Article by Laura Bastin

AMH Speech Language Pathologist

Many people notice gradual forgetfulness or delays in thinking of specific words or names as they age. These are part of normal aging. Of concern is when these problems are more frequent, represent a change compared to the prior level, and are increasing in severity.

Mild cognitive impairment (MCI) is defined as a step between the expected cognitive decline of normal aging and the more serious decline of dementia. Mild cognitive impairment does not always lead to dementia, but developing dementia is more likely. MCI can involve problems with memory, language, thinking, and judgment that are greater than normal age-related changes. The person with mild cognitive impairment is not demented and retains independence in most functional activities.

Contributing Factors

The strongest risk factors for MCI are increasing age and genetics, but just having the gene doesn't guarantee that you'll experience cognitive decline.

Other medical conditions and lifestyle factors have been linked to an increased risk of cognitive change, including:

• Depression. When you're depressed, you often feel forgetful and mentally "foggy." Treating depression may help improve memory, while making it easier to cope with the changes in your life.
• Sleep Apnea. This condition makes it difficult to get a good night's rest. Sleep apnea can make you feel excessively tired during the day, forgetful, and unable to concentrate. Intermittent lack of oxygen during the night could also contribute to cognitive problems.
• Hearing Loss. Research is finding that the worse your hearing is, the more likely you are to develop dementia. This may be because the work of hearing takes away from the ability to process and retain the meaning. Not being able to hear can also lead to more social isolation, which can contribute to cognitive and communication problems.
• Diabetes. Poorly controlled blood sugars can damage nerve cells in the brain and lead to cognitive impairment. Diabetes-related damage to blood vessels may also lead to cognitive problems.
• Smoking. Smoking is known to contribute to cerebrovascular disease which can lead to mini-stokes or hardening of the arteries which can cause cognitive decline.
• Obesity. Studies have shown a correlation between obesity and dementia, but the exact nature is not well understood.
• Taking multiple medications. Medications can interact or cause sedation, especially in the elderly.

What can I do?

Based on recent research and 2017 recommendations from the National Institute on Aging, National Institutes of Health, and the National Academies of Sciences, Engineering, and Medicine, the following three areas are the most encouraging, but not conclusive, interventions you can do to help prevent brain cells from dying early and to combat Mild Cognitive Impairment:

• Exercise on a regular basis. Regular physical exercise has known benefits for heart health and blood vessels, including those that supply your brain. Aerobic and weight training can actually change your brain for the better.
• Cognitive Training. Memory studies have shown that training with memory, intellectual stimulation, social engagement, computer use, playing games, reading books, and other mental activities may help preserve function and slow or prevent cognitive decline.
• Manage your Blood Pressure. People with MCI are more likely to have problems with the blood vessels inside their brains. These problems often start in mid-life and are “silent.” In your 40’s and 50’s and beyond, it is important to maintain a healthy blood pressure. Your doctor will monitor your blood pressure and recommend steps to lower it if it's too high.

If you or your doctor are concerned about cognitive changes, you may be referred to a specialist with expertise in evaluating mental function. This specialist may be a neurologist, psychiatrist, or neuropsychologist. In addition to the above listed management strategies, medication may be prescribed. They may also recommend therapy. Therapy can help improve brain function as well as work with you to determine appropriate compensatory strategies to help you function.