Junior REIS/UnsplashYou’ve forgotten a few appointments lately and you find yourself losing track of conversations. Close friends or family may have also noticed some changes in your memory or thinking.Becoming more forgetful and feeling slower in your thinking is normal in older age. But when these changes are more than you’d expect for your age it might be a sign of mild cognitive impairment.So does that mean you’ll soon develop dementia? The short answer is no, not necessarily. And there are things you can do to help prevent, slow or reverse the decline.How do I know if I have it?With mild cognitive impairment, changes in memory and thinking may not feel “mild” but are less severe than those in dementia. They also do not impact your ability to carry out daily activities. No single test can diagnose mild cognitive impairment. Rather, a diagnosis is made based on your medical history, information from a friend or family member, and from the results of clinical tests that measure problems with memory or thinking. So if you think you might have mild cognitive impairment, see your GP. They can perform some memory tests and refer you for further testing if needed. Your GP can also rule out other conditions that might be causing your symptoms. These include nutritional deficiencies, thyroid problems or depression. Addressing these can potentially reverse the changes in memory and thinking.Why haven’t I heard of it?Mild cognitive impairment is not a new diagnosis. But it’s commonly under-diagnosed.Not everyone agrees diagnosis benefits people with mild cognitive impairment. This is partly due to the uncertainty of how it may progress and stigma surrounding memory and thinking problems. It can also impact how someone feels about themselves or is treated in the community.But a diagnosis provides the opportunity to take positive steps to stay independent for longer. It can also reassure you about whether your current activities may be affected. For example, a diagnosis is unlikely to immediately impact someone’s ability to drive safely, which is a common concern.So, you have a diagnosis. Now what?There are many things you can do after a diagnosis of mild cognitive impairment to help maintain your memory and thinking for longer. Regular check ups with your GP or specialist are important to detect further changes, review medications, and manage any ongoing health conditions such as high blood pressure or diabetes. Slowing cognitive decline over the long term is also possible by targeting a range of factors, such as diet, exercise and keeping your brain active through social activities and learning new things. Science is moving towards trying to prevent mild cognitive impairment progressing to dementia. This involves combining the known benefits of making positive health behaviour changes with new drug treatments for some forms of dementia, namely Alzheimer’s disease. Lifestyle changes can make a difference even if you’re not eligible for current drugs. Read more: What’s the difference between Alzheimer’s and dementia? How is it linked to dementia?Mild cognitive impairment is often considered an intermediate stage between normal cognitive ageing and dementia, but this is not always the case.Not all people with mild cognitive impairment have the underlying brain changes associated with Alzheimer’s. This means not everyone goes on to develop it and some people don’t continue to decline at all. Reviews examining multiple studies suggest about 6–11% of people with mild cognitive impairment develop dementia each year. Overall, about 40% of people with mild cognitive impairment will go on to develop dementia in the next five years. While this may seem high, up to 28% of people may revert to normal cognition.We are getting better at predicting which people with mild cognitive impairment go on to develop dementia, particularly Alzheimer’s. Tests to help make these predictions are continuing to be improved but are not widely available in the clinic. Read more: Can wiggling your pinky really stop cognitive decline? Is it too late to do anything about it?We are better placed than ever to address changes in thinking and memory as we age. And it’s never too early or too late to reduce your risk of mild cognitive impairment or dementia.There are now 14 well-established risk factors for dementia which, if eliminated, could reduce the overall number of dementia cases by 45%.You can reduce your personal risk by looking after your health, such as eating well and being physically active, as well as doing less-well known things, such as getting your eyes checked. A good place to start is to assess your own dementia risk with a free online tool. This can show you where you might be able to make positive changes to your health and lifestyle.There’s also hope for the future for the treatment of both mild cognitive impairment and dementia.Cost and poor motivation are among barriers for people to reduce their risk of dementia. However, new online programs aim to reduce these barriers by providing people with mild cognitive impairment more accessible advice about implementing lifestyle changes and setting goals. And despite a major review finding Alzheimer’s drugs do not meaningfully slow progression of the disease, and may harm, others say newer drugs in this class still show promise and will likely help at least some people. Planning aheadWhether or not you have been diagnosed with mild cognitive impairment, it is always a good idea to be prepared for the future should your cognition and memory decline. Ensure supports are in place to manage your affairs and your care. Talk to your family about your wishes. This will help make sure you and your family can focus on what is most important – living well now.Nikki-Anne Wilson has previously received funding from the Australian Association of Gerontology and the UNSW Ageing Futures Institute.