The 4 ‘red flags’ that differentiate dementia from MCI

There’s a lot of confusion out there over what MCI is and what dementia is, and what the difference between them is and how you can tell?

And it’s not just the people with MCI who are confused. Doctors often add to the confusion.

Either they don’t seem to quite understand it all that well themselves, or they do a poor job of explaining it.

So when you come across a doctor who can really cut through the confusion and explain this in a simple, understandable way, that’s a really good thing. Which is why I want to share the insights of Dr. Jo Cleveland of the Wake Forest Baptist Medical Center.

Not only does she lay it out clearly, but she goes on to explain the four red flags that can help show when MCI may be progressing to dementia, and that’s a good thing to know.

Hi, I’m Tony Dearing, of GoCogno.com, the website for people with mild cognitive impairment.

If you follow my work, you know that I am not anti-doctor. I am always encouraging you to be a partner with your doctor in health. If you have a good doctor who really understands MCI and does a good job of communicating it to you, you are really fortunate.

But that still seems to be the exception. In my experience, rarely does a person walk out of the doctor’s office having just been diagnosed with MCI and say, “OK that was really hard to hear, but at least I clearly understand what I’m dealing with and I know what I need to do to cope with it.”

Which is why I’m always glad to come across a doctor like Jo Cleveland, who is a geriatrician and the medical director for the Healthy Aging and Brain Wellness Clinic at Wake Forest Baptist.

She’s the subject of a helpful article that clearly explains the three degrees of memory loss:

  • SHORT-TERM MEMORY LOSS
  • MILD COGNITIVE IMPAIRMENT
  • DEMENTIA

And here are some key take-aways that I want to share with you today. First, she says, don’t think of these as the stages of memory decline, because that implies that each leads to the next, and that’s not necessarily so.

The second takeaway is that according to Cleveland, there are gray area where it’s hard to tell, so yes, that does add somewhat to the confusion.

“In early MCI you’re going to be a lot like a person with normal aging memory loss, and in late MCI you’re going to be a lot like a person with dementia,” she says.

Takeaway No. 3 is Cleveland’s explanation of the important differences between MCI and what’s normal, age-related short-term memory loss. They include:

  • THE MEMORY LOSS IS MORE PRONOUNCED.
  • LANGUAGE PROBLEMS ARE MORE COMMON.
  • PEOPLE WITH MCI ALSO MIGHT NEED MORE HELP WITH A MULTI-STEP PROCESS LIKE PLANNING A TRIP.

The fourth takeaway is one that I hadn’t previously heard explained quite this way. She identifies what she calls the four “major red flags.”

“Four things – money, medications, meals and mobility, by which we mean driving — are major red flags that I talk to patients and families about,” Cleveland says. “If someone is starting to have trouble with one or more of these they need to be evaluated.”

But again, it’s important to remember that most people with MCI don’t progress. Many are able to halt their memory loss and stabilize at MCI, and some improve or even return to cognitively normal.

I wish every person with MCI had a doctor as wise and helpful as Dr. Cleveland. At the very least, anyone can benefit from what she has to say, and the link to the article is below.

I encourage you to read it, and I hope to see you again next week. Until then, as always, be kind to your mind.

Read the full article featuring Dr. Cleveland here: Cognitive Decline Eventually Affects Everyone, Just Not to the Same Extent

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