Q:ย I realize that I sometimes have difficulty connecting a name and a face.ย I presume that this is mild cognitive impairment.
On researching the topic online, I find a variety of suggestions for alleviating it.ย These include supplements (lipoic acid, vitamin E, omega 3s, curcumin), food choices (fish, vegetables, black and green teas), aerobic exercise, yoga, and meditation.ย
Do these actually help with mild cognitive impairment? What’s been proven to work?
A:ย It’s common for older adults to feel they’re having trouble with certain memory or thinking tasks as they get older.
I can’t say whether it’s mild cognitive impairment (MCI) in your particular case. But we can review what is known about stopping or slowing cognitive changes in people diagnosed with MCI.
First, letโs start by reviewing what MCI is, and how it’s diagnosed. Then I’ll share some information on the approaches you are asking about, as well as other approaches for treating MCI.
What is Mild Cognitive Impairment?
Mild cognitive impairment (MCI) means having cognitive abilities (memory and thinking skills) that have become worse than “normal” for your age. However, the memory or other problems shouldn’t be so bad that you no longer can complete daily life tasks you used to do, such as finances or meal preparation, without assistance.
In other words, the impairments canโt be bad enough to meet the criteria for dementia, which requires cognitive skills to have declined to the point that independence in common daily life tasks is compromised.
If you’re concerned about your memory, itโs important that you not assume it’s MCI. Instead, you’ll want to have your thinking skills assessed by a clinician. This is how you can find out if your difficulties fall within the range of “normal age-related changes” versus being worse than normal, which is a criterion for having MCI.
Studies find that many older people feel that their memory or thinking is getting worse. However, this doesn’t necessarily mean they have MCI.
This is because declines in certain types of memory and thinking skills are now known to be part of normal “cognitive aging.” For more on what is often normal with aging, see 6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This).
In fact, difficulty connecting “names and faces” is common among normal older adults. Itโs probably due to the known slowing in brain processing speed that occurs as people age.
As of 2013, MCI is also called “mild neurocognitive disorder” whereas dementia has been renamed “major neurocognitive disorder.” While you might not need to know these more technical terms, it may save some confusion if you are reading about newer research. (Most practicing doctors still use the older terms.)
Experts agree that some people with MCI are essentially in the very earliest symptomatic stages of a brain-changing condition such as Alzheimer’s or another type of dementia. It is also possible for cerebral small vessel disease to cause vascular cognitive impairment, which can eventually become vascular dementia.ย Studies suggest that over 5 years, 30-40% of people with MCI will progress to dementia.
However, thatโs only 30-40% of people. So not all MCI is early dementia. Some people with MCI never seem to get much worse, and some even seem to get better.
How is mild cognitive impairment diagnosed?
MCI is diagnosed through a clinical assessment done by a qualified doctor or other healthcare professional.
A clinical assessment should usually include:
- Interviewing the patient regarding his concerns, and inquiring about difficulties managing life tasks, such as Activities of Daily Living and Instrumental Activities of Daily Living (ADLs and IADLs)
- Assessing whether family members and other observers have noticed anything concerning
- Evaluating cognitive abilities using a short office-based test, such as theย Montreal Cognitive Assessment
- Checking prescribed and over-the-counter medications, to see if any are known to make thinking worse (seeย 4 Types of Brain-Slowing Medication to Avoid if You’re Worried About Memory)
- Evaluating for medical conditions, including mental health conditions andย sleep disorders, that can worsen thinking or can mimic early dementia
Laboratory work is often necessary, to check for problems such as thyroid disorders, vitamin B12 deficiency, and electrolyte imbalances.
After this initial assessment, a person might be referred for additional neuropsychological testing. These tests provide a more in-depth assessment of specific memory and thinking skills. They can help further categorize MCI as “amnestic” (meaning the problems are mainly with memory) versus non-amnestic.
