Mild cognitive impairment remedied
DEAR DOCTOR K: My father’s doctor says he has mild cognitive impairment. What does that mean?
DEAR READER: Mild age-related memory loss — “Where did I leave my keys?” — is normal. But people with mild cognitive impairment (MCI) have memory loss and/or trouble thinking that are more persistent and severe than normal.
There are two types of MCI. Amnestic MCI involves memory loss. People with non-amnestic MCI have problems with other cognitive functions. They may have difficulty with language: They may have trouble finding the words to express themselves. Or they may have trouble concentrating on a task, or in figuring things out, like how to replace the battery in the remote. Some people have both types of MCI.
MCI differs from normal, age-related memory loss in the kind of information a person forgets. With normal memory loss, people tend to forget things that aren’t terribly important to them. They might forget the name of a casual acquaintance, for example. With MCI, a person may not be able to learn and retain important new information. They may not remember the name of the new president of the company they work for. Or they may forget about the upcoming wedding of a family member.
On memory tests, people with amnestic MCI have more trouble remembering the details of pictures they’ve just seen or paragraphs they’ve recently read. Their memory difficulty is comparable to that of someone with very mild Alzheimer’s disease.
But they do well on tests that measure other mental functions, such as their ability to keep the details of routine activities straight. On these tests, people with amnestic MCI perform as well as people who don’t have MCI. And they perform much better than people with Alzheimer’s. In a person with MCI, cognitive impairment does not yet substantially interfere with day-to-day functioning. This is the critical difference between someone with MCI and someone with dementia.
Some people with MCI remain stable for years. But people with MCI are much more likely to develop dementia, particularly Alzheimer’s disease.
There is no specific treatment for MCI. The following tips can help your father optimize his mental functioning. They can also help him stave off other medical conditions, such as cardiovascular disease, that can further impact memory and thinking:
n Get his vision and hearing checked.
n Ask his doctor if any of his medications might be contributing to his condition.
n Limit alcohol to no more than two drinks per day.
n Eat a healthy diet.
n Exercise regularly.
n Stay socially engaged.
n Do challenging mental tasks every day, such as solving crossword puzzles, playing games (chess, bridge, Scrabble) and reading.
There is no way to predict perfectly whether someone with MCI will get worse. But your father (with your help and encouragement) can reduce that risk.
Dr. Komaroff is a physician and professor at Harvard Medical School. To send questions, go to AskDoctorK.com, or write: Ask Doctor K, 10 Shattuck St., Second Floor, Boston, MA 02115.