A Closer Look at How Cognitive Decline Happens

Mild lapses in memory, moments of forgetfulness, or trouble recalling a name you just mentioned are frustrating — but are they signs of something more? 

Cognitive decline is a complex and often misunderstood concept, marked by confusing terminology. For example, people usually use the terms mild cognitive impairment (MCI), dementia, and Alzheimer’s disease interchangeably. 

But there are subtle differences between these conditions, and knowing what’s what can help you figure out when to seek help.

At Rios Healthcare Associates in Houston and Sugar Land, Texas, Tomas Rios, MD, and Nicolin Neal, MD, along with our dedicated team, specialize in addressing these concerns. 

Here, we explain what happens biologically during cognitive decline, whether it’s inevitable with aging, and what you can do to reduce your risk.

Cognitive decline, dementia, and Alzheimer’s disease

To grasp the full scope of cognitive decline, let’s distinguish between MCI, dementia, and Alzheimer’s disease.

Mild cognitive impairment (MCI)

MCI involves noticeable issues with memory, reasoning, or other thinking skills. These changes go beyond the typical signs of aging but don’t interfere significantly with everyday life.

For instance, you might forget the date of a doctor’s appointment but still make it after checking your calendar.

Dementia

Dementia refers to a broad set of symptoms, including significant memory loss, difficulty with reasoning or language, and problems with daily activities. It’s more severe than MCI and often requires support or care from loved ones or professionals.

Alzheimer’s disease

This degenerative condition is the most common form of dementia. It begins with subtle symptoms of memory issues or confusion, later progressing to impairments in language, decision-making, and basic physical functions. 

Alzheimer’s involves abnormal protein buildups (amyloid plaques and tau tangles) in the brain, leading to irreversible damage.

What happens to your brain biologically during cognitive decline?

An aging brain undergoes inevitable changes, including occasional slower processing speeds or mild memory lapses. However, cognitive decline develops when there are significant disruptions to normal brain function. Here’s what happens:

Shrinkage of brain regions: Key areas, such as the hippocampus (responsible for memory), may shrink with age or due to conditions like Alzheimer’s.

Neuron damage: Neurons (brain cells) may lose the ability to communicate efficiently, disrupting memory retention and reasoning.

Beta-amyloid plaques and tau tangles: These abnormal protein deposits are hallmarks of Alzheimer’s. They damage and kill brain cells over time. 

Reduced blood flow: Poor circulation can limit the delivery of oxygen and nutrients to the brain and reduce its performance. Conditions like diabetes and hypertension can accelerate this process.

Inflammation: Persistent brain inflammation often accompanies cognitive decline, aggravating damage to neural pathways.

While some biological factors are inevitable with age, not all cognitive changes lead to dementia or Alzheimer’s.

Is MCI inevitable as you age?

The short answer is no. While minor memory lapses are relatively common, MCI isn’t a guaranteed part of aging: Genetics, lifestyle choices, and overall health play crucial roles. 

For example, regular physical activity, mental stimulation (such as puzzles or reading), and healthy eating habits can significantly reduce risk. You might slow cognitive decline or even reverse it in cases linked to issues like thyroid imbalances, sleep apnea, or depression.

Rios Healthcare Associates offers a comprehensive assessment to identify any reversible causes behind MCI, helping develop personalized plans to enhance your cognitive health.

How to tell when MCI becomes dementia

At first, it may be tough to tell the difference between mild cognitive impairment and more serious issues. Here are some early signs of dementia:

• Increased difficulty with complex tasks, such as paying bills or managing medication 
• Noticeable changes in personality or mood, such as heightened frustration or apathy 
• Forgetting familiar names, streets, or routines consistently 
• An increased inability to recognize familiar places or people 

If you or a loved one experiences any of these signs, meeting with Dr. Rios or Dr. Neal can provide clarity and peace of mind. We use advanced diagnostic tools and cognitive assessments to determine the extent of the issue and recommend appropriate interventions.

To learn more, call Rios Healthcare Associates or request an appointment online today. We’re here to offer valuable guidance and help you maintain a fulfilling, independent life.