Ask the Doctors

Dear Doctor: My brother-in-law, who recently retired from his job as a research scientist at age 68, has been diagnosed with mild cognitive impairment. I don't want to upset my sister with too many questions, so I wonder if you can explain what this means? Is he going to get Alzheimer's? Can anything be done?

Dear Reader: Mild cognitive impairment is a condition of decline in functions like memory, language and reasoning that is slight but still perceptible. People with MCI will have more trouble than others their age in finding the right words when speaking, and in remembering routine activities like events or appointments. They begin to lose track of things, like car keys or glasses. They may have lapses in logic or judgment and can sometimes have trouble following the thread of a conversation or the plot of a film or book. In some cases, MCI is also associated with a dulling of the sense of smell and difficulties with movement. When the condition affects memory, it's known as amnestic MCI. When motor skills and questions of judgment are involved, it's known as non-amnestic MCI.

These changes may take place gradually, but eventually they become significant enough that close friends and family members will notice. However, they do not approach the severity of symptoms of various types of dementia. For example, the disorientation, mood shifts, personality changes and aggression that are often part of Alzheimer's and other kinds of dementia are not present in MCI. The affected individual is often aware that something within him or her is changing, which can be frightening.

Diagnosis often entails a complete medical history, a neurological exam to evaluate the functioning of the nerves and reflexes as well as balance and coordination, brain imaging tests, blood tests, cognitive testing and input from individuals in the patient's daily life to assess mental status and independent function.

The causes of MCI are not yet understood, and thus far there are no drugs or medical treatments to address the condition. Although individuals diagnosed with MCI have been found to be more likely than others to go on to develop Alzheimer's disease, the progression is not a certainty.

When it comes to nontraditional treatments, the results are mixed. There is anecdotal evidence that gingko biloba or vitamin E can be helpful, but thus far they have not stood up to the rigors of a clinical trial. Some studies suggest that regular exercise can help with cognition. It is recommended that individuals with MCI take part in regular social activities and engagement, as well as mental challenges and stimulation. A diet of lean protein, healthful fats, and plenty of fruits, vegetables and leafy greens is good and plays a role in cognitive issues as well as cardiovascular health.

It's kind of you to not push for information at this time. But do let your sister know you're available when she needs you. This is a scary time for her as well as for her husband. Knowing you're close by can help pierce the isolation that a diagnosis like this can cause.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Owing to the volume of mail, personal replies cannot be provided.)

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