Q. Two members of our book group have early signs of cognitive impairment. We have become so close after 10 years of being together. Is there any way we can be useful? Also, please help us understand what might be coming next. Many thanks, L.E.
The Alzheimer’s Association defines mild cognitive impairment (MCI) as an early stage of memory loss or other cognitive abilities, which may include the use of language or visual and spatial perceptions. A distinguishing feature of those with MCI is their ability to conduct most of their activities of daily living independently. The changes experienced typically are serious enough for others to notice yet they do not affect individuals’ ability to carry out daily activities.
A USC Dornsife study suggests that among the eight million people predicted to have mild cognitive impairment (MCI) based on their demographic profile, only eight percent were diagnosed. If the underlying cause is related to Alzheimer’s Disease, the lack of awareness is problematic since early diagnosis is key to delaying the onset of the disease. Furthermore, over three-quarters of the public know little about MCI and often assume it is part of the normal aging process. And many with symptoms are reluctant to see their doctor. So getting a diagnosis can be a challenge.
Let’s talk about prevalence. Roughly 12 to 18 percent of those age 60 or older are living with MCI. It increases with age with one in four individuals ages 80 to 84 experiencing MCI symptoms. Age is a major risk factor but not the only one. A significant risk factor is carrying the gene variant APOE-4 gene which is linked to Alzheimer’s Disease.
Note that not everyone with MCI develops Alzheimer’s Disease. Roughly 10 to 20 percent of people age 65 or older with MCI develop dementia over a one-year period. In many cases, the symptoms stay the same or even improve, according to the National Institute on Aging. Whether it is permanent depends on the underlying causes.
Age and the gene are just two of the risk factors. Some medical conditions can increase the risk including diabetes, high blood pressure, high cholesterol, obesity and depression. Add to that lifestyle habits such as smoking, a sedentary lifestyle and lack of social engagement.
Susan Howland, the senior program director for the Alzheimer’s Association, noted an increase in the number of phone calls the association is receiving from family members, those with MCI or early stages of Alzheimer’s disease. They are looking for support and how to maximize living with these challenges. She tied this increase to “more individuals seeking a diagnosis sooner, health systems referring patients to local support programming and the introduction of disease-modifying treatment that is most effective in those with MCI and early-stage Alzheimer’s disease.” She ended our conversation with the following quote: “We need to add life to years, not years to life.”
Unfortunately, there is no single or specific test for MCI. What is needed is a thorough evaluation that includes a physical and neurological exam, lab and memory tests, a review of one’s medical history and medications and clinical observations. A good start is a visit with one’s primary physician and also a visit with a specialist such as a geriatrician, neurologist, psychiatrist or neuropsychologist. There are many ways for a friend to be a friend. Consider suggesting the following tips and possibly supporting your friends in achieving them.
- Set up an appointment with a healthcare professional for an evaluation.
- Establish a routine of putting belongings in the same place so they are easy to find. For example, keep your keys on a hook or your wallet in the same drawer.
- Declutter and simplify. One might label a drawer of its contents as a reminder.
- Keep a calendar or diary as a reminder of appointments and things that need to be accomplished. That might include doctor appointments and social events.
- Use technology to take medications that are prescribed on various days and at different times. See the following for suggestions.
- Help research a support group that focuses on memory. You might even join your friends at a group meeting as company and encouragement.
Here are a few resources for additional MCI information and support: The Alzheimer’s Association 1(800) 272 3900; the Alzheimer’s Association LA, (844) 435 7259 and Alzheimer’s, Orange County, (949) 955 9000.
Thank you, L.E., for your important question. Your sensitivity and caring are gifts to your two friends. Stay well and safe – and know the smallest acts of kindness can save another’s world.
Helen Dennis is a nationally recognized leader on issues of aging and the new retirement with academic, corporate and nonprofit experience. Contact Helen with your questions and comments at Helendenn@gmail.com. Visit Helen at HelenMdennis.com and follow her on facebook.com/SuccessfulAgingCommunity