In this poll, Mrs. M was a 72-year-old woman who presented to the cardiovascular (CV) clinic with reports of increasing forgetfulness manifested as trouble remembering names and word-finding difficulties.

The poll results are:

Of a total of 89 votes, most (76%) thought that this was a case of mild cognitive impairment (MCI) versus dementia (6%), with some thinking it was possibly age related (18%).

Explanation
Mrs. M had subjective reports of memory deficits and her intimate contacts have noticed a decline. Age-related cognitive decline is differentiated from mild neurocognitive disorder or MCI by objective testing. In this case, her scores on the Mini-Cog and Montreal Cognitive Assessment (MoCA) tests indicate that she could have MCI. Moreover, she continues to be independent with all her activities of daily living (ADLs) but is starting to have problems with some of her instrumental ADLs (IADLs) (managing medications).

In these cases, a cognitive health assessment with an interview (patient and knowledgeable informant) and objective testing is necessary to reach the diagnosis. A person with a major neurocognitive disorder (dementia) will have significant cognitive decline that interferes with independence in everyday activities. Mrs. M should not be classified as having dementia because there is no significant change in her IADLs at present. However, her cognitive and functional changes should be monitored because people with MCI might progress to dementia.

To further assess and monitor Mrs. M's functional decline, a functional activities questionnaire would be a useful tool.

The population of older adults seen in CV practices with multiple chronic conditions and accompanying cognitive dysfunction is growing. Learn more in the expert analysis Cognitive Function in Older Adults With Cardiovascular Disease(s).

Clinical Topics: Cardiovascular Care Team, Geriatric Cardiology, Sleep Apnea

Keywords: Aged, Activities of Daily Living, Mental Status and Dementia Tests, Cognition Disorders, Cognition, Dementia, Memory Disorders, Geriatrics

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