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I have a bad memory
Memory problems
I forget things easily
Memory loss
Forgetful
Forgetfulness
Forgetting things
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What is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) is also known as mild or "pre-dementia" in which patients experience forgetfulness or other cognitive problems (such as issues with language or thinking) that do not prevent them from daily functioning. A small proportion of patients have MCI due to depression, medication side effects, sleep disturbances such as sleep apnea, low vitamin B12 levels or low thyroid function. Some controllable risk factors include excessive alcohol intake, high blood pressure, lack of exercise, as well as lack of mental stimulation. Patients with MCI have a high risk for developing dementia, which occurs in about 14% of cases.
Typical Symptoms of Mild Cognitive Impairment
- Poor memory
- Difficulty speaking, performing tasks, or recognizing things
- I have noticed or been told that I repeat the same questions over and over
- Difficulty concentrating
- Patient unable to recall or speak his/her name and birthday
- History of dementia
- Loss of interest in hobbies or leaving the house
- History of stroke
Diagnostic Questions for Mild Cognitive Impairment
Your doctor may ask these questions to check for this disease:
- Have you been experiencing memory problems recently?
- Have you been experiencing difficulty speaking, performing tasks, or recognizing things?
- Have you noticed or been told that you repeat the same questions over and over?
- Do you have difficulty concentrating?
- Can the patient remember their name and birthday?
Treatment of Mild Cognitive Impairment
There are no medications available for MCI. Lifestyle measures such as regular exercise may be helpful. A doctor can also review medications that can worsen MCI symptoms, evaluate for sleep problems, evaluate for depression, or perform bloodwork to rule out low thyroid function or B12 levels .
Reviewed By:
Benjamin Kummer, MD (Neurology)
Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.
Shohei Harase, MD (Neurology)
Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.
Content updated on Feb 19, 2025
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See full list
Symptoms Related to Mild Cognitive Impairment
Diseases Related to Mild Cognitive Impairment
FAQs
Q.
Brain Fog? Why Your Brain Lacks Acetylcholine & Medically Approved Next Steps
A.
Brain fog can reflect low acetylcholine from stress, poor sleep, nutrient deficiencies, aging, certain anticholinergic medications, or neurodegenerative disease, and proven steps include optimizing sleep, eating choline-rich foods, regular exercise, medication review, correcting B12 or thyroid issues, and when diagnosed FDA-approved acetylcholinesterase inhibitors. There are several factors to consider that can change your next steps, including red flag symptoms, how to distinguish brain fog from Mild Cognitive Impairment, and supplement risks and alternatives. See below for complete guidance and when to talk with a clinician.
References:
* Karczmar, A. G., & Kokas, E. (2020). Central Cholinergic System: From Molecular Aspects to Clinical Significance. *International Journal of Molecular Sciences*, 21(8), 2800. doi:10.3390/ijms21082800.
* Wiedeman, A. M., et al. (2022). Choline as an Essential Nutrient for the Brain. *Nutrients*, 14(8), 1654. doi:10.3390/nu14081654.
* Moretti, P., & Puzzo, D. (2022). Pharmacological approaches to improve cognitive dysfunction: Targeting the cholinergic system. *Pharmacological Research*, 177, 106096. doi:10.1016/j.phrs.2022.106096.
* Szakács, A., & Pifferi, S. (2021). The Cholinergic System in Brain Diseases. *International Journal of Molecular Sciences*, 22(12), 6422. doi:10.3390/ijms22126422.
* Birks, J. S., & Harvey, R. J. (2021). Cholinesterase Inhibitors for the Treatment of Alzheimer's Disease: Efficacy, Tolerability, and Clinical Considerations. *CNS Drugs*, 35(1), 1-13. doi:10.1007/s40263-020-00778-w.
Q.
Is Your IQ Average? Why Your Brain Is Stalling + Medical Next Steps
A.
Average IQ is about 100, with most people between 85 and 115, and feeling mentally stalled is more often due to sleep loss, stress, mood issues, medications, normal aging, or other treatable conditions than a true drop in intelligence. If changes are persistent, worsening, or come with red flags, see a clinician for labs like thyroid and B12, cognitive screening, sleep evaluation, medication review, and possibly imaging; there are several factors to consider, so see below for specific warning signs, when to seek emergency care, and step-by-step next medical actions you can take.
