We all know the embarrassment of losing our train of thought in the middle of a sentence or forgetting the name of a friend. For most of us, these so-called “senior moments” are just a normal part of getting older—and you don’t even have to be a senior to experience them.
But what if you’re more forgetful than most of your friends? What if you’re forgetting important things that you shouldn’t forget, such as making a mortgage payment or the best route to get home? What if you’re forgetting appointments or whether your favorite team won a recent game?
These could be signs of mild cognitive impairment (MCI), a subtle memory disorder that is more pronounced than normal memory lapses but not serious enough to significantly interfere with daily life. If you have it, you can take steps that might keep it from progressing…
MCI was first described by researchers at the Mayo Clinic in 1999. Only in the last few years has it become an official diagnosis that is recognized by physicians and insurance companies. The disorder is characterized by memory lapses serious or frequent enough that other people notice but that are not accompanied by problems with basic thinking or reasoning skills. The affected individual typically is able to carry out his/her usual activities. Because it’s a new diagnosis, there’s a lot that doctors still don’t know, including how many Americans have it…how it will progress over time…and what can be done to treat it.
The risk: Preliminary research suggests that about 40% to 50% of people diagnosed with MCI will go on to develop Alzheimer’s disease within three to four years. It’s possible that many cases of MCI are an early form of dementia, although some patients never get worse and live normal lives.
Because MCI’s symptoms are subtle, it is difficult to distinguish it from normal, age-related changes. A physician with expertise in cognitive disorders and aging, such as a neurologist or geriatrician, is best qualified to make an MCI diagnosis.
To make a diagnosis, he/she can do the following…
Standard memory tests can determine whether your mental capacities are normal for a person of your age. These tests usually are performed by a neurologist or a neurological testing service.
Hippocampus measurement. Your doctor might recommend tests that measure the size and metabolism of the hippocampus, the part of the brain associated with memory. Studies have shown that patients with MCI have lower glucose metabolism in this part of the brain and possibly atrophy (shrinking) of the tissues.
Medical history and testing. Many physical problems can cause symptoms that mimic MCI. These include a deficiency of vitamin B-12…depression…and an underactive thyroid gland. The side effects of certain medications can cause memory problems as well. These medications include antispasmotics, antihistamines and antidepressants.
There are no FDA-approved treatments for MCI. However, drugs that are used to treat Alzheimer’s disease might be helpful.
Example: A three-year study that looked at more than 750 adults with MCI, published in The New England Journal of Medicine, found that those who were given donepezil (Aricept) were less likely to develop Alzheimer’s disease within one year than those who didn’t take it. Unfortunately, the same study found that the benefits did not last. After three years, the Alzheimer’s risk was the same in people who took the drug and those who didn’t.
What you can do now that might help…
Exercise. People who exercise regularly do better on neuropsychological tests than those who don’t exercise. Exercise increases levels of nerve growth factor, a substance used by brain cells. It also improves circulation to the brain, which is helpful for memory and mood.
We don’t know what effects, if any, exercise will have on the progression of MCI, but anything that improves memory, mood and cognitive functions might be helpful. Recommended: Some form of aerobic exercise, such as walking, for 30 minutes most days.
Maintain a healthy weight. New research from the Mayo Clinic suggests that consuming between 2,100 and 6,000 calories per day may double the risk for MCI among people age 70 and older. The higher the amount of calories consumed, the higher the risk. Also, people who are obese in middle age are about four times more likely to develop Alzheimer’s or other forms of dementia in later life than those who are leaner. It’s possible that inflammatory substances produced by fat increase brain damage that can lead to dementia.
Stay mentally active. The brain continues to form neurons and connections between neurons throughout life. Patients who are mentally active form the most connections and develop reserves that can slow the onset of Alzheimer’s symptoms.
There’s no evidence that mental workouts can reverse MCI, but people who keep their minds challenged—by working, taking classes, volunteering, doing puzzles, etc.—will have better cognitive function.
Source: Scott Roberts, PhD, associate professor in the department of health behavior and health education at University of Michigan School of Public Health in Ann Arbor. He is codirector of the Dual-Degree Program in Public Health and Genetic Counseling and director of the Genomics, Health and Society Program at the Center for Bioethics and Social Sciences in Medicine. He is co-principal investigator of the REVEAL Study, an NIH-funded clinical trial of a genetic risk-assessment program for people with mild cognitive impairment. http://HBHEGenetics.sph.umich.edu