Monday, June 20, 2016

How Mild is "Mild Cognitive Impairment"?

As we get older, we start having a constant fear that our lapses in memory are the beginning of Alzheimer’s disease. After cancer, Alzheimer's disease has taken hold as the number one fear among Americans.  We all have memory lapses, at any age. But when we are older we tend to be more aware of these lapses in memory and we become more fearful when we forget.  We try and add humor in order to alleviate this fear. We say things like it’s a senior moment, a brain fart, a mental hiccup, misfiring neuron, and my favorite synaptic lapse. Despite the humor the fear persists.

The problem is that although all those with Alzheimer’s disease started off experiencing memory loss, not all those that have memory loss will develop into Alzheimer’s disease. In fact even with documented memory impairment you are more likely to have some other underlying condition than Alzheimer's disease. Unfortunately what we call Mild Cognitive Impairment (MCI), the term used to refer to these bouts of memory lapses, is itself not well understood.

There are problems measuring memory loss using MCI. When we refer to “cognitive” we should be referring to our mental processes that should include perception, judgment, reasoning, AND memory. However, MCI is most often just limited to memory. So if you have a failing memory then it is assumed that the rest of your cognitive abilities are similarly diminished. This is not only not true but also simplistic. The second issue with this method of defining your mental capacities is the assumption that there is an average or normal level of memory and that this level is stable. This is of course not true. From experience we know that we have good days and bad days, at any age. Memory is not a static library but an active engaging process that is vulnerable to many external factors, particularly emotional trauma. Memory can become compromised during episodes of grief, retirement, an upcoming medical operation or divorce among many other situations that distracts our ability to remember past events.. This is made worse by lack of sleep, which accompanies stressful times, and is one of the biggest issues with older adults.

In addition, being retired means that you can take little naps during the day. But this results in not feeling sleepy at night, or getting up in the early hours of the day. Sleep deprivation not only affects your memory but also changes your mood, balance and appetite.  In some cases, sleep disorders are due to changes in our brain, such as the reduction in melatonin, but we can do something about this, as we will discuss later on.

But perhaps the biggest culprit that affects our memory is medication. Medication among older adults is perhaps the single most significant cause of problems. Such iatrogenic diseases--problems caused by bad medical practices--remains a hidden problem among older adults. Medication can have drastic effects on memory. Even if you have been taking the same medication for some time, your body processes chemicals differently as you age. Especially if you have recently started taking additional medications or substances. In particular, nearly all sleeping pills, over-the-counter antihistamines, anti-anxiety medications and antidepressants can have negative effects on memory. Medications that you might be taking for other existing conditions can also start having negative effects on your memory such as some medications used to treat schizophrenia, and pain medicines used after surgery.

Identifying the cause of your memory lapses is important because it means that you can reverse these problems. Some memory problems can also be related to vitamin B1 and B12 deficiency, easily checked with a blood test. Some health issues, such as thyroid, kidney, or liver disorders also can lead to memory loss. In addition, some herbal medicines, recreational drugs and also the use of alcohol will negatively effect memory.

These are all likely culprits for why your memory has gotten worse. Rather than jumping to the conclusion that you have Alzheimer’s disease. Unfortunately, nearly all websites that offer advice on memory loss--despite the caveat that not all memory loss leads to Alzheimer's disease--invariably end up with a definition of Alzheimer's disease. It is important to think of these other ways that your health can be changed rather than resigning yourself to saying that it is Alzheimer’s. Especially since Alzheimer's disease is so passive a disease. At least by approaching it as a lifestyle issue  you retain control, you can change your condition.

A recent study by Dale Breseden from southern California has successfully reversed clinically diagnosed Alzheimer’s disease. Breseden did this not with some magic potion or a new drug, but with some simple behavior strategies, involving diet, exercise and social/physical activities. This recent study reported how an intervention included:

Cutting out all simple carbohydrates and reducing wheat products and processed foods, while increasing consumption of vegetables, fruits and non-farmed fish;
Fasting 12 hours before bedtime and 3 hours between dinner and bedtime;
Yoga and meditation for 20 minutes a day;
Exercising for at least 30 minutes a day, 4-6 days a week;
Taking melatonin each night (used to ease insomnia), and increasing sleep to 7-8 hours;
Taking methylcobalamin (a form of vitamin B), vitamin D3, fish oil and CoQ10 supplements each day; and,
Increasing oral hygiene through use of an electric flosser and electric toothbrush.

Using this comprehensive life-style change, Bredesen saw nine out of the 10 patients improve within 3‐6 months. These improvements were sustained for two-and-one‐half years from initial treatment. The one person who did not improve was because their dementia was so great that he forgot to carry out the exercises. Not surprisingly, this life-style change was found to have a positive impact on multiple other chronic illnesses in addition to Alzheimer’s disease. Memory loss is unlikely to be due to Alzheimer’s disease, but use this as an indication that you need to address some of your life-style patterns and aim to live a healthier life. There is nothing mild about Mild Cognitive Impairment but it does not mean its a death knell.

© USA Copyrighted 2016 Mario D. Garrett