of the early stages of dementia.
Being diagnosed with MCI does not mean you will definitely develop dementia, but it can increase the risk. It is not currently possible to predict who will develop dementia after a diagnosis of MCI.
If you have symptoms of MCI, make an appointment with your GP. If possible, take a family member or friend with you as they can discuss the changes they have noticed.
The GP should ask about your symptoms and how they are affecting you and carry out some simple checks, including:
- blood pressure
- heart rate
- physical checks, eg of movement, coordination and reflexes
- blood tests
- basic tests of memory, concentration and thinking, eg asking you to name some common objects; remember and recall an address; and complete a simple drawing (often a clock face)
If these checks identify an underlying cause of your symptoms, these can often be managed with medication, lifestyle changes or talking therapies.
However, if the GP cannot find any pre-existing conditions and feels that the symptoms you are experiencing are not simply normal age-related changes, they may refer you to a memory clinic for further assessments.
This may result in a diagnosis of MCI or – if the symptoms and changes are more severe – a diagnosis of dementia.
There is no specific treatment for MCI, but if there is an underlying health problem like an underactive thyroid, managing this well – including keeping up with regular testing and reviews and taking any medication as prescribed – may improve the symptoms.
Making some lifestyle changes could also prevent MCI worsening and improve your ability to cope with everyday life.
- Try to exercise regularly – ideally five days a week for 30 minutes at a time
- Keep socially active, eg by meeting up with friends, taking part in activities outside the home, or volunteering
- Aim to follow a healthy, balanced diet – the NHS Eatwell guide may be helpful
- Keep hydrated – try to drink at least six to eight glasses of fluids per day
- If you drink alcohol, keep within the recommended guidelines: please see Drinkaware for advice
- If you smoke, try to stop – NHS stop smoking services may be helpful
- Do not take recreational drugs
- Look at boosting your brain health, eg with puzzles, card games, board games, learning a language
It is not always possible to stop MCI worsening, but there are steps you can take to help reduce the symptoms and their impact on your life.
- Follow a consistent daily routine, eg by waking, having meals and going to bed at the same time each day
- Look for ways to make everyday life easier, eg by shopping in smaller supermarkets, using a calendar to keep track of daily activities, and setting reminders on your phone
- Take your time over activities such as projects at work: break them down into smaller steps so they are not overwhelming
- Make clear plans for things that you need to do, eg driving to an unfamiliar place, going on holiday or managing finances
- Keep up with health checks, medication reviews, eye tests and hearing tests
- Ask for help from family and friends if you need it, and be specific about what you need help with, eg shopping, attending an appointment or looking after children to give you a break
- If you feel able, tell your employer about your diagnosis so they can put support in place at work if you need it
- Unlike with dementia, you do not always have to inform the DVLA (DVA in Northern Ireland) of a diagnosis of MCI, but if you, or your family or friends, feel it is affecting your driving, you must notify them. They may request a medical report from your GP or ask you to take a driving assessment
Following a diagnosis of MCI, your GP should invite you for a review after 12 months – if you are not contacted, or if you notice a worsening in your symptoms before then, you can book an appointment yourself.
It is a good idea to keep a record of any changes and symptoms you are noticing, especially if you or your family and friends think they are worsening.
If you are eventually diagnosed with dementia, the memory clinic will make a plan for your ongoing care and support, such as:
- medication (if suitable)
- a needs assessment and home assessment from social services
- support groups for people with dementia
To speak to a dementia specialist Admiral Nurse about mild cognitive impairment or dementia, please call our free Helpline on 0800 888 6678 (Monday-Friday 9am-9pm, Saturday and Sunday 9am-5pm) or email helpline@dementiauk.org or you can pre-book an appointment by phone or video call.
Dementia UK resources
Employment and young onset dementia
Getting a diagnosis of young onset dementia
Call the Dementia UK Helpline
Our free, confidential Dementia Helpline is staffed by our dementia specialist Admiral Nurses who provide information, advice and support with any aspect of dementia.
