Background: Mild cognitive impairment (MCI) is often considered as a precursor of dementia but is found to have other outcomes as well. It has variations in presentations including memory complaint, cognitive or behavioral manifestations. It is considered as the appropriate stage for intervention to prevent its progression to dementia and therefore, requires early identification for which various diagnostic modalities such as neuroimaging, neuropsychological tests, and biological markers are considered. Aims and objectives: To study and analyze the natural history of MCI and cognitive decline in patients complaining of memory impairment. Materials and Methods: Thirty patients were studied after dividing them into two groups; 10 for the study of MCI and 20 for the study of dementia in the Department of Medicine, MY Hospital Indore (MP). For the assessment of MCI simple battery of psychometric tests including the mini-mental state examination (MMSE) of Folstein, the 15 second version of the Isaac’s test (IST) for verbal fluency, the 4- line version of Zazzo’s Cancellation test (ZCT) and the 4-item version of Instrumental activities of daily living (4-IADL) (Modified Lawton’s scale) were used and the patients were reevaluated at 6 and 12 months with the same battery of test as their baseline assessment. Dementia patients were assessed on various parameters of language and speech and were graded as mild, moderate and severe impairment. Results: In our survey baseline assessment revealed that participants had deficits in associated learning and naming, subsequent cognitive decline was more precipitous in these individuals who also showed higher relative risk of evolution towards dementia. On all the psychometric tests we found that risk of evolution towards dementia significantly increased after one year. These patients gradually deteriorated on MMSE, and verbal fluency also declined. All 20 patients in our study had word findings difficulty. In comprehension majority (45%) of the cases had mild impairment. 19 out of 20 subjects had reduced verbal fluency, out of which 70% were severely impaired. Conclusion: Data suggest that cognitive changes can be detected well before onset of Alzheimer disease.