What’s more, while people with M.C.I. may go on to develop Alzheimer’s disease or other dementias, the progression is not a guarantee. Treating M.C.I. can “prolong that period of being independent by months or years,” said Andrew Kiselica, a neuropsychologist at the University of Missouri who specializes in diagnosing dementia.
Lifestyle Changes and Adjustments
The first step to treating M.C.I. is to search for a biological reason for someone’s symptoms using blood tests, brain scans and other clinical assessments. Many cases of M.C.I. are caused by neurodegenerative diseases, but there are other conditions that can affect cognition, including sleep apnea, depression, hearing loss, cirrhosis of the liver or a vitamin deficiency. “Those sorts of things may be potentially addressed with treatment and potentially reversible,” Dr. Kiselica said.
Even if the root cause for M.C.I. is a neurodegenerative disease, taking care of some of these “exacerbating causes” can help improve symptoms, said Dr. Halima Amjad, an assistant professor of medicine specializing in geriatrics at the Johns Hopkins University School of Medicine. A doctor might swap out medications that are causing brain fog or other cognitive side effects, or fit a person for hearing aids so that they can be more socially engaged. “They might not be the only cause, but if they’re making cognition worse, let’s make it better,” she said.
Evidence also suggests that lifestyle interventions, particularly exercise and diet, can slow cognitive decline. “It’s almost a cliché for a doctor to say you need to eat right and exercise,” Dr. Fredericks said. “But we have a lot of really good data that, especially in the very earliest stages of illness, things like a significant amount of cardiovascular exercise, like eating a Mediterranean diet” can be very helpful for cognition, as well as quality of life. Experts typically recommend 150 minutes of moderate intensity or 90 minutes of vigorous intensity aerobic activity per week, plus two days of resistance training.
Introducing Medication
Drugs called cholinesterase inhibitors have been used to treat dementia for years. These medications block the breakdown of a common neurochemical called acetylcholine that is important for attention and memory. They don’t address the underlying causes of the disease, but they can help improve symptoms.
