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Cognitive Decline & Impairment.

Cognitive Decline is mild changes in brain function causing people to have trouble remembering, learning new things, concentrating, or making decisions.

by Dr. Brent Agin, MD

Founder and CEO

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Cognitive decline refers to mild changes in brain function that cause people to have trouble remembering, learning new things, concentrating, or making decisions.  What would be called normal age-related cognitive change does not impair a person's ability to perform daily activities, although forgetfulness can still be quite annoying. Decline isn't as severe as cognitive impairment, which can be the result of damage, disease or an increased level of cognitive decline. There are several opportunities to help improve symptoms and slow progression. Age-related cognitive decline and cognitive impairment have been suggested to result from an increase in brain neuron (nerve cell) loss, which then contributes to imbalance of the brain’s ability to manage and fight inflammation and potential for further disease. Utilizing therapies that can support neuron health and help slow neuron loss can contribute to a reduction in symptoms and risk of neurodegenerative disease.

Mild cognitive impairment (MCI) is the 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. If you or a loved one start to become aware that memory or mental function has been progressively worsening, this could be considered MCI, but symptoms should not be severe enough to significantly interfere with your daily life and usual activities..

Some of the signs of MCI:

  • Becoming more forgetful
  • Forgetting important events such as appointments or social engagements.
  • Lose your train of thought or the thread of conversations, books or movies.
  • You feel increasingly overwhelmed by making decisions, planning steps to accomplish a task or understanding instructions.
  • Have trouble finding your way around familiar environments.
  • Family and friends notice changes in cognition.

There is no specific test to confirm a diagnosis of mild cognitive impairment (MCI). Your doctor will decide whether MCI is the most likely cause of your symptoms based on the information you provide and results of various tests that can help clarify the diagnosis.

Cognitive decline and MCI may increase your risk of later developing dementia caused by Alzheimer's disease or other neurological conditions. If discovered early and treated, people with cognitive decline and MCI never get worse and can actually improve dramatically.

Risk factors for cognitive decline & impairment include:

  • Increasing age, most common after age 70
  • Gene APOE-e4 that is linked to Alzheimer's disease
  • Diabetes
  • Smoking
  • High blood pressure
  • Elevated cholesterol
  • Obesity
  • Depression
  • Lack of physical exercise


Treating cognitive decline and impairment starts with lifestyle – sleep, diet, exercise and stress management. A healthy lifestyle can directly improve cognition and reduce risks of negative changes or disease of the brain. Beyond lifestyle, there are several supplements and medications that can help slow or resolve the symptoms of cognitive decline and even help protect you from cognitive diseases.

Research has found that just a six month regimen of aerobic exercise can reverse symptoms of mild cognitive impairment in older adults. There is also existing evidence that dietary factors including antioxidants, fatty acids, B vitamins are associated with lower incidence of cognitive decline, stroke, and dementia. Adding the other components of a healthy lifestyle will only increase this opportunity.

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