Ultimately, the process of diagnosing MCI is similar toย diagnosing dementia: it requires documenting concerns and difficulties, objectively assessing cognitive abilities, and ruling out other medical problems (includingย medication side-effectsย andย delirium) that might be interfering with brain function.
But in MCI, the cognitive impairments shouldย notย be severe enough to interfere with independence in daily life tasks.
For more on evaluating the complaint of cognitive impairment in older adults, see here: Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check.
You can also learn more about how MCI is diagnosed in this video, “MCI, Alzheimer’s and Dementia: What’s the Difference“:
What are proven ways to treat mild cognitive impairment?
In many clinical trials, the goal in “treating” mild cognitive impairment has been to reduce the risk of progression to Alzheimerโs or another dementia.
Unfortunately,ย almost nothing has been proven to work, although some approaches are promising and certain approaches (especially exercise) probably delay the progression to dementia.
In particular, no oral medications are actually FDA-approved for the treatment of MCI, as none have been shown to prevent progression to dementia.
(Note: Two controversial new Alzheimer’s antibody drugs — Aduhelm and Leqembi — did get FDA-approved in recent years. They can be used in certain cases where testing shows the MCI is pre-clinical Alzheimer’s disease. See the Medications in MCI section below.)
In 2018, the American Academy of Neurology issued their “Practice guideline update summary: Mild cognitive impairment. (The guideline was reaffirmed in 2021.) They suggest that clinicians recommend regular exercise and say they “may recommend cognitive training.” They make a stronger recommendation for stopping medications that interfere with cognition, and they reiterate that “no high-quality evidence exists to support pharmacologic treatments for MCI.”
Much of the research on treating mild cognitive impairment is summarized in the Agency for Healthcare Research & Quality’s (AHRQ) detailed 2017 review:ย Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimerโs-Type Dementia. This review’s conclusion notes that exercise is promising but most treatments have failed to show conclusive benefits so far.
You can also learn more about scientifically tested treatments for MCI in this video:
Exercise for MCI
The approach that seems most consistently promising is exercise, although itโs unclear which exercise is best. One randomized study showed an improvement in patients doing different exercises, whereasย another indicated that resistance training helped. A 2022 systematic review concluded that resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive decline in patients with cognitive dysfunction.”
A sensible approach is to include all important types of exercise. That is: aerobic, resistance, balance, and flexibility exercises.
Although it may not be clear which one is best for MCI, all four are necessary to maintain overall health and mobility in older adults.
You can learn more about the four types of exercise at the National Institute on Aging’s site: Four Types of Exercise Can Improve Your Health and Physical Ability.
There is also promising research showing that a group movement program called PLIE can improve outcomes in MCI:ย Preventing Loss of Independence through Exercise (PLIร): A Pilot Trial in Older Adults with Subjective Memory Decline and Mild Cognitive Impairment.
Dietary approaches for MCI
There is research to suggest that diet plays a role in dementia. However, itโs not yet clear what particular diet will prevent MCI from progressing in most people.
In general, a diet that is good for overall health will also be good for brain health. The MIND diet (a variant of the Mediterranean diet) is probably a good place to start. The general principles include:
- Eat lots of vegetables, of all types and colors
- Eat berries, and other fruits
- Eat nuts, avocados, and other forms of “healthy” fats
- Eat fish at least once a week (preferably fish low in mercury)
- Eat beans and legumes
- Limit meat and animal-based saturated fats
- Minimize transfats, packaged food, fast food, added sugar, and cured meat products
Of note, a 2023 randomized controlled trial of the MIND diet did not find that this diet prevented cognitive decline. However, the control group followed a mild caloric restriction diet, and both groups slightly improved over three years.ย
A 2021 scholarly review of nutrition and cognition can be read here: Effects of Nutrition on Cognitive Function in Adults with or without Cognitive Impairment: A Systematic Review of Randomized Controlled Clinical Trials.
Some experts recommend vegan diets for better brain health, but most experts feel that the scientific evidence doesn’t justify this.
