You get up from your recliner and walk into the next room to get a drink, but by the time you get there you forget what you were going for. Or you can’t recall the name of a friend you’ve known for years. We’ve all experienced these temporary memory blips – but when should it be recognized as a problem to discuss with your doctor?
In normal aging, a person may occasionally forget names and words and misplace things, but when one frequently forgets conversations and information that one would normally remember such as an appointment or important task, the condition is identified as mild cognitive impairment, or MCI.
According to the Alzheimer’s Association, MCI causes cognitive changes that are serious enough to be noticed by the person affected and by family members and friends, but do not affect the individual’s ability to carry out everyday activities. MCI can develop for multiple reasons, and individuals living with MCI may go on to develop dementia while others will not.
“MCI affects about 6 million U.S. citizens,” said Dr. Lori Posk, an internal medicine doctor with Cleveland Clinic Indian River Hospital. “MCI is seen in about 15 to 20 percent of patients over the age of 65. Worldwide, MCI is expected to grow to 10 million cases per year with an estimated 150 million cases by the year 2050. The global cost of treating MCI is predicted to be about $1 trillion. With our aging population we are seeing more cases all the time. But a lot of people don’t know that there is an opportunity to decrease the prevalence of MCI if it’s diagnosed early enough.”
Examples of memory and thinking problems that might be indicators of MCI include memory loss, such as forgetting recent events, forgetting the names of family and friends, and repeating the same stories and questions. Having trouble coming up with desired words or difficulty understand written and verbal communication is another warning sign. The inability to focus and struggling with planning and problem solving are other red flags.
“It’s estimated that 32 to 38 percent of patients with MCI will convert to dementia within a five-year follow up period,” Dr. Posk said. “But there are modifiable risk factors that can be treated and make a dramatic difference in the patient’s life.
“Risk factors are based on the stages of life. Earlier in life, less education is a risk factor and predictor in developing dementia later on. One of the things to pay attention to during mid-life is the loss of hearing. If people just used hearing aids, we could decrease the incidence of MCI by 8 percent. Traumatic brain injuries due to sports or falls contribute to about 3 percent prevalence. These are modifiable risk factors that can be addressed and treated.”
Altogether, there are key identifiable and modifiable risk factors for MCI and dementia: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, infrequent social contact, excessive alcohol consumption, head injury and environmental pollution. Modifying those factors might prevent or delay up to 40 percent of dementias, according the Lancet Commission on dementia prevention.
“Limiting alcohol intake, wearing a hearing aid, maintaining good blood pressure, treating sleep apnea and being physically and socially active are ways to control MCI,” Dr. Posk said. “There are some disease-modifying medications coming down the pipeline that might stop the progression of the disease but not necessarily reverse it. That’s why identifying patients at an early stage before it develops into full-blown dementia is so important.”
If you or someone you know are exhibiting signs of MCI, the best course of action is to discuss it with your primary care doctor. Oftentimes the person experiencing the memory loss doesn’t want to admit or recognize there might be a problem. In those cases, a family member can get in touch with a physician and then the physician can weave it into the conversation or, better yet, make it part of their routine yearly checkup.
If you want to test yourself before you go to the doctor, there are numerous online cognitive tests that you can access in the privacy of your own home.
“Make sure that any test you take is validated and normalized because there is a lot of variability in tests,” Dr. Posk advised. “Cleveland Clinic has a website (www.HealthyBrains.org) that offers an interactive platform designed to provide individualized brain health assessment tools, lifestyle tips and medical news. A brain checkup test developed by Cleveland Clinic measures cognitive impairment through recall of words and images, and is used by many doctors in the diagnosis of MCI and dementia.
“If there are any concerns about memory, please address them with your doctor,” Dr. Posk added. “Don’t ignore it. MCI won’t go away by itself, but early identification and modification of risk factors can make a big difference in your daily life.”
Dr. Lori Posk earned her medical degree from Michigan State University and completed her internship and internal medicine residency at Cleveland Clinic Foundation in Ohio. She just celebrated her 30th anniversary with Cleveland Clinic and was transferred to Cleveland Clinic Indian River Hospital in August 2019. Her office is in the Health and Wellness center located at 3450 11th Court in Vero Beach. To schedule an appointment, call 772-794-3364.
