Question: A friend in her 70’s has been diagnosed with “mild cognitive impairment.” She thinks this means she will have Alzheimer’s. Do you have any information about this?

Answer: In June 2011, the New England Journal of Medicine reported that Mild Cognitive Impairment (MCI) had been found in ten to twenty percent of the plus-sixty-five population. Although MCI may appear as a transitional stage between normal aging and dementia, not everyone diagnosed with it will see their symptoms progress. In some cases they may even regress.

According to the Alzheimer’s Disease Information and Referral Center’s website, MC is a condition in which people have memory or other thinking problems greater than normal for their age and education, but their symptoms are not as severe as those seen in people with Alzheimer’s disease. More older people with MCI, compared with those without MCI, go on to develop Alzheimer’s.

When memory loss is the main symptom, the term “amnestic MCI” is used, and this stage may be an early indicator of the eventual onset of Alzheimer’s. When deficiencies are in areas other than memory such as inability to make sound judgments, complete a sequenced task, follow instructions or difficulties with visual perception,the term “nonamnestic” is used. This diagnosis may be a precursor to other diseases such as Lewy Body Dementia..

Since no specific test is available to confirm MCI, doctors at the Mayo Clinic diagnose based on criteria developed by a panel of international experts. Information provided by the patient and corroborated by a family member or friend is considered as well as the results of blood tests, imaging and mental status tests. A diagnosis of MCI is made in a person who has not been diagnosed with dementia but has problems with memory or another mental function and abilities have declined over time from a higher level. Generally, overall mental function and daily activities are not impaired but symptoms may cause worry and inconvenience.

At the present time there is no prevention or treatment for MCI and the cause of this syndrome remains unknown. Although there is no proven treatment, some researchers suggest that the same treatments used for Alzheimer’s may be helpful.  However, studies using these drugs have resulted in disappointing outcomes. Benefits have been limited while side effects were significant. In a two-year study “Homocysteine and Cognitive Decline in Healthy Elderly,” 168 people who had been diagnosed with MCI were given either a high-dose vitamin or a placebo. Those receiving the vitamins (the three B vitamins folic acid, B6, and B12) cut their rate of brain shrinkage by up to one half. These vitamins inhibit the production of the amino acid homocysteine, which is associated with cognitive decline.  Other studies have concluded the most promising preventative is physical exercise, including regular brisk walks.

Dr. Barry Reisberg, professor of psychiatry at New York University School of Medicine and an expert in Alzheimer’s reported that one of his patients, a 78-year old woman, had learned to use the subway and even pilot an airplane in the two and a half years following her diagnosis. Encourage your friend to remain active, stay in touch with her doctor and continue living life to its fullest.  Flying lessons are optional.