What IS becoming clear is one’s response to a certain diet is highly individual, and appears to be especially driven by the microbiome (the community of gut microbes) we each have in our intestines. So newer research is developing dietary approaches that help people do the trial and error necessary to find out which diet reduces inflammatory markers, blood fat levels, and stabilizes blood glucose levels in their own body.
Although it will be a while before we know whether these personalized diet approaches can treat MCI in particular, I expect that a better diet will improve brain outcomes in at least some people.
Otherwise: one of my favorite clinical nutrition trials is titled the โCocoa, Cognition, and Aging (CoCoA) Study.โ In 2012 the researchers published the results of a study in which they found that giving people with MCI a daily cocoa drink led to improved cognitive function and insulin metabolism eight weeks later.
Now, we still donโt know if daily cocoa would change the likelihood of having dementia a few years later. But it’s encouraging news for those who like dark chocolate.
Supplements for MCI
Some researchers have found thatย a vitamin B supplementย (a combination of folic acid, vitamin B6, and vitamin B12) reduces cognitive decline in MCI. But thisย may only be in people who have high homocysteine levels.
(Homocysteine is a common amino acid – one of the building blocks that make up proteins – found in the blood. High levels have been associated with low intake of folate and vitamin B12.)
Aย large trial published in 2005ย found that vitamin E had no effect on the progression of MCI.
A variety of other anti-oxidants have been studied, but so far nothing seems to be definitely beneficial. A review of anti-oxidants can be foundย here.
A 2018 Cochrane Review concluded that “the evidence on vitamin and mineral supplements as treatments for MCI is very limited.”
Vitamin D has also been studied, with mixed results when it comes to meaningfully influencing cognitive outcomes. You can find a good summary of research studying the association between Vitamin D, cognitive decline, and Alzheimer’s here. It’s probably reasonable to try to avoid frank vitamin D deficiency by taking a daily supplement of 800-1000 IU. But there is no evidence that treating MCI with higher doses of vitamin D will delay progression to dementia.
One type of supplement not covered in the Cochrane review was omega-3 fatty acids, which are found in fatty fish (as well as in some other foods such as nuts and seeds). Supplementation of omega-3 fatty acids via fish oil has shown some beneficial effects for cardiovascular health, which means it might help with brain health as well. To date, I would describe the evidence for omega-3 fatty acid supplements helping in MCI as promising but not yet proven (when it comes to preventing progression to dementia).ย A good review on this topic is here: Omega-3 fatty acids and cognitive decline: a systematic review.
In general, when people ask me about supplements and MCI, I tell them that I think it’s reasonable to consider vitamin B12 and omega-3 fatty acids, and that I think all older adults should take 800-1000 IU/day of vitamin D. These supplements are unlikely to harm and may help treat common deficiencies that can worsen cognitive decline. That said, there’s no proof that these supplements can treat or delay MCI in most people, so it’s important to be realistic about the likely small effect.
Medications for MCI
Oral medications
There are currently no oral medications that have FDA approval for the treatment of MCI.
Some medications have been studied in randomized controlled trials, but have not been shown to prevent the progression of MCI. These include medications FDA-approved for the treatment of dementia and Alzheimer’s, such as donepezil,ย galantamine, rivastigmine, and memantine (brand names Aricept, Razadyne, Exelon, and Namenda, respectively).
Oneย 2012 reviewย published by the respected Cochrane Library concluded that these types of medicines ” should not be recommended for mild cognitive impairment.”
However, many doctors prescribe these medications to people with MCI, especially if they have amnestic MCI. In theory, this might help mitigate some of the memory symptoms.
But if a person with MCI doesn’t notice some improvement after starting the medication, they should not be surprised. And they should not feel obligated to continue the medication.
