ANN ARBOR, Mich. -- For up to one in five Americans over age 65, getting older brings memory and thinking problems- along with the embarrassment of not being as "sharp" as they once were, and the worry that it will get much worse.
They might just call it "getting older". But officially, when memory or cognitive problems don't interfere significantly with daily living, doctors call them mild cognitive impairment, or MCI.
What can be done to prevent or slow MCI? And how much should seniors fear that their thinking or memory problems will get much worse? A pair of doctors from the University of Michigan Medical School and VA Ann Arbor Healthcare System have put together a definitive look at the evidence, based on a thorough review of recent studies about MCI.
Published in this week's issue of the Journal of the American Medical Association , their review article should help doctors and the seniors they treat.
"MCI is hard for both clinicians and for patients and their families, because it's a scary prospect - and because there's still a lot we don't know about this condition," says Kenneth Langa, M.D., Ph.D., who co-authored the article with U-M and VA colleague Deborah Levine, M.D., MPH. "We still don't have great answers to give patients and families, but the medical literature shows there are certainly factors that can influence the risk, severity, and progression of MCI. We hope this review will spread awareness of those, and help guide patient care."
"While no medications have been proven to treat MCI successfully," says Levine, "it's still a treatable condition. Our review shows good evidence that aerobic exercise, mental activity, social engagement, and stroke prevention help reduce the risk of further cognitive decline." She notes that the review of medical literature they conducted paid close attention to the quality of the evidence in each study.
Among the key findings of their review, and what they mean for seniors:
Stroke prevention strategies include controlling high blood pressure, stopping smoking, lowering cholesterol with drugs called statins and taking aspirin or other medicines to prevent blood clots.
In the end, he says, MCI can be a complicated issue, and that can make it even scarier for patients and their families. More research is needed on the factors that put someone at increased risk of MCI, new options for treating it, and better research on what the risk of progression to dementia is. But until new findings are available, this new review should help doctors and patients alike.
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Both Langa and Levine are faculty members in the Division of General Medicine at the U-M Medical School, and members of the U-M institute for Healthcare Policy and Innovation. Langa also holds positions in the U-M Institute for Social Research and School of Public Health. Levine has a joint appointment in the U-M Department of Neurology. The review article is part of the Care of the Aging Parent series, funded by the SCAN Foundation. Reference: JAMA , Dec. 17, 2014, Vol. 312 No. 23
JAMA