INTRODUCTION
Mild Cognitive Impairment (MCI) is quite a dangerous disorder, which may lead to such serious complications as the development of the Alzheimer's disease. In actuality, MCI is a subject of detailed studies and many researchers attempt to understand the essence of the disease and possible ways of prevention and treatment of the disorder. MCI may have multiple manifestations but there is still no effective treatment to the disorder. At the same time, a considerable part of the population is vulnerable to the risk of the development of MCI. In actuality, the study of MCI is crucial because the prevention of the development of this disorder can help a large number of people, who are at risk and, what is more important, the prevention of MCI decreases the risk of the development of the Alzheimer's disease. In such a context, the early diagnosing and effective treatment of the disorder are essential. At the same time, the effectiveness of treatment of MCI depends on the early diagnosing because the earlier the disorder is diagnosed the easier is the treatment. At this point, it is worth mentioning the fact that today health care professionals do not have an effective method of treatment. Nevertheless, they can slow down the progress of MCI and divert the development of the Alzheimer's disease. Therefore, the study of the essence, causes and development of MCI as well as effective methods of treatment and prevention of the disorder are the major challenges health care professionals have to cope with, otherwise, a large number of people will face the risk of the development of MCI and the Alzheimer's disease as its possible complication.
DEFINITION
First of all, it is important to dwell upon the definition of the disease to understand its essence, development and possible complications. In fact, the definition of the disease will help to understand risks the population is exposed to and possible causes of the disease as well as treatment that can help to stop the development of the disorder or, at least, to minimize its negative effects. At this point, it is worth mentioning the fact that MCI is still under-researched and further detailed studies of the disorder are needed. Nevertheless, today, specialists (Feldman, et al., 2007) agree upon the essence of the disease. In this respect, the definition of Mild Cognitive Impairment (MCI) traditionally implies that MCI is the disorder which is an intermediate stage between the expected cognitive decline of normal aging and the more pronounced decline of dementia (Morris et al., 2001).
In fact, MCI may have multiple manifestations. Specialists (Birks & Flicker, 2006) argue that, as a rule, MCI is diagnosed in individuals, who have cognitive impairments beyond their age and education, but these impairments do not interfere in their regular life and activities. In such a way, MCI is positioned as a precursor of more serious and dangerous disorders associated with mental health, neurological disorders and other health problems, which may appear in patients with MCI as possible complications of the disorder. At this point, specialists (Grundman, et al., 2004) warn against the importance of the early diagnosing and treatment of MCI because they insist that complications of MCI emerge, if patients ignore their problems and do not call in a doctor and fail to start treating MCI.
In actuality, the risk of negligence of MCI from the part of patients is very high. MCI does not interfere in the regular life of patients. Therefore, inconveniences caused by the disease and the deterioration of patients' health often remain unnoticed by patients. As a result, the disorder keeps progressing until irrevocable changes occur to patients' health and serious complications, such as the Alzheimer's disease begin. In such a situation, the prevention of the development of MCI becomes crucial and patients should be aware of risks and threats associated with failure to diagnose and to start treating MCI at the early stages of the development of the disorder. This means that patients should be very careful in relation to their health and consult health care professionals as soon as they notice consistent deterioration in their health associated with MCI. Specialists researching the problem of MCI (Feldman, et al., 2007) argue that health care professionals and social workers should convey detailed information about the disorder to patients, especially aging ones.
POSSIBLE COMPLICATIONS
In order to understand the full extent, to which the development of MCI may be dangerous to human health, it is necessary to dwell upon the analysis of possible complications that MCI can provoke, especially if the impairment is not diagnosed at the early stage of its development and the treatment has not been started yet. At this point, it is possible to refer to recent studies dedicated to the problem of MCI and its effects on human health. One of recent studies has shown that individuals with MCI have an increased risk of developing Alzheimer's disease over the next few years, especially when their main problem is memory (Birks & Flicker, 2006). In such a way, patients, who have problems with their memory and their condition keeps deteriorating as MCI progress, their health problem can evolve and transform into the Alzheimer's disease.
On the other hand, specialist (Petersen et al., 1999) argue that not everyone diagnosed with MCI goes on to develop Alzheimer's. In other words, MCI does not necessarily lead to the development of the Alzheimer's disease. Therefore, patients diagnosed with MCI may not suffer from the Alzheimer's disease. The risk decreases even more, if patients are diagnosed at the early stage of the development of MCI and the treatment helps to prevent the development of the Alzheimer's disease as one of its most dangerous complications. In addition, the Alzheimer's disease develops as patients suffer from memory problems. This is why specialists (Birks & Flicker, 2006) recommend health care professionals to pay a particular attention to patients with MCI involving memory disorders because they are particularly vulnerable to the risk of the development of the Alzheimer's disease.
