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Successful Aging: Paying attention to Alzheimer’s disease and mild cognitive impairment

Q. I recently went to my internist for a routine physical and complained about some memory changes and a bit more. He said that it is likely I am suffering from what he called mild cognitive impairment. That sent me into an anxious fearful spin with sleepless nights. What is it and does that mean I will get Alzheimer’s disease? E.E.

A. Dear E.E.

Having sleepless nights after receiving such a message is completely understandable. Note that I am not in a position to determine why you have had the change you describe. What I can do is talk a bit about mild cognitive impairment.

At the outset, let’s recognize we all occasionally misplace our keys or forget a name. This is particularly true as we get older. If such episodes become more frequent or interfere with what you want to do, it’s time to pay attention.

Paying attention means seeing a healthcare professional who specializes in diseases and treatment of older adults also known as geriatricians. The problem is that there are few board-certified geriatricians, either locally and nationally. In total, there are only about 7,500 in the nation for a population of about 46 million. In addition to looking in your area, consider contacting UCLA at (310) 206-8272 and USC at (323) 442-5900.

Mild cognitive impairment, also known as MCI, is a condition that exists between usual cognitive decline associated with normal aging and more serious signs of dementia and Alzheimer’s disease. The Alzheimer’s Association estimates that 15 to 20 percent of adults older than 65 may have it. It is difficult to diagnose.

The Mayo Clinic lists several symptoms that indicate MCI; it’s possible to have one or all of them:

Forgetting things more often

Forgetting important events such as appointments or social engagements

Losing your train of thought or the thread of a conversation

Feeling increasingly overwhelmed by making decisions, planning or interpreting instructions

Beginning to have trouble finding your way around familiar environments and tending to get lost

Showing increasingly poor judgment or becoming more impulsive

Family and friends noticing any of these changes

Becoming concerned about your mental performance

In experiencing MCI, one also may suffer from depression, irritability, aggression, anxiety or apathy.

Here is the concern. According to the Alzheimer’s Association, people with MCI and particularly those with a memory problem are more likely to develop Alzheimer’s disease or other dementias than people who do not have MCI. However, and this is a big however, MCI does not always lead to dementia. In some cases, individuals revert to normal conditions or they remain stable.

Acknowledging that the causes of MCI are not clear, the Family Caregiving Alliance suggests some risks factors:

Being 65 years and older

Having a family history of MCI, Alzheimer’s disease or another form of dementia

Having high blood pressure, diabetes, stroke, high cholesterol or heart disease

Substance and alcohol abuse

Lack of exercise

Unfortunately there is no single or specific test for MCI. What is needed is a thorough evaluation that includes a physical and neurological exam, lab and memory tests, a review of one’s medical history and medications and clinical observations. The experience of the individual and close family and friends are also part of the evaluation process.

According to Debra Cherry, PhD, executive vice-president of Alzheimer’s Greater Los Angeles, there are strategies one can take to maximize your cognitive function. “Strong evidence suggests that aerobic exercise, even at modest levels, can reduce your risk for cognitive impairment. Weight-building exercise has also been shown to be effective and there is some support for keeping socially and mentally active, eating a heart- and diabetes-health diet can build your reserve and reduce your risk for dementia.”

E.E., it’s important to note that some people with MCI never get worse and do not develop Alzheimer’s disease. Before you jump to a definite diagnosis, see a geriatrician for a thorough evaluation. For more information and suggested providers contact Alzheimer’s Greater Los Angeles at or call (844) 435 7259.

Thank you for your very important question. Sending you positive good wishes. Take care.

Send email to Helen Dennis at, or go to

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