Anti-amyloid infusion treatments
Amyloid is a protein that abnormally accumulates in the brain in Alzheimer’s disease. In recent years, the FDA has decided to approve certain anti-amyloid antibody treatments, to treat those forms of mild cognitive impairment that have been shown to be due to very early Alzheimer’s disease. This type of proof requires special scans and biomarkers that are usually only done as part of research studies and often are not routinely covered by insurance.
These newer treatments are infusions, which means they are administered intravenously. They can cause brain swelling and potentially serious side-effects, so they also require very careful monitoring. Although these treatments do seem to reduce amyloid in the brain, the clinical benefit (meaning, does it meaningfully delay the progression of Alzheimer’s symptoms) is unclear.
Aducanumab (Aduhelm) was approved by the FDA in 2021. The approval was controversial, due to weak evidence of clinical benefit, and Medicare has opted to not cover this medication for the time being, unless the person is enrolled in a trial.ย ย
A similar medication, lecanemab (Leqembi) was approved in 2023. ย Its phase 3 randomized trial concluded that lecanemab “resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events.” In July 2023, Medicare announced that it will cover lecanemabย provided there is participation โin a qualifying registry with an appropriate clinical team and follow-up care.โย
Yoga and meditation for MCI
Stress tends to worsen brain function. So it’s possible that stress-reducing activities like yoga or meditation might help in MCI.
Yoga has mainly been studied in older adults with “normal” cognition. Results suggest yoga can benefit cognitionย but further research is recommended.
A 2019 review of yoga specifically for mild cognitive impairment or dementia reached similar conclusions:ย The effects of yoga on patients with mild cognitive impairment and dementia: A scoping review.
Qigong and tai chi are also being studied for MCI.
Meditation and related mindfulness practices may improve MCI. Smaller studies, such as this one, have found that a mindfulness program was associated with encouraging brain changes on functional MRI scans.
However, other studies of mindfulness in MCI, such as this one,ย have not shown an improvement in outcomes. Most systematic reviews, such as this one, conclude that mindfulness is promising but not proven, as a treatment for MCI.
That said, even though the evidence isn’t very strong, I highly recommend that anyone with MCI try a mindfulness-based intervention. For those who are able to find a practice that works for them, I believe this can play a valuable role in coping with the worry and uncertainty that often comes with MCI. A good way to get started is to sign up for an 8-week mindfulness-based stress reduction (MBSR) course. Paying for a live course or online course often helps one complete the course. There is also a free self-paced course available here.
Yoga, qigong and tai chi are also good ways to practice balance, so in general I feel pursuing this approach to manage MCI is a good idea.
Brain training for MCI
People sometimes wonder if “brain training” can keep MCI from progressing to dementia. So far this is unknown.
Much of the brain training research has studied whether the intervention improves memory and cognitive function in the short-term. A 2016 review found that brain training does indeed seem to improve certain cognitive abilities in the short-term.
But, it’s still unclear whether this results in long-term benefits, or delays overall progression to dementia. A good summary of the research on this topic can be found in this chapter of the AHRQ review: Cognitive Training.
The biggest problem with cognitive training for MCI, in my opinion, is that commercially available programs are almost certainly not as good as the programs being used in research. For this reason, if you want to pursue this approach to treating MCI, I recommend seeing if you can enroll in a clinical trial.ย
Hearing aids for MCI
Last but not least, if you’ve been concerned about MCI, it is probably worthwhile to have your hearing checked, and any hearing loss corrected if possible.
Quite a lot of research has confirmed that there is an association between hearing loss and cognitive impairment.
Now, does treating hearing loss actually prevent or delay the progression of MCI? This is a hot topic that is being actively researched. So far, a large retrospective study has found that using hearing aids did reduce progression to dementia. Randomized trials are now underway to see if they can confirm this finding.
Personally, I think treating hearing loss sounds more likely to improve MCI outcomes than brain training does, so I would highly recommend this approach.
Although hearing aids have historically been expensive and challenging to obtain, over-the-counter hearing aids are expected to be available soon.
For more on hearing loss in aging, see 4 Key Things to Know About Age-Related Hearing Loss.
