Mild Cognitive Impairment(MCI), Dementia, and Alzheimer’s–these terms have have become part of my daily vocabulary.

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MILD COGNITIVE IMPAIRMENT was a term I didn’t know before Ralph’s diagnosis.

Defining Mild Cognitive Impairment (MCI) is what the Alzheimer’s Association calls “a work in progress” because research is still in relatively early stages.  Not all MCI leads to Alzheimer’s, and even for those (like Ralph) whose brain shows changes consistent with Alzheimer’s, there is no way to know when  MCI will turn into Alzheimer’s. But here are some basic, and I mean basic, definitions:

A General Definition, from the Mayo Clinic:

“Mild cognitive impairment (MCI) is an intermediate stage between the expected cognitive decline of normal aging and the more serious decline of dementia. It can involve problems with memory, language, thinking and judgment that are greater than normal age-related changes.”

Distinguishing Amnesiac and Nonamnesiac MCI, from the Alzheimer’s Association:

“MCI that primarily affects memory is known as “amnestic MCI.” With amnestic MCI, a person may start to forget important information that he or she would previously have recalled easily, such as appointments, conversations or recent events. 


“MCI that affects thinking skills other than memory is known as “nonamnestic MCI.” Thinking skills that may be affected by nonamnestic MCI include the ability to make sound decisions, judge the time or sequence of steps needed to complete a complex task, or visual perception.”

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 Dementia is a scarier term for me, perhaps because it is used to describe so many behaviors that frighten people.

According to the Alzheimer’s Association, “Dementia is not a specific disease. It’s an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person’s ability to perform everyday activities. Alzheimer’s disease accounts for 60 to 80 percent of cases.”

And the Mayo Clinic adds, “Dementia indicates problems with at least two brain functions, such as memory loss and impaired judgment or language, and the inability to perform some daily activities such as paying bills or becoming lost while driving.”

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And then there is ALZHEIMER’S, the term I once used in uneasy jokes about lost car keys. Not anymore.

The Alzheimer’s Foundation explains, “Alzheimer’s disease is a progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in loss of memory, thinking and language skills, and behavioral changes.
These neurons, which produce the brain chemical, or neurotransmitter, acetylcholine, break connections with other nerve cells and ultimately die. For example, short-term memory fails when Alzheimer’s disease first destroys nerve cells in the hippocampus, and language skills and judgment decline when neurons die in the cerebral cortex.
Two types of abnormal lesions clog the brains of individuals with Alzheimer’s disease: Beta-amyloid plaques—sticky clumps of protein fragments and cellular material that form outside and around neurons; and neurofibrillary tangles—insoluble twisted fibers composed largely of the protein tau that build up inside nerve cells.”

All the organizations and medical facilities agree, Alzheimer’s is not a normal part of the aging process. And at the moment it is incurable.