25 de July de 2025
Cognitive decline: key facts for early detection and treatment
Cognitive decline is a process involving the loss of mental functions such as memory, language or planning ability. It mostly affects older adults, although it can occur at any age. Recognising the early signs and understanding the different stages of cognitive decline is essential to prevent its progression to more severe forms.
“We aim to make the diagnosis as early as possible in this first stage, which we call mild cognitive impairment”
Dr. Adrià Tort, neuropsychologist at barnaclínic+
What is mild cognitive impairment?
Mild cognitive impairment (MCI) is a clinical syndrome characterised by an objective decline in cognitive performance in one or more domains, which does not significantly impair daily functioning. In other words, the person remains autonomous.
The symptoms of mild cognitive impairment vary depending on the domain affected: they may include memory issues, difficulty finding words, trouble with attention or planning, or visuospatial difficulties.
“Cognitive decline implies a significant loss of cognitive function”
Dr. Adrià Tort
Although it is not a disease in itself, mild cognitive impairment can be the early stage of dementia. Alzheimer’s disease is, in fact, one of the main causes of mild cognitive impairment. Detecting it early allows for therapeutic strategies to slow down its progression.
Cognitive decline in the elderly: symptoms and types
The symptoms of cognitive decline in the elderly can be grouped into two main types:
- Amnestic cognitive impairment: mainly affects memory. It often involves trouble remembering recent information, repeating questions, or increased reliance on reminders.
- Non-amnestic cognitive impairment: affects language, attention, executive function or spatial orientation.
Although independence is preserved, the person may need more time or external help for daily tasks.
Normal ageing vs. cognitive decline
Ageing does not necessarily mean declining. Some mild changes such as forgetfulness or slower processing are normal. However, cognitive decline is different:
“Ageing does not mean declining. We must overcome the stereotype that equates ageing with losing mental ability”
Dr. Adrià Tort
The main difference between cognitive decline and normal ageing is that MCI affects daily functioning more persistently and noticeably. Both patients and their families tend to notice these changes. They can be confirmed through a neuropsychological evaluation.
How cognitive decline progresses: stages and evolution
Cognitive decline can follow several paths:
- Stable course: cognitive performance remains unchanged.
- Reversion: improvement when the cause is treatable (e.g. depression, medication side effects, nutritional deficits).
- Progression to dementia: in many cases, especially when caused by a neurodegenerative disease.
Clinically, we describe the following stages of cognitive decline:
- Mild cognitive impairment: as described, with no major impact on functionality.
- Moderate cognitive decline: difficulties emerge in complex situations.
- Severe cognitive decline: the person loses autonomy. Life expectancy may be reduced, depending on the underlying condition.
Diagnosis of cognitive decline
Diagnosis is based on a comprehensive clinical assessment at specialised centres like barnaclínic+:
- Clinical interview and neurological examination
- Full neuropsychological evaluation
- Additional tests: blood tests, brain imaging (CT or MRI), and biomarkers in blood or cerebrospinal fluid if diseases like Alzheimer’s are suspected.
These tools help differentiate normal ageing from early cognitive impairment. Cognitive tests help determine the exact stage and potential prognosis.
Treatment of cognitive decline
Treatment depends on the underlying cause. At barnaclínic+, we recommend a multidisciplinary approach including:
- Cognitive stimulation
- Regular physical exercise
- Mediterranean diet
- Control of cardiovascular risk factors
- Good sleep hygiene
- Mental health support
- Pharmacological treatment, if needed
“It can be treated, depending on the underlying cause, with programmes that improve patient functionality and quality of life”
Dr. Adrià Tort
Moreover, during this initial phase, the patient still retains the ability to make key decisions, such as planning for the future or establishing a power of attorney in case of cognitive decline.
