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If you sometimes misplace your keys or eyeglasses because you are distracted, it could be normal behavior. But if that starts happening a lot more frequently as you age, or with items that you never used to misplace, that may be a sign of MCI.—Mild Cognitive Impairment.
In addition, if you are finding the tax forms more challenging, or having trouble organizing your bills, when you always accomplished those tasks easily, that too, can be a red flag. But, if you always put your glasses on the nightstand and lately you’ve been leaving them in the kitchen cupboard, or the refrigerator that is cause for concern.
After death or illness of a loved one, research indicates that the two leading fears in retirement are: 1. Outliving savings and investments, and 2. Deteriorating Health leading to losing independence.
The difference between MCI and dementia is subtle, although in some cases, MCI does not progress—or progresses slowly—to dementia. For about 1/3 of people, it happens within five years of their diagnosis, according to an analysis in Neuropsychology Review; although for others, the timeframe can vary widely. Each person’s trajectory is different. Approximately 12 to 18% of Americans age 60 or older have mild cognitive impairment., According to the Alzheimer’s association.
Sometimes symptoms of MCI might be caused by over medication— a study involving people in their 60s, published in the International Journal of clinical pharmacy found significantly higher rates of cognitive impairment among those on five or more medications.
Meanwhile, someone with MCI often will do well on a battery of thinking tests, but their short term memory will be impaired. That seems to be the classic story.
While there is no cure, an early diagnosis of MCI means people can be treated sooner and new drugs may slow the disease, allowing people to plan for the future and be involved in important decisions. A study in Neurology
suggests a positive association between the diet, getting daily exercise and staying socially engaged. Doctors also recommended getting adequate sleep and managing health conditions that can worsen cognitive problems, like high blood pressure, diabetes, and high cholesterol.
Interesting to note, some doctors indicate the most favorable definition of Alzheimer’s dementia would be as a disorder of social function—because it is the quality and quantity of social support that can determine a patient’s quality of life and speed of disease progression.
As Americans continue to live longer, MCI and dementia, are poised to become the biggest challenge of the next few decades.
Thanks for highlighting this growing health issue. Based on what I read, there is a high probability that we will be impacted either directly or by caring for a loved one, as we grow older.
Link:
https://www.alz.org/alzheimers-dementia/facts-figures
sir, The MCI condition its typically an interim phase between normal aging and early stage dementia, although Unfortunately, most people do go on to develop worsening dementia, especially if it is due to a neurologic condition such as Alzheimer’s disease. Untreated hearing loss can also hasten the progression.
Thank you for your interest and the link you provided.
I finally got around to reading this. We have been back and forth visiting the family member with ALS. Marjorie, thank you for this article. I see there are some links that I will need to check also. I had made a post when the forums started about when do you know that you need to step in with elderly parents, but didn’t get a lot of responses. So this helps. Spouse’s mother is having some of the issues discussed in this thread and we live 4 hours away. It is hard to know what to do, especially when she doesn’t think she has a problem.
I did also want to mention for an elderly person who is having cognitive problems that seem to be getting worse is to check for UTI as it can do this. Chris
Chris, so good of you to be concerned about your spouse’s mother. And it is difficult living a distance from her. People with MCI usually know that something is wrong but many times will cover up their condition through fear that they may have to move from their home and other dire concerns. I think seeing a Neurologist is the best route. They usually like to see the family as well, to get a better insight into what exactly has changed about the person’s memory and behavior.
Good luck, Chris. I hope you and your spouse will be able to gently persuade your mother-in-law to visit a doctor and that you and he/she will be able to accompany her. It must be so difficult, especially with your family member who has ALS. I know this weighs on your mind and my prayers go out to you.
Chris, great point on the UTIs. My mother-in-law had cognitive decline, leading to dementia, and chronic UTIs. It was tough to figure what was causing what. But the mental symptoms were definitely worse when she had a UTI.
At my CCRC, residents are given a cognitive test at the annual wellness check-up. It’s usually given orally. People who know they process information better when alone, or better by reading than by hearing, can find this in-person testing stressful, which of course can make results less accurate. Our introverts group requested a cognitive test that could be self-administered. Residents may now use one of the SAGE tests found at this link. Anyone can take it; it’s free and fun.
This link you provided is so useful. Takes the stress out of such tests.
Rather than do medical testing, you can help someone evaluate their situation with a cognitive test. One of the better ones is the MOCA. The test takes about 15 to administer and gives you a numerical score. The link below has the instructions and a PDF of the test that you can print. The test can be re-administered to help you understand how a person’s cognitive abilities are changing…..It cannot be self-administered.
