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It’s Not Alzheimer’s. It’s Just MCI.

Taken from AlzheimersWeekly.com, July 2015

20% of people over 65 have memory and thinking problems that don’t interfere with their day-to-day life. Doctors call this MCI, short for Mild Cognitive Impairment.

For up to one in five Americans over age 65, getting older brings memory and thinking problems- along with the embarrassment of not being as “sharp” as they once were, and the worry that it will get much worse.

They might just call it “getting older.” But officially, when memory or cognitive problems don’t interfere significantly with daily living, doctors call them mild cognitive impairment, or MCI.

What can be done to prevent or slow MCI? And how much should seniors fear that their thinking or memory problems will get much worse? A pair of doctors from the University of Michigan Medical School and VA Ann Arbor Healthcare System have put together a definitive look at the evidence, based on a thorough review of recent studies about MCI. Published in the Journal of the American Medical Association, their review article should help doctors and the seniors they treat.

“MCI is hard for both clinicians and for patients and their families, because it’s a scary prospect—and because there’s still a lot we don’t know about this condition,” says Kenneth Langa, M.D., Ph.D., who co-authored the article with U-M and VA colleague Deborah Levine, M.D., MPH. “We still don’t have great answers to give patients and families, but the medical literature shows there are certainly factors that can influence the risk, severity, and progression of MCI. We hope this review will spread awareness of those, and help guide patient care.”

“While no medications have been proven to treat MCI successfully,” says Levine, “it’s still a treatable condition. Our review shows good evidence that aerobic exercise, mental activity, social engagement and stroke prevention help reduce the risk of further cognitive decline.”

The key findings of their review offer the following strategies:

  • Speak up to your doctor about memory and thinking problems
  • Keep your body and brain active
  • Keep strokes at bay
  • Review medications with your doctor. (Multiple medicines can fog the brain)
  • Avoid over-treatment of high blood pressure and diabetes

What are the odds? That’s the key question in the mind of anyone with suspected or diagnosed MCI—how likely are they to get worse and progress to dementia and not be able to function independently. Reassuringly, Levine says, the evidence available shows that progression from MCI is far from a sure thing.

“The numbers are less scary than many people believe,” she notes. “The majority of people with MCI will not progress to dementia and loss of independence, even after 10 years. Some patients with MCI will actually have improved cognition after a year or two, if their cognitive test scores were brought down by an acute illness that gets addressed.” Older adults with MCI are 12 times more likely to die from cardiovascular disease than to die of dementia. So, preventing stroke and heart attack by controlling vascular risk factors is crucial for people diagnosed with MCI.

More evidence is needed for a number of new detection/treatment options. The review of the literature showed that a number of new blood tests and brain imaging options have been proposed and preliminarily tested for diagnosing MCI, and tracking or predicting its progression to dementia. But many of these tests haven’t yet been proven to offer significant benefit to patients, says Langa. And in fact, there can be some risk of “over-diagnosis” when a test identifies a problem that would not go on to cause significant problems for a patient.

In the end, he says, MCI can be a complicated issue, and that can make it even scarier for patients and their families. More research is needed on the factors that put someone at increased risk of MCI, new options for treating it, and better research on what the risk of progression to dementia is. But until new findings are available, this new review should help doctors and patients alike.

The Dublin Club is a unique memory loss group designed specifically for adults who are experiencing mild memory loss or MCI. See how improved mental fitness, greater knowledge about memory loss and the camaraderie of others with similar goals and concerns can reduce the risk of further decline. The next Dublin Club will meet for a 12-week session on Wednesdays, September 16 – December 9 from 9:30-11:30am. The Time is Now! Join the Dublin Club. Call 633-3700