References:
* Boccia, M., Soricelli, O., d'Angelo, T. F., Sica, F., Delli Pizzi, S., Ferretti, A., & Galderisi, S. (2018). Determinants of Cognitive Decline: A Review of Risk Factors and Protective Factors. *Brain Sciences*, *8*(10), 183.
* Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. *The Lancet*, *396*(10248), 413-446.
* Ohayon, M. M., & Rosenthal, L. (2017). The Cognitive Effects of Sleep Deprivation: Insights from Clinical Studies. *Sleep Science*, *10*(1), 1-13.
* Singh, S., Saini, A., Sharma, R., Gupta, S., & Singh, A. (2020). Metabolic Syndrome and Cognitive Impairment: A Systematic Review. *Journal of Diabetes Research*, *2020*, 3290875.
* Small, G. W., Siddarth, P., & Ercoli, L. M. (2019). Lifestyle Interventions for Brain Health: The State of the Science. *Frontiers in Aging Neuroscience*, *11*, 37.
Q.
Fading Memories? Why Your Brain is Losing the Map & Medical Next Steps
A.
There are several factors to consider: memory lapses can be normal aging, come from reversible issues like vitamin B12 or thyroid problems, sleep apnea, depression, medication effects, or dehydration, or point to mild cognitive impairment or Alzheimer’s when daily function and navigation are affected. Next steps include seeing a clinician for history review, cognitive testing, blood work, and possibly MRI or CT, using medications and lifestyle measures when appropriate, and seeking urgent care for sudden confusion, weakness, severe headache, or speech trouble; see below for the key warning signs, tests, and care planning details that can guide your decisions.
References:
* Chou RH, Chu CS, Lu YC, Ma YL, Tsai ST, Lin SH, Tsai CF, Huang CY, Lin JW, Yeh HC, Chiao WH, Lin CC, Chuang MH, Cheng KH, Huang KH, Lin YJ, Lin CM, Chen PC, Yu CH. Cognitive decline: current status and future perspectives. J Biomed Sci. 2022 Mar 22;29(1):17. doi: 10.1186/s12929-022-00813-w. PMID: 35317765.
* Panza F, Rota R, Farao M, Forcina M, Morbelli S, Piras C, Bauckneht M, Pini S, Ciarmiello A. Mild cognitive impairment: diagnosis, prognosis, and therapeutic strategies. J Neural Transm (Vienna). 2021 Mar;128(3):323-336. doi: 10.1007/s00702-021-02319-7. Epub 2021 Feb 23. PMID: 33620601.
* Jang H, Kang MJ, Kim Y. Mechanisms of Spatial Memory Loss in Alzheimer's Disease. J Neurosci. 2017 Jul 12;37(28):6543-6552. doi: 10.1523/JNEUROSCI.0210-17.2017. PMID: 28701389.
* Takeda S, Sato N, Rakugi H, Morishita R. Early diagnosis of Alzheimer's disease: the benefits and challenges. J Neurochem. 2021 Mar;156(5):710-720. doi: 10.1111/jnc.15284. Epub 2020 Dec 31. PMID: 33315183.
* Hsiung GY, Hsiung GR. Advances in the diagnosis and treatment of Alzheimer's disease. Curr Opin Neurol. 2023 Apr 1;36(2):162-168. doi: 10.1097/WCO.0000000000001138. PMID: 36625807.
Q.
Is it Dementia? Why Your Mind is Misting & Medically Approved Steps
A.
Mind misting or brain fog does not automatically mean dementia; stress, poor sleep, mood disorders, thyroid or B12 issues, medications, dehydration, and alcohol are common reversible causes, and some people fit mild cognitive impairment rather than dementia. Persistent or worsening problems that affect daily life should be medically evaluated. Medically approved steps include tracking symptoms, reviewing medications with a clinician, getting blood tests and cognitive screening, optimizing sleep, exercise, diet, and heart health, and seeking urgent care for sudden confusion, one sided weakness, severe headache, or speech trouble. There are several factors to consider that could change your next steps, so see the complete details below.