Alternative health treatments for MCI
Some health practitioners claim to be able to treat memory loss, and in recent years, many people have asked me about the Bredesen Protocol, which came to public attention when Dr. Dale Bredesen published his book “The End of Alzheimer’s.”ย
I did read the book and thought Dr. Bredesen was bringing up some promising ideas for the mainstream neurology community to consider. In particular, I agree that a comprehensive approach targeting multiple factors that aggravate brain health is what’s most likely to stall (or maybe even reverse) cognitive decline. And I agree that lifestyle treatments (e.g. changing nutrition, exercise, stress levels) are vastly under-used.
The problem, however, is that mainstream neurologists feel that Dr. Bredesen has gotten way, way ahead of his scientific evidence, when it comes to describing his protocol as a program that “prevents and reverses cognitive decline.” I have reviewed his publications and I agree: he is reporting promising hypothesis-generating results, but no more than that. Meanwhile, he now has a substantial financial interest in promoting his protocol, for which desperate people are paying substantial sums out of pocket.
If you want to consider his protocol, it’s important to know that it’s very time and labor-intensive, and also expensive (because insurance probably won’t cover most of it). It also seems less likely to work in people who are older (e.g. in their 80s and 90s). And it’s likely impossible to get someone who is not motivated to participate in the treatment (I’m looking at you, adult children concerned about your parent with MCI.)
You can read some of the critiques of this type of MCI treatment here:
- Bredesen Protocol offers false hope of reversing Alzheimerโs disease
- Can we trustย The End of Alzheimerโs?
- Scholarly description of the Bredesen protocol:ย Precision Medicine Approach to Alzheimerโs Disease: Successful Pilot Projectย (note: ages of included patients were 50-76, with MoCA at least 19)
My main recommendations for managing MCI
The bottom line is that no treatment has been convincingly proven to improve long-term outcomes in MCI. So, I believe itโs best to focus on general things that promote brain health.
That is:
- Stay physically active and exercise regularly
- Address risk factors for cardiovascular disease
- Consider the MIND diet (or better yet, a personalized nutrition approach that helps you stabilize inflammation, glucose levels, and fat levels in your blood)
- Identify and treat any hearing loss
- Avoid brain-slowing medications
- Treat sleep disorders when possible and avoid chronic sleep-deprivation
- Avoid delirium
- Find constructive ways to manage chronic stress (consider a mindfulness-based stress reduction class, meditation, or yoga)
- Seek treatment if you have signs of depression or chronic anxiety
- Pursue positive social activities, purposeful activities, and activities that “nourish the soul”
For more information on these common-sense brain health approaches (which are generally good for physical health and healthy aging), see “How to Promote Brain Health: The Healthy Aging Checklist, Part 1.”
If you’re worried you might have MCI
You can see that this is a complex area. Mild cognitive impairment is not as simple to diagnose as diabetes, nor is it as easy to treat.
However, itโs just as important to see a doctor. So donโt make assumptions if you notice changes in memory or thinking. Thatโs a huge risk.
Instead,ย if you have signs of MCI, make sure you get evaluated by a professional. See your doctor.
They can check what other factors may be affecting your memory and thinking. They can support you and help you find answers to your questions. They can help you manage your symptoms and provide peace of mind.
So donโt sit, and wait, and worry.
Pick up the phone and make an appointment. Make sure they check for medication side-effects and other medical problems that can worsen thinking. And make sure they know if youโve been having trouble with finances, driving, or other life tasks.
And then if you are diagnosed with MCI, you can come back to this article for a refresher on what approaches are most promising, when it comes to treatment.
I also recommend looking into joining a clinical trial. You can search for trials near you (you will also be shown online trials!) at the Alzheimers.gov site.ย
This article was last reviewed and updated by Dr. Kernisan in February 2024.
Eliot Obi-Tabot says
Which is the best test to evaluate if the medication I’m taking for cognitive impairment is working?
