How do you differentiate mild cognitive impairment (MCI) from dementia in daily functioning?

• A. MCI has objective cognitive decline without significant impairment in instrumental activities of daily living.
• B. MCI has impairment in basic ADLs
• C. Dementia has no cognitive decline
• D. MCI has impairment in instrumental ADLs

Answer: (A)

Daily functioning is what separates MCI from dementia. Instrumental activities of daily living are the complex tasks that keep someone independent in daily life—things like managing money, taking medications correctly, using transportation, cooking, and shopping. In mild cognitive impairment, you can find objective cognitive deficits on tests, but these individuals generally maintain independence in these instrumental tasks and can still perform basic self-care.

This preservation of IADLs distinguishes MCI from dementia, where the cognitive problems progress to interfere with instrumental daily activities, and eventually with basic activities of daily living as the condition worsens. So, the idea that MCI involves objective cognitive decline while instrumental daily functioning remains largely intact best captures the difference.