Mild Cognitive Impairment in Older Adults
MCI or Mild Cognitive Impairment is common, but most Americans don't know about it. MCI occupies that grey zone between normal aging of the brain and dementia. About 1 and 7 people age 60 or older have it. In a national survey, 82% of respondents were unfamiliar with the condition or knew little about it. MCI is often confused with normal aging because it is very subtle. Roughly 10 million Americans have MCI.
Symptoms can include forgetting people's names, forgetting you said something already, forgetting a story, and forgetting words. MCI is noticeable to the person affected and the people around them, but it's not so severe that it interferes with their daily activities. This is, in part, why it isn't easy to diagnose. Diagnosis is critical, but many do not want a diagnosis. A third of patients with MCI will be diagnosed with Alzheimer's disease within five years. Before then, we have access to tests that can reveal whether MCI is attributed to Alzheimer's. Early diagnosis of Alzheimer's can play a significant role in patient outcomes. Most tests can use imaging, blood, or spinal fluid to establish likely causes. These tests can reveal the presence of sticky plaques and tangled fibers in the brain, which is a hallmark of Alzheimer's. Brain imaging studies show that people with MCI have shrinkage of the hippocampus, enlargement of the brain's fluid-filled spaces, and reduced use of glucose in key brain regions. The strongest risk factors for MCI are:
Increasing age
Having a specific form of a gene known as APOE e4
Diabetes
Smoking
High blood pressure
Elevated cholesterol
Obesity
Depression
Lack of physical exercise
Infrequent participation in mentally or socially stimulating activities
MCI can't always be prevented, but there are environmental factors that may increase your risk of developing the condition. Research has shown these steps may help prevent cognitive impairment:
Avoid excessive alcohol use
Reduce your risk to head injury
Don't smoke
Manage health conditions
Practice good sleep hygiene and manage sleep disturbances
Consume a nutrient-rich diet that has plenty of fruits and vegetables and is low in saturated fats
Engage socially with others
Exercise regularly at a moderate to vigorous intensity
Stimulate your mind with puzzles, games, and memory training
Aduhelm is a controversial drug approved last year by the FDA. It can remove the sticky plaques from the brain, but it is still unclear if it can slow memory loss. In cases where MCI is caused by high blood pressure, depression, or sleep apnea, the symptoms can resolve when treating the underlying condition.