Nicole Didyk, MD says
The memory tests that we commonly use when diagnosing dementia aren’t really designed to be used to follow progression or response to medication , but in practice, we often use them for those purposes.
The reliability of these tests depend on them being administered by someone with appropriate training and professional background. I made a little video about memory tests, which you can watch here: https://youtu.be/ixJFtRCwrMA
Another way to see if the medication is working would be to ask family and friends if they’ve noticed any improvement in your attention, language skills, or memory. Most memory pills are of very modest benefit and it can be difficult to tell how well they’re working. I usually wait until someone has been on medication for at least 3 months before evaluating the response.
Mary says
Can the effects of taking doxylamine succinate for many years be reversed or does it cause permanent damage?
Nicole Didyk, MD says
Doxylamine succinate is the active ingredient in the OTC sleep aid Unisom, but it’s actually an antihistamine, designed to relieve allergy symptoms.
Although the drug itself doesn’t hang around in the body for very long, we Geriatricians advise against long-term use of a mediation like doxylamine succinate because of its anticholinergic properties. We have good evidence that prolonged use of anticholinergic medications can increase the risk of cognitive impairment, but the good news is that stopping the medication can reduce that risk.
So, I wouldn’t think of it as “permanent damage”, but reducing or stopping anticholinergic drugs can definitely have short term and longer term benefits for older adults.
Robert Barletta says
Hello Dr
I think you are great and have been reading your post for some time now. My mother likely has MCI she has been relatively stable for a few years. Covid didnโt help her situation given the isolation and lack of socializing. My question however is you mention in post above that there is a vitamin B mix that can help with MCI. Would you kindly be able to give the exact name of it or a link to e-commerce site? Thank you so much!!!
Nicole Didyk, MD says
Hi Robert and thanks for reading the articles, I’m so glad that they’ve been helpful.
In the study that Dr. Kernisan mentions, the participants took Vitamin B12 500 micrograms, Folate 800 micrograms, and Vitamin B6 20 mg once daily. These are likely readily available at the pharmacy, but may need to be taken separately. I would just caution that this was a small study, of about 110 individuals, so it isn’t as scientifically powerful as a larger study would be. In addition, it seems that those who had some benefit had a lower homocysteine level, so it may not help in everyone.
B vitamins can also be obtained through the diet, with intake of leafy green vegetables, grains and animal products if you don’t want to take a pill.
Joy Martin says
Hi, Iโm A 48-49 year old female with chronic intractable migraines, migraine with without aura, cervicogenic migraines, high blood pressure etc.. my neurologist nurse says my mri is normal but it says that there are scattered subcortical and periventricular flair hyperintensity densities in the supratentorial white matter which may be related to migraine, high blood, pressure,prior infection..Iโve asked my drs to explain more than once what this means and I still get no answers. I struggle with memory, attention, balance, fine motor skills, It feels like my brain scrambles or shorts out and I get disoriented. Any thoughts you might have would be appreciated.
Nicole Didyk, MD says
Hello Joy and it sounds like you’re wanting to learn more about your MRI findings. You might find this post about small vessel disease (which can cause white matter changes) helpful. Although this website mostly covers issues about older adults, someone in your age group with similar issues may find it useful as well.
Rubi r abarientos says
Hi! Good morning. Can i ask? What can i do to me. My situation is tbi my vission is doble and blurrd please help me.?
Leslie Kernisan, MD MPH says
Sorry but I don’t have any particular expertise with traumatic brain injuries. I would recommend looking for a health provider who specializes in treating this condition. You might also find it helpful to look for an online community of people recovering from TBI. Good luck!
