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Mild Cognitive Impairment (MCI) - Draft

Checked: 10-01-2025 by Rob Adams Next Review: 10-01-2027

Overview

Mild problems with memory or thinking that may be noticeable by the patient/ carer/ clinician, and may result in reduced score on cognitive testing, but not so much that they interfere with doing everyday tasks- ie no functional impairment. Problems may be with one or more thinking skills, for example memory or learning, reasoning, attention, language, levels of interest and motivation.

Diagnosis

Cognitive testing - should be carried out to assess the degree of impairment - see the Dementia - Assessment & referral page or CKS guidance (1).
Exclude other causes - see the Cognitive Disorders page for advice on excluding other causes of cognitive impairment.
Investigations - should be arranged for other causes as appropriate (may include bloods and brain imaging).

If no other causes are found and the patient does not meet the threshold for a diagnosis of dementia then consider a diagnosis of Mild Cognitive Impairment.

Risk of developing dementia

Every year, about one in ten people who have been diagnosed with MCI develop dementia. For half of people with MCI their symptoms do not get worse or get better (Alzheimer’s Research UK).

Management in primary care

Lifestyle advice

Address potentially reversible risk factors that may reduce the risk of progression to dementia including high blood pressure/obesity/ poor diabetic control/smoking/ excess alcohol/ physical inactivity/ loneliness/importance of correcting hearing and vision deficits to reduce dementia risk.

Medication

There is no licensed drug treatment for MCI (2). Medications may be given to treat underlying risk factors.

In particular, consider assessing QRISK3 and underlying vascular risk factors. Consider appropriate lifestyle and drug management.

Provide patient information:

Mild cognitive impairment (MCI) | Alzheimer's Society - link to further information about diagnosis and tips for living with MCI.
What is Mild cognitive impairment? - Alzheimer's Research UK - link to leaflet including advice to patients about getting involved in research.
Dementia: Helping your brain to stay healthy - pdf leaflet from the Alzheimer's Society.

Follow up

Arrange to review and repeat cognitive assessment after 6 months to look for evidence of progression of cognitive impairment that may indicate emerging dementia.

Referral

A diagnosis of MCI can usually be made in primary care and a referral is not required.

If there is diagnostic uncertainty then consider appropriate referral as advised in the Cognitive Disorders page.

Referral to the Dementia Wellbeing Service is usually not required and referrals may be returned if criteria are not met.

Resources

(1) Dementia | Health topics A to Z | CKS | NICE

(2) Mild cognitive impairment treatments - Alzheimer's Research UK

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.