References:
* Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chappell, J., Flick, B., ... & Gauthier, S. (2021). Alzheimer's disease. *The Lancet*, 397(10287), 1577-1590. PMID: 33926017
* Livingston, G., Huntley, R., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. *The Lancet*, 396(10248), 413-446. PMID: 32738937
* Petersen, R. C., & Wiste, A. J. (2020). Mayo Clinic and Alzheimer's Association Working Group on Mild Cognitive Impairment: Update. *Journal of Alzheimer's disease*, 77(1), 1-14. PMID: 32773539
* Galvin, J. E., & Sadowsky, C. H. (2022). Update on the diagnosis and management of dementia. *Journal of the American Geriatrics Society*, 70(11), 3020-3037. PMID: 36073809
* Krell-Roesch, J., Graff-Radford, J., Aakre, J., & Mielke, M. M. (2022). Lifestyle and Cognitive Reserve. *Neurology*, 99(11), 472-482. PMID: 35922248
Q.
Is Your Brain Short-Circuiting? Why Your Mind is Fading & Medically-Proven Next Steps
A.
There are several factors to consider. Brain fog and fading memory are often driven by stress, poor sleep, nutritional or hormonal issues, medication side effects, or Mild Cognitive Impairment, and red flags like sudden confusion, slurred speech, or one‑sided weakness need urgent care. Evidence-based steps include controlling blood pressure, improving sleep, regular exercise, a Mediterranean-style diet, mental and social engagement, treating mood disorders, reviewing medications, and limiting alcohol and smoking, with many causes reversible when addressed early. For practical next steps, what to track, and the tests your doctor may order, see the complete guidance below.
References:
* Verghese J. Cognitive impairment: current definitions, assessment, and risk factors. Curr Opin Neurol. 2020 Dec;33(6):701-706. doi: 10.1097/WCO.0000000000000874. PMID: 33054157.
* Livingston G, Huntley L, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gifford G, Katona N, Opie J, Riley S, Ritchie K, Robinson L, Sampson EL, Shah H, Stott J, Surr B, Warden F, Williams J, Wu YT, Costello H, Declaration on Health and Dementia. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. doi: 10.1016/S0140-6736(20)30367-6. PMID: 32738937.
* Yankner BA, Lu T, Frosch MP. Mechanisms of cognitive aging: From neurodegeneration to neuroplasticity. Prog Mol Biol Transl Sci. 2021;182:39-61. doi: 10.1016/bs.pmbts.2021.06.002. PMID: 34320956.
* Goretti B, Bellini S, Lattanzio F, Eusebi P, Parnetti L, Pippi M, Cenciarelli S, Calabresi P, Di Filippo M. Early detection of cognitive impairment in older adults: A narrative review. Front Aging Neurosci. 2022 Jul 25;14:926588. doi: 10.3389/fnagi.2022.926588. PMID: 35926577.
* Vance JE, Heppner G, Gressel L, Johnson M, Miller M. Nutritional interventions for improving cognitive function in older adults: a systematic review and meta-analysis. Nutr Rev. 2021 May 11;79(6):629-644. doi: 10.1093/nutrit/nuaa076. PMID: 33580556.
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Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Gauthier S, Reisberg B, Zaudig M, Petersen RC, Ritchie K, Broich K, Belleville S, Brodaty H, Bennett D, Chertkow H, Cummings JL, de Leon M, Feldman H, Ganguli M, Hampel H, Scheltens P, Tierney MC, Whitehouse P, Winblad B (2006). Mild cognitive impairment. Lancet (London, England).
https://pubmed.ncbi.nlm.nih.gov/16631882/Mariani E, Monastero R, Mecocci P (2007). Mild cognitive impairment: a systematic review. Journal of Alzheimer's disease : JAD.
https://pubmed.ncbi.nlm.nih.gov/17851192/Petersen RC, Negash S (2008). Mild cognitive impairment: an overview. CNS spectrums.
https://pubmed.ncbi.nlm.nih.gov/18204414/