Mild Cognitive Impairment (MCI) is a condition marked by memory loss that is annoying and frustrating to the person experiencing it, but does not significantly affect a person’s ability to function. It typically occurs in older age and may affect up to 40% of older adults.
Have you or someone you know experienced any of the following:
If you would like more information about memory screening, please contact Summit Research Network by calling (503) 228-CARE (2273) or fill out the form below and we will contact you. Walk in appointments will also be welcome on a first come, first serve basis on [Month] [Date], [Year].
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