Preventing MCI and early onset of dementia – start prevention in your forties

Today’s Asaichi NHK TV programme highlighted the topic of MCI and suggested strategies for its prevention. According to the doctors, MCI starts manifesting from age forties, and we should take steps to be aware of the symptoms and to prevent MCI decline and descent into dementia. Japan has the largest (one of the largest) numbers of seniors and centenarians in the world, and this area of research is in a relatively advanced stage compared to the rest of the world.

What is MCI?

MILD COGNITIVE IMPAIRMENT

Mild cognitive impairment (MCI) causes a slight but noticeable and measurable decline in cognitive abilities, including memory and thinking skills. A person with MCI is at an increased risk of developing Alzheimer’s or another dementia.

Experts classify mild cognitive impairment based on the thinking skills affected:

MCI that primarily affects memory is known as “amnestic MCI.” A person may start to forget important information that he or she would previously have recalled easily, such as appointments, conversations or recent events.

MCI that affects thinking skills other than memory is known as “nonamnestic MCI.” Thinking skills that may be affected include the ability to make sound decisions, judge the time or sequence of steps needed to complete a complex task, or visual perception.

MCI increases the risk of later developing dementia, but with preventative measures taken early enough, some people may never develop dementia or Alzheimer’s.

In diagnosing MCI, the first 6 items are your top clues of the onset of MCI, according to the Asaichi programme:

  • However many times someone repeats an instruction or something to you, you seem to forget it (no.1)
  • Forgetting your promises made to someone, and insisting otherwise when reminded (no. 2)
  • Inability to recall recent events (no. 3)
  • Forgetting to relay phone messages to family members or other people (no. 4)
  • Forgetting umbrellas, glasses, keys, but an important clue is losing especially large or important items ( no. 5)
  • Not being able to remember how to take your medicine (no. 6)
  • Forgetting where commonly placed things are in your home
  • Forgetting faces and places introduced
  • Confusion over time and spatial locational challenges
  • Verbal confusion in mid-sentence

If you manifest one of more of the above symptoms, you probably have nothing to worry about, beyond that, you should start exercising preventative measures to avoid further decline of your cognitive faculties. If you are manifesting all of the above symptoms, you should have yourself checked at a specialist clinic and possibly have a brain scan.

I’ve found more info at the Alzheimer’s website: http://m.alz.org/10-warning-signs.asp

1) MEMORY LOSS THAT DISRUPTS DAILY LIFE

One of the most common signs of Alzheimer’s is memory loss, especially forgetting recently learned information. Others include forgetting important dates or events; asking for the same information over and over, Increasingly needing to rely on memory aids (e.g. remider notes or electronic devices) or family members for things they used to handle on their own.

A Typical Age-Related Change

Sometimes forgetting names or appointments, but remembering them later.

2) CHALLENGES IN PLANNING OR SOLVING PROBLEMS

Some people may experience changes in their ability to develop and follow a plan or work with numbers. They may have trouble following a familiar recipe or keeping track of monthly bills. They may have difficulty concentrating and take much longer to do things than they did before.

A Typical Age-Related Change

Making occasional errors when balancing a checkbook.

3) DIFFICULTY COMPLETING FAMILIAR TASKS AT HOME, AT WORK OR AT LEISURE

People with Alzheimer’s often find it hard to complete daily tasks. Sometimes, people may have trouble driving to a familiar location, managing a budget at work or remembering the rules of a favorite game.

A Typical Age-Related Change

Occasionally needing help to use the settings on a microwave or to record a television show.

4) CONFUSION WITH TIME OR PLACE

People with Alzheimer’s can lose track of dates, seasons and the passage of time. They may have trouble understanding something if it is not happening immediately. Sometimes they may forget where they are or how they got there.

A Typical Age-Related Change

Getting confused about the day of the week but figuring it out later.

5) TROUBLE UNDERSTANDING VISUAL IMAGES AND SPATIAL RELATIONSHIPS

For some people, having vision problems is a sign of Alzheimer’s. They may have difficulty reading, judging distance and determining color or contrast, which may cause problems with driving.

A Typical Age-Related Change

Vision changes related to cataracts.

6) NEW PROBLEMS WITH WORDS IN SPEAKING OR WRITING

People with Alzheimer’s may have trouble following or joining a conversation. They may stop in the middle of a conversation and have no idea how to continue or they may repeat themselves. They may struggle with vocabulary, have problems finding the right word or call things by the wrong name (e.g., calling a “watch” a “hand-clock”).

A Typical Age-Related Change

Sometimes having trouble finding the right word.

7) MISPLACING THINGS AND LOSING THE ABILITY TO RETRACE STEPS

A person with Alzheimer’s disease may put things in unusual places. They may lose things and be unable to go back over their steps to find them again. Sometimes, they may accuse others of stealing. This may occur more frequently over time.

A Typical Age-Related Change

Misplacing things from time to time and retracing steps to find them.

8) DECREASED OR POOR JUDGMENT

People with Alzheimer’s may experience changes in judgment or decision-making. For example, they may use poor judgment when dealing with money, giving large amounts to telemarketers. They may pay less attention to grooming or keeping themselves clean.

A Typical Age-Related Change

Making a bad decision once in a while.

9) WITHDRAWAL FROM WORK OR SOCIAL ACTIVITIES

A person with Alzheimer’s may start to remove themselves from hobbies, social activities, work projects or sports. They may have trouble keeping up with a favorite sports team or remembering how to complete a favorite hobby. They may also avoid being social because of the changes they have experienced.