CAUSES
In such a situation, it is important to understand causes of MCI because through understanding of causes, it is possible to find out possible solutions to the health problem, including MCI. Specialists (Birks & Flicker, 2006) argue that MCI does not have one common reason, which is a starting point in the development of the disorder. Instead, specialists (Petersen et al., 2006) argue that MCI has multiple causes which contribute to the development of the disease. At the same time, some causes are natural, which are provoked by the physiological development of human body, whereas other causes may be external and provoked by the lifestyle of individuals, and other factors, which people can prevent.
Nevertheless, specialists focus on the search of major causes of MCI, among which they single out plaques and tangles, which are microscopic protein clumps characteristic of Alzheimer's disease (Feldman, et al., 2007). The accumulation of such clumps deteriorates blood circulation that affects the normal functioning of the brain and provokes the development of various impairments associated with MCI. At the same time, this cause of the development of MCI can provoke the further complication of the disorder, if it is not treated, to the extent that it can lead to the development of the Alzheimer's disease.
Furthermore, another cause of MCI may be Lewy bodies, which are microscopic clumps of another protein associated with Parkinson's disease, dementia with Lewy bodies and some cases of Alzheimer's disease (Petersen et al., 2006). Basically, this cause of the disease can provoke both the Parkinson's disease and the Alzheimer's disease, especially if MCI is not diagnosed and the treatment has not been started.
In addition, specialists argue that small strokes or reduced blood flow through brain blood vessels can also provoke the development of MCI (Birks & Flicker, 2006). Specialists (Grundman, et al., 2004) argue that small strokes and reduced blood flow through brain affects the normal functioning of the brain and leads to the steady development of various problems, including memory problem. Also, specialists, point out that shrinkage of the hippocampus, a brain region important for memory, can provoke MCI (Petersen et al., 2006). In such a situation, patients suffer from the steady development of MCI and consistent deterioration of memory, although these problems may remain being unnoticed by patients for a considerable time. On the other hand, the ignorance of this problem can provoke the development of the Alzheimer's disease.
Recent researches show that plaques (abnormal clumps of beta-amyloid protein) throughout the brain may provoke the development of MCI in patients (Birks & Flicker, 2006). In fact, clumps circulating through the brain increase the risk of the development of MCI and its complications consistently. In such a way, clumps increase the risk of the development of MCI and its complications.
In addition, specialists point out that enlargement of the brain's fluid-filled spaces (ventricles) is another cause of MCI (Feldman, et al., 2007). At this point, it is worth mentioning the fact that the development of the disorder can increase the risk of the development of complications. Patients need to start the treatment and prevention of the development of the disease at the early stage of its development.
Moreover, the reduced use of glucose, the sugar that's the primary source of energy for cells, in key brain regions is one of the major reasons for the development of MCI (Morris et al., 2001). In fact, the emergence of MCI cannot derive from one factor solely. Instead, the combination of multiple factors affects consistently the development of MCI. The combination of diverse factors mentioned above increase not only the risk of the development of MCI but also the development of complications that derive after the progress of MCI.
At this point, it is worth mentioning the fact that understanding of causes of MCI is crucial for its early diagnosing and for understanding of possible ways of treatment of the disease. As the matter of fact, the emergence of multiple factors that increase the risk of the development of MCI make patients vulnerable to the development of complications that result from the progress of MCI. In such a situation, the development of MCI increases risks of the development of complications and the early diagnosing of MCI can prevent the development of the Alzheimer's disease, the Parkinson's disease, and other complications.
RISK FACTORS
At the same time, along with major causes of MCI, specialists reveal major risk factors, which can increase negative effects of internal and environmental factors on the health of patients. In actuality, specialists (Petersen et al., 2006) argue that aging is one of the major risk factors, which threatens to patients because aging is one of the major factors contributing to the development of MCI. In this respect, it is worth mentioning the fact that the development of MCI is a natural process because aging leads to consistent changes in human body that make people vulnerable to the development of the disease, such as MCI. As people grow older, they cannot resist to the negative impact of their environment and internal changes in human body.
In addition, specialists (Feldman, et al., 2007) distinguish genetic factors as one of the risk factors that can provoke the development of MCI. In fact, people may inherit the development of the disorder but specialists (Morris et al., 2001) argue that genetic factors rather increase the risk of the development of MCI but they are not the primary cause of the disorder. They are just a risk factor that should be taken into consideration in the course of diagnosing the disease. Therefore, health care professionals should be aware of possible risks associated with genetic heritage of individuals.
Diabetes can be another risk factor that may provoke the development of MCI. Specialists (Morris et al., 2001) argue that diabetes leads to the misbalancing and poor regulation of the level of sugar and insulin in the blood that may provoke dysfunction of blood circulation and development of clumps affecting the brain. As a result, the risk of the development of MCI increases. Patients may suffer from serious health problems and the complication of diabetes can lead to cardio-vascular diseases and MCI. In such a way, the complications of diabetes can outgrow into serious health problems, among which MCI may be a transitional form to the development of the Alzheimer's disease and other health problems.