Montreal Cognitive Assessment (MoCA): This test involves memorizing a short list of words, naming objects shown in pictures, copying shapes and performing other tasks. This test takes about 15 minutes to complete.
https://championsforhealth.org/wp-content/uploads/2018/12/MOCA-8.1.8.2-English.pdf
I’m considering getting a baseline with this test: https://www.apollohealthco.com/brainscan/
Great piece Marjorie. We started noticing the little changes in my mother-in-law first – she no longer opened and filed the mail automatically -especially her Vanguard statements. When I saw a stack of unopened ones I knew there was an issue. Being vigilant and patient with loved ones is very important.
Rick, you have all the characteristics of a kind, patient and loving caregiver.
its also important to go along with whatever they say—within reason, or divert the conversation. They can say the most fantastic things. My father in law had a lot of confusion.
Thanks Marjorie. My wife’s aunt forgot my name, but she knew I was somehow related. She started calling me “her man”. She would ask, “where’s my man – aren’t we going out”. We loved it.
When it comes to new drugs, there’s a recent NYT article that suggests they should be approached with extreme caution.
I read that article and was shocked. But healthcare is all about being shocked. There is a propublica article about how insurers deny care to their insured.
You are right Kathy. In researching some of the newer drugs, it is said they can prolong the disease for about 7 months. Not long, but possibly 7 months more of life. Some have side effects too..
The article is about Leqembi and Kisunla, which might buy you five to seven months, but at the risk of brain bleeds, some severe, and death. They are also extremely expensive. Other countries have refused to approve them, and I would not take them. But as I have posted before, my aim if I receive a dementia diagnosis is not to try to squeeze out a few more months of clarity, but a one way trip to Switzerland. At least that would include mountains.
Kathy, I did read the article you referenced and Leqembi was the drug that was part of my research..
thanks for your input.
Interesting but scary article. Thanks for posting the link.
Marjorie, very interesting article. How does one’s doctor (which type of doctor..) test for MCI? What are the current treatment regiments for it? Thanks for bringing this subject up.
Anyone who experiences memory changes that affect daily functioning should see a neurologist,who will take a thorough history, conduct a physical examination, and likely order blood work. Depending on the results, the neurologist may recommend one or more standardized cognitive tests—to assess memory, reasoning, attention, language, and visual, motor and social functions; as well as various imaging studies, such as MRI and PET scans.
As far as treatments, it depends on test results and it should be noted that there are some dementias that are not AD—Alzheimer’s Disease.
Thanks for your interest.
Marjorie, now that I have “arrived” at the place I need to be financially, and my investments are automated with a “keep it simple stupid” strategy, I really appreciate topics on health and lifestyle.
We truly do need to be aware of maladies such as MCI and prostate cancer that are likely to effect us as we live longer.
Thanks for this information.
Dan, I think you have a good start, with your easy going, fun personality. Your attitude is good. Your KISS strategy is a non stressor, so important to mental health.
I have been fascinated with this troubling disorder for sometime. My mother was diagnosed with late onset Alzheimer’s Disease and my friend, Katie, who I wrote about in My Inheritance article died from complications of Lewy Body Dementia.
Undiagnosed MCI is common. Medical professionals see it when they take a patient history. Questions take more effort to answer than they should. If the spouse is present, there is often a habitual helping behavior. The family often doesn’t realize there’s a problem, and are many times resistant to the truth.
When I first met my wife’s father he was in his late 70s. Her mother finished his sentences, but my wife and her mother seemed to think that was normal. He was a man of routine, and functioned well in his normal environment. Not until he moved to our town did his cognitive problems become more apparent. We learned that my mother-in-law had coordinated the move across country. My wife and I were amazed that we had missed the diagnosis.
Even when you know it’s coming, it sometimes takes a “tipping point” event to make it undeniably obvious to everyone, including the person in question. My mom’s came when she entered her garage from the outside, but the door to the house was locked, and she “forgot” that all she had to do was push the lighted button to the garage door opener to get out. She spent 3 days “trapped” in the garage before being “rescued”! We discovered later that her house was full of discretely placed post-it notes that had kept her looking “normal” for at least several months, maybe longer.
There’s only so much you can do from the outside, especially if the person in question refuses to cooperate. Unfortunately, that’s often part of the effects of the cognitive impairment itself. The person becomes distrustful of others, and the isolation becomes a self-reinforcing feedback loop. It’s heart-breaking to watch, and unfortunately can take years to play out.
Ed, your comments sound all too familiar. Some people have incredibly detailed memories, so if it slips a little bit, they may still perform far above other people their age, but someone who knows them well will see the decline.
Thanks for your input, Ed