Cognitive impairment can lead to Alzheimer’s

Sometimes a word is on the tip of your tongue, but you can never find it. Or perhaps a smell is familiar but you can’t place it. Or maybe you struggle with reasoning and judgment in ways that you never did before. If that’s the case, you could be experiencing mild cognitive impairment. By itself, mild cognitive impairment doesn’t force you to make any changes to your daily habits.

You can still drive your car, enjoy your hobbies, and carry on routine conversations. You might get frustrated with your deteriorating memory, but your life is minimally impacted by MCI, which affects 15 to 20 percent of people age 65 or older.

Of concern, however, is that MCI could be a precursor to Alzheimer’s disease, a progressive diagnosis that will limit your ability to do certain daily tasks.

In the United States, between 5 million and 7 million people have been diagnosed with Alzheimer’s. The elderly are more often affected, as about 42 percent of those age 85 or older have some sort of dementia, and Alzheimer’s is the most prominent.

Researchers have not yet identified what causes Alzheimer’s, but age, family history, genetics, environmental factors, and immune system problems could be related.

There is no medication that will cure Alzheimer’s or prevent it from progressing, but some medicines have proven to be effective at lessening symptoms, such as memory loss, depression, sleep problems and confusion. Excitement is building, however, over new drugs called disease modifiers that are being developed for use in MCI and mild Alzheimer’s disease.

Exercise and social activities are important to help manage the disease. So are good nutrition, a healthy lifestyle, and a calm and well-structured environment.

Caregiver’s Guide

• Any skills lost will not be regained, but the following tips can help people and families living with Alzheimer disease:
• Plan a balanced program of exercise, social activity, good nutrition, and other health lifestyle activities.
• Plan daily activities that provide structure, meaning, and goals.
• As the person is less able to function, change activities and routines to let the person take part as much as possible.
• Keep activities familiar and satisfying.
• Allow the person to do as many things by him or herself as possible. The caregiver may need to start an activity, but allow the person to complete it as much as he or she can.
• Give "cues" to help the person. For example, label drawers, cabinets, and closets to let the person know what is in them.
• Keep the person out of harm's way by removing all safety risks. These might include car keys and matches.

• As a caregiver, understand your own physical and emotional limits. Take care of yourself and ask for help if you need it.

Making decisions

An Alzheimer’s diagnosis helps you and your family make plans for the future. When your disease progresses, where will you live, and who will make important decisions for you?

Over time a person with Alzheimer's disease will most likely need to stay in a place that specializes in care for people with this disease.

If you recognize the early stages of Alzheimer’s, consider filling out a living will and health care power of attorney. This will help your family understand your wishes while you can still make sound decisions.

As mentioned earlier, Alzheimer’s disease cannot be cured, but understanding the disease and what to expect can help you and your family make the best decisions for treating it.

Dr. Mary Kathryn Rudyk is a specialist in Geriatric Medicine at Senior Health Associates and New Hanover Regional Medical Center.