A Typical Age-Related Change

Sometimes feeling weary of work, family and social obligations.

10) CHANGES IN MOOD AND PERSONALITY

The mood and personalities of people with Alzheimer’s can change. They can become confused, suspicious, depressed, fearful or anxious. They may be easily upset at home, at work, with friends or in places where they are out of their comfort zone.

A Typical Age-Related Change

Developing very specific ways of doing things and becoming irritable when a routine is disrupted.

According to Asaichi, the key impact areas upon our lives are:

Loss of key “kuku-kaka” (mnemonic aid) areas show up  dangers, esp. :

Ku-suri – MEDICINE admin. dangers
Ku-ruma – CAR control dangers…need to stop driving altogether
Kane – Money control, administration)
Kaji (disaster causation … Forgetting to turn off the firestove, gas heaters, etc., and to lock the door)

(can you recall all the 4 Ks ???)

According to Japanese research, some effective strategies to prevent MCI deterioration of cognitive faculties and dementia include the following:

  • Keep a 2-day diary recording all events up till 2 days ago without aids or others’ assistance. Record mistakes made too.
  • Walking strategies, increase stride and pick up heels by 5cm – This is expected to increase substances that promote the growth of nerve cells due to slightly challenging aerobics exercise. Increase walking activities or take up vigorous aerobic heart-pumping exercise for at least 5 min daily (exercise increases blood pumped to your heart but the blood also nourishes the brain)
  • Step aerobics, dance or other exercise all the while thinking, introducing new elements just before consolidating old memories
  • Practise Memory Recall Games – try to recall 10 items (average proper functioning capability, you should be able to recall around 8-10 items). At one experimental centre, an effective strategy with dementia and Alzheimer’s patients was to have patients look at and repeat and recall the random sequence of color-coded color charts. (This is very similar to Dr Shichida’s method of training children in perfect recall and retrieval and especially their Mandala colour-coded geometric charts)

ABOUT MILD COGNITIVE IMPAIRMENT

Mild cognitive impairment causes cognitive changes that are serious enough to be noticed by the individuals experiencing them or to other people, but the changes are not severe enough to interfere with daily life or independent function. Because the changes caused by MCI are not severe enough to affect daily life, a person with MCI does not meet diagnostic guidelines for dementia.

Learn more:
WHAT IS ALZHEIMER’S?

DIAGNOSIS

Mild cognitive impairment is a “clinical” diagnosis representing a doctor’s best professional judgment about the reason for a person’s symptoms.

Early diagnosis is essential according to the TV programme, it is best to prepare yourself as well as family members for the eventuality that one descends into dementia or Alzheimer’s. See: http://www.alz.org/alzheimers_disease_why_get_checked.asp
A medical workup for MCI includes the following core elements:

Thorough medical history, where the physician documents current symptoms, previous illnesses and medical conditions, and any family history of significant memory problems or dementia

Assessment of independent function and daily activities, which focuses on any changes from a person’s usual level of function

Input from a family member or trusted friend to provide additional perspective on how function may have changed

Assessment of mental status using brief tests designed to evaluate memory, planning, judgment, ability to understand visual information and other key thinking skills

In-office neurological examination to assess the function of nerves and reflexes, movement, coordination, balance and senses

Evaluation of mood to detect depression; symptoms may include problems with memory or feeling “foggy”

Laboratory tests including blood tests and imaging of the brain’s structure

If the workup doesn’t create a clear clinical picture, the doctor may recommend neuropsychological testing, which involves a series of written or computerized tests to evaluate specific thinking skills.

CAUSES AND RISKS

The causes of mild cognitive impairment are not yet completely understood. Experts believe that many cases result from brain changes occurring in the very early stages of Alzheimer’s disease or other dementias. The risk factors most strongly linked to MCI are the same as those for dementia: advancing age, family history of Alzheimer’s or another dementia, and conditions that raise risk for cardiovascular disease.

TREATMENT AND OUTCOMES

No medications are currently approved by the U.S. Food and Drug Administration (FDA) to treat mild cognitive impairment. Drugs approved to treat symptoms of Alzheimer’s disease have not shown any lasting benefit in delaying or preventing progression of MCI to dementia. See above…plus:

Coping Strategies:

  • Exercise on a regular basis to benefit your heart and blood vessels, including those that nourish your brain
  • Control cardiovascular risk factors to protect your heart and blood vessels, including those that support brain function
  • Participate in mentally stimulating and socially engaging activities

MCI increases the risk of later developing dementia, but some people with MCI never get worse. Others with MCI later have test results that return to normal for their age and education. Experts recommend that a person disgnosed with MCI be re-evaluated every six months to determine if symptoms are staying the same, improving or growing worse.

Researchers hope to increase the power to predict MCI outcomes by developing new diagnostic tools to identify and measure underlying brain changes linked to specific types of dementia.

The above information is based on today’s broadcast NHK TV Asaichi programme    <“もの忘れ”が気になるあなたへ 最新!認知症対策> URL: www1.nhk.or.jp/asaichi/2014/05/12/01.html as well as the Alzheimer Association Alz.Org. Webpages URLs: http://m.alz.org/mild-cognitive-impairment.asp and http://m.alz.org/causes-and-risk-factors.asp

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