Older parent has become forgetful
My 77-year-old mom has been forgetful and not as sharp as she used to be. Her doctor said she has a problem called Mild Cognitive Impairment. Is this a real illness or just her being older? As we age, our bodies change and so do our brains. Your question is a good one, as normal aging includes changes in how our brain functions.
The real issue is how does Mild Cognitive Impairment (MCI) fit in as part of normal aging? A diagnosis of MCI is determined by looking at the history provided to the physician and through some cognitive testing. Individuals with MCI often complain of forgetting things, hav- ing trouble with decisions and finding their way around. They may mix up social engagements and not be able to follow books or movies as easily as they did in the past. It should also be noted that a person with MCI may have mood changes and be irritable, anxious or depressed.
Often, people notice the changes themselves and may come forward with complaints. They may feel that they are not “at the top of their game.” This may be a cause of stress for them or their family.
A key difference between dementia and MCI is that the individual does not have trouble with their usual activities of daily living, such as shopping, managing their schedule of commitments and getting around town on their own. With an MCI diagnosis, Mom is likely still able to do the things that she needs to do, but maybe not as well.
With MCI, there is a decline over time that is noted by people who are diagnosed with the condition. Their history usually reveals that they are having more trouble with decisionmaking and planning, and possibly following more complex instructions.
You can’t be diagnosed with MCI and dementia simultaneously. The doctor likely did some cognitive testing and a complete checkup to rule out any other serious neurological problems.
People with MCI are at greater risk of developing dementia. Some studies note that 10-15 per cent of people with MCI develop dementia every year. However, not everybody progresses to dementia and a certain proportion of individuals actually get better. The risk factors for MCI are age and other medical and lifestyle factors such as exercise, smoking, high blood pressure, diabetes and social isolation or lack of mental stimulation.
Presently, there is no drug or treatment specifically designed to treat MCI, but research is underway to look at what can be done to delay or prevent the symptoms from progressing to dementia.
Your doctor surely ensured that mom is treated for any other concerns (like high blood pressure or depression). Making sure that all medical problems that can affect the brain are dealt with is imperative.
“Research shows that people with MCI can learn and apply memory strategies. This is good news, as memory habits that promote everyday memory in turn promote sustained functional independence,” says Dr. Kelly Murphy, a psychologist at Baycrest Health Sciences.
Dr. Murphy co-authored the book Living with Mild Cognitive Impairment: A guide to maximizing brain health and reducing risk of dementia, published by Oxford University Press (2012). Keep an eye on mom and on her day-to-day functioning, and report any concerns. She may need some additional support, but don’t let the MCI diagnosis panic you or her.
The best thing to help mom is to ensure she keeps active and stimulated, and make sure she is both mentally and socially busy. Ensure that she is eating properly and exercising. There are programs to help learn strategies to cope with some of the memory issues and support for caregivers like you. Nira Rittenberg is an occupational therapist who specializes in geriatrics and dementia care at Baycrest Health Sciences Centre and in private practice. She is co-author of Dementia A Caregiver’s Guide available at baycrest.org/ dacg Email questions to caregivingwithnira@baycrest.org.