Furthermore, patients can provoke the development of MCI and increase its development through dangerous habits, such as smoking. In fact, smoking affects cardio-vascular system of human body that may lead to the development of negative trends and complications, including the appearance of major causes of the development of MCI. In such a way, smoking increases the risk of the development of MCI substantially because of its negative impact on human body and cardio-vascular system in particular. As a result, the supply of the brain with blood and blood circulation may deteriorate, clumps may appear and all these factors lead to the development of MCI.
At the same time, the psychological state of individuals is also very important. In this regard, specialists (Feldman, et al., 2007) argue that depression may be one of the risk factors, which can provoke the development of the disease. In such a way, depression is a risk factor because the deterioration of the psychological state of patients provokes changes in the physiological state of patients. As a result, if an individual is exposed to the permanent impact of stressful factors and suffers from depression his or her psychological problems can outgrow and transform into serious health problems, including MCI. In such a way, patients can undermine their physiological health under the impact of psychological problems.
In addition, such factors as the high blood pressure and elevated cholesterol also increase the risk of the development of MCI. These factors affect the functioning of cardio-vascular system and blood circulation in human body. In a long-run perspective, they may lead to irrevocable changes which can become causes of MCI. If the impact of these factors is not eliminated, patients are likely to develop MCI as well as its complications, including the Alzheimer's disease.
In addition, specialists (Petersen et al., 2006) argue that the lack of physical exercises is one of the major causes of the development of MCI. In fact, the poor or the lack of physical exercises affects the cardio-vascular system, as well as other vitally important systems of human body. As a result, patients develop numerous health problems and grow more and more vulnerable to the development of MCI.
Finally, specialists (Morris et al., 2001) stand on the ground that infrequent participation in mentally or socially stimulating activities may be risk factors contributing to the development of MCI. In fact, social and mental activity contributes to the active functioning of the brain and blood circulation, decreasing the risk of formation of clumps and emergence of other risk factors and causes of MCI. In such a way, the lack of social and mental activities should be taken into consideration while diagnosing MCI and developing its treatment methods.
DIAGNOSING
In actuality, specialists distinguish several basic methods of diagnosing of MCI. First of all, as a rule, specialists (Feldman, et al., 2007) recommend using neurological exam, including reflexes, eye movements, walking and balance, sense of touch. The neurological exam helps to identify major signs of MCI, which develop at the neurological level. Furthermore, blood tests help to rule out physical problems, such as a vitamin B-12 deficiency or an underactive thyroid glance (Morris et al., 2001). In such a way, the blood tests helps to identify physiological changes associated with the development of MCI at the early stage of the development of the disease. In this regard, it is very important to conduct the blood test in a combination of other methods of diagnosing MCI to prove the accuracy of the test and the diagnosis.
At the same time, the brain imaging is considered to be one of the most reliable methods, which are widely-applied by health care professionals to identify consistent changes in human brain and to identify first signs of progressing MCI (Feldman, et al., 2007). In fact, this method is very reliable and many specialists (Feldman, et al., 2007) agree that the brain imaging can provide health care professionals with accurate and reliable results in terms of MCI diagnosing. Finally, the mental status testing helps to identify changes in the mental health of patients and diagnose MCI. However, the combination of tests and diagnosing techniques should be used, especially the brain imaging to diagnose MCI accurately.
POSSIBLE TREATMENT
In actuality, specialists argue that there is currently no treatment for MCI approved by the FDA (Feldman, et al., 2007). Neverhteless, it is possible to refer to some of the studies conducted by different researches, which reveal some positive trends in the development of MCI treatment. For instance, results of a large, federally funded trial showed that 10 milligrams of donepezil (Aricept) daily can reduce the risk of progressing from amnestic MCI to Alzheimer's disease for about a year, but the benefit disappears within three years. The trial also showed that 2,000 international units of vitamin E daily do not reduce the risk of progressing (Feldman, et al., 2007). Two other studies have tested galantamine (Razadyne) as a treatment for MCI. These studies found no benefit, but the data showed an increased number of deaths in participants taking galantamine compared with those receiving the placebo (Feldman, et al., 2007).
In addition, many specialists (Petersen et al., 2006) recommend using Alzheimer's drugs to treat MCI, especially, if patients have problems with memory and face a risk of the development of the Alzheimer's disease. Moreover, treating other conditions, including high blood pressure, depression, sleep apnea can also help to treat MCI effectively.
At the same time, patients should remember about the active lifestyle and regular physical exercises as major factors that prevent the risk of the development of MCI. In addition, specialists recommend patients a diet low in fat and rich in fruits and vegetables, and omega-3 fatty acids (Feldman, et al., 2007). Finally, specialists recommend active involvement in social engagement and intellectual stimulation as preventive measures to stop the development of MCI and minimize its risk
CONCLUSION
Thus, it is obvious that MCI exposes patients to serious risks, including the risk of the development of the Alzheimer's disease. Today, there is no effective treatment to cure patients from MCI. Nevertheless, the active lifestyle of patients and their awareness of possible risks and threats associated with MCI can prevent the development of the disease. Finally, the early diagnosing of the disease is one of the major conditions of its successful treatment.
