What Is “Mild Cognitive Impairment"?

You hear the term now and again, “MCI”. Is it a diagnosis?


Doctors sometimes tell an older patient he has this, but no one seems to exactly pin down what it means. How mild is “mild” and what does it mean in terms of diminished capacity? Here it is in a nutshell:

Mild Cognitive Impairment refers to a degree of cognitive decline that is in between the cognitive changes associated with normal aging and those associated with clinical features of dementia.

Many people who get a diagnosis of MCI do go on to develop dementia but some do not. Here’s an example of a person who has MCI but does not have dementia.

Gertrude is 89 years of age and has been living alone in her own home. She got confused on her way home and was found driving on the wrong side of the road. A Good Samaritan brought her home. Fortunately, she did not hit any other cars. Cognitive decline was the cause of her confusion. She has mild cognitive impairment. She must not drive anymore, and she is willing to admit that she has to give up the keys.

She can’t remember what is in her bank account.


Recently there was fraudulent activity and a large amount of cash was stolen by hackers. She must also give up managing her own finances.

Gertrude is very independent.


She can take care of herself physically, though she does need her cane to walk. She wears hearing aids, but is able to follow the conversation around her very well when she can hear. She is clear about her likes and dislikes and communicates them emphatically. She is oriented to the date, and place where she is. Her short term memory is poor. She should not live alone any longer as she could forget to turn off the stove or the water faucet.

Gertrude is a good example of a person in what we call “the gray zone”. She is partly independent and partly dependent now. She is able to do a lot for herself but she needs help with her finances particularly. She appointed a licensed fiduciary to handle her bills and watch her bank accounts for her. She and the fiduciary went to both her banks to make sure the fiduciary’s name is on the accounts. She will have a companion live in with her to keep an eye on her safety but still allow her to do the things around the house and in the community she likes to do. The companion will do the driving. As she gets older, her care needs will probably escalate. But for now, she has just what she needs and she accepts that her independence is getting limited by her memory loss.

If you know someone who seems to have the same issues as Gertrude, you will be interested in Chapter 10 of my book The Family Guide to Aging Parents: Answers to Your Legal, Financial and Healthcare Questions . That chapter is Protecting Our Aging Parents From Abuse. I offer you five good tips, steps you can take now to keep your loved one safe. They are Protective Measures: talk with them about financial abuse, educate yourself, start having more frequent contact, snoop a bit, and check the mail from time to time. Get your copy now and learn more, with all you need to know to keep someone like Gertrude safe!