Written by Edward Shehab
Fact checked by The Brain Blog Team
As we age, it’s totally normal to feel like our memory is faltering. You may forget a name here and there, struggle to find a word, or lose your keys more often. So when is it appropriate to take a cognitive function screening to find out if your mental acuity is truly waning?
According to the Alzheimer’s Association, Mild cognitive impairment (MCI) “causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer's or another dementia.”
About 15 to 20% of Americans are affected by MCI, and while cognitive changes may be noticed by family members, people with MCI are often able to carry on with their basic daily responsibilities. However, they may experience memory loss, have issues performing complex tasks, and need assistance making difficult decisions.
There are several ways to determine the level of someone’s cognitive functioning, including online self tests, standard diagnostic screening tools, and patient examination.
Several online cognition self-tests are available, in both free and paid options, though the value of these tools isn’t currently scientifically supported by the medical research community.
One example, the Food for the Brain Cognitive Function Test seems to present a valid option for adults between the ages of 50 and 70, with an emphasis on homocysteine as a risk factor for cognitive impairment, dementia and Alzheimer’s disease.
Dementia Care Central also has an online test, which “provides concerned family members with a Clinical Dementia Rating score for their loved one. This score indicates the relative level of dementia the individual may have and what, if any, next steps might be taken.”
The majority of credible cognition screenings trusted by the eldercare and Alzheimer’s community are in-person screenings conducted by a medical professional.
A true Mild Cognitive Impairment diagnosis can only come from a physician, preferably a neurologist specializing in neurodegenerative diseases, after a thorough examination that includes cognition function screening. Most physicians use the SAGE test, as the starting point for determining a patient’s cognitive functioning as it relates to others their age.
Ohio University developed the Self-Administered Gerocognitive Exam (SAGE), “designed to detect early signs of cognitive, memory or thinking impairments. It evaluates your thinking abilities and helps physicians to know how well your brain is working.” It includes questions about the date, simple problem-solving, identification of drawn images, listing names of animals, and some drawing tests with basic instructions.
This type of cognition testing can help the patient and their physician determine if and what further medical testing should be done. You can view the test in English here: SAGE Evaluation
How do you know if you have Mild Cognitive Impairment? Family members may notice that you’re forgetting things more frequently or having difficulty with complex tasks like bill paying or solving day-to-day problems. The National Institute on Aging shares that early symptoms can include missing appointments, losing and forgetting things, and experiencing difficulty formulating words during conversation. It’s best to consult with your general practitioner when you notice symptoms like these, so that the cause or causes can be determined and self-care practices can be put into place to support future brain health.
Mild Cognitive Impairment can have several causes, from medication side effects and vitamin deficiencies to infections and neurodegenerative disorders. According to the Cleveland Clinic, “Cognitive impairment — which is also called ‘cognitive decline’ — can come on suddenly or gradually, and can be temporary or more permanent. It may or may not keep getting slowly worse; it all depends on the underlying cause or causes.”
Harvard Medical School says there is much we can do to reduce the risks of getting MCI, including the typical healthy lifestyle tips of eating right and exercising regularly. More specific suggestions include:
These suggestions will help you maintain your optimal physical (and brain) health. It takes effort to age well, but we’re sure you’ll agree that it’s worth it.
While a healthy diet can improve your overall health, it may not be enough to help minimize existing MCI or stave off future brain health issues. Fortunately, ongoing clinical research has demonstrated the value of supplementation for brain health.
Recent clinical double-blind placebo research has confirmed that cognitive performance can be improved in individuals with MCI, following supplementation with Omega-3s, Carotenoids and Vitamin E; this supplement is commercially known as Memory Health®.
This is the first study to identify trends in improved cognitive performance in individuals with MCI following supplementation with omega-3s, carotenoids and Vitamin E. The patients with MCI receiving the active intervention, in the form of the Memory Health brain health supplement, exhibited improvement in episodic memory and global cognition, while the placebo group remained unchanged or worsened for all measurements.
Omega-3 fatty acids (ω-3FAs), carotenoids, and vitamin E are important constituents of a healthy diet. While they are present in brain tissue, studies have shown that these key nutrients are depleted in individuals with mild cognitive impairment (MCI) in comparison to cognitively healthy individuals. Therefore, it is likely that these individuals will benefit from targeted nutritional intervention, given that poor nutrition is one of the many modifiable risk factors for MCI. Evidence to date suggests that these nutritional compounds can work independently to optimize the neurocognitive environment, primarily due to their antioxidant and anti-inflammatory properties. To date, however, no interventional studies have examined the potential synergistic effects of a combination of ω-3FAs, carotenoids and vitamin E on the cognitive function of patients with MCI. Individuals with clinically confirmed MCI consumed an ω-3FA plus carotenoid plus vitamin E formulation or placebo for 12 months. Cognitive performance was determined from tasks that assessed global cognition and episodic memory. Ω-3FAs, carotenoids, and vitamin E were measured in blood. Carotenoid concentrations were also measured in tissue (skin and retina). Individuals consuming the active intervention (n = 6; median [IQR] age 73.5 [69.5–80.5] years; 50% female) exhibited statistically significant improvements (p < 0.05, for all) in tissue carotenoid concentrations, and carotenoid and ω-3FA concentrations in blood. Trends in improvements in episodic memory and global cognition were also observed in this group. In contrast, the placebo group (n = 7; median [IQR] 72 (69.5–75.5) years; 89% female) remained unchanged or worsened for all measurements (p > 0.05). Despite a small sample size, this exploratory study is the first of its kind to identify trends in improved cognitive performance in individuals with MCI following supplementation with ω-3FAs, carotenoids, and vitamin E.