Katie says
Hello, I’m 49 and have been preparing my Will. The extent of my family history for dementia is one maternal aunt who progressed to late stage Alzheimer’s. I have white matter disease from untreated high blood pressure when I was younger (doctors just thought I was nervous when I had doctor’s visits). Anyway, although I realize it’s not likely, if I lose my memory, I do not want to live. I need to put this in my Will. My question is: I know there are some states where assisted suicide is legal. I’ve been studying the laws for these states, then saw your website and thought I would ask for your feedback on the subject. Do you know if there are any states where you don’t have to be a resident for years? That’s my most important question. Thank you for your time. Katie
Leslie Kernisan, MD MPH says
Hm, I actually don’t know what are the residency requirements for physician-assisted suicide. However, I’m pretty sure that in all states where it is legal, the person has to have mental capacity at the time of the suicide, and they also have to be terminally ill at that time. So people with dementia generally do not qualify, because by the time their dementia is advanced enough for them to be likely to die within 6-12 months, they will have lost mental capacity for a long time.
If you would prefer to not be kept alive if you’d significantly lost your memory, you will need to relay that in an advance directive. (Not in your will; wills are about the disposition of your property and estate after you die.) We have resources on advance planning here. You can also find an advance directive specific for dementia on the ConversationProject.org website.
Sebastian Conti says
I sustained a bilateral basilar skull fracture 40 years old and was in a coma for one week. Would you comment please how TBI affects the risk of dementia? Thank you.
Leslie Kernisan, MD MPH says
The relationship between traumatic brain injury (TBI) and dementia is an area of active research. A study of TBI in older adults found that it was associated with Parkinson’s disease and Lewy Body accumulations, but not Alzheimer’s pathology.
Association between Traumatic Brain Injury and Late Life Neurodegenerative Conditions and Neuropathological Findings
I think it’s unclear what the risk would be for someone with your situation, having a TBI at age 40.
I would encourage you to focus on dementia risk factors that you can actually control now. Good luck!
Dave says
Hello Doctor Kernisan. My wife, age 62, has had memory issues for about a year now. They can be long term, or short term, depending on the day. She has seen her primary doctors, as well as a Neurologist and a Neuropsychologist. She has had labs, CT Scan, XRays, etc. all of which have shown nothing.
They told us to reevaluate her meds, which we have done. She wasn’t on any of the meds that you’ve mentioned, although we have modified some dosages, and discontinued one. Her Neuropsychologist said he “may” have some MCI, but nothing conclusive.
She is under stress due to our daughter and 2 year old granddaughter, that she is forced to watch 40 hours per week, and I think this is contributing to her issues, but my wife feels she has no choices in this situation.
We don’t know where to turn to anymore. Due you have any suggestions? Thank you for your time, and excellent, informative column.
Leslie Kernisan, MD MPH says
Sorry to hear of your wife’s memory problems. If she has had a reasonable evaluation, then the main things to do are try to optimize lifestyle factors that promote brain health, and otherwise, cross your fingers and wait to see how things evolve.
Exercise, good sleep, reducing stress, and probably some kind of mindfulness/meditative practice all seem to help. Some people believe that significantly changing the diet can also make a difference; I suspect it depends on whether a person is prone to experience inflammation or other health changes due to their diet. The neurologist Dale Bredesen describes an extremely intensive lifestyle change program in his book the End of Alzheimer’s. My neurology colleagues in academia tell me it has not been adequately tested or proven, but it might give you some ideas on lifestyle changes to consider. Good luck!
Jag says
Please suggest how to find a knowledgeable compassionate geriatrics doctor like you in San Diego who would accept Medicare. My cardiologist would not approve of a high fat diet. I have calcified veins.
Leslie Kernisan, MD MPH says
My suggestions on finding geriatric care are here:
How to find geriatric care โ or a medication review โ near you
Good luck!
Ron Wilson, says
I came to this site looking for info on dealing with a spouses MCI and the psychotropic meds she is on. There is a lot of info out there on the web but your site is like an oasis full of clear insight, knowledge and compassion. Thank you for your contribution to helping others and to making the world a better place.
Leslie Kernisan, MD MPH says
Thank you, I’m so glad you find the site helpful. Good luck helping your spouse.