A Caregiver's Guide to Mild Cognitive Impairment
How to help someone with mild cognitive impairment (MCI)
Be sure to get an accurate diagnosis. Mild cognitive impairment (MCI) is sometimes called "pre-dementia," but only about 15 percent of cases each year advance to dementia -- and some cases never do (some people's memories even improve over time). Other causes of these symptoms include medication side effects, head injury, alcohol abuse, and depression.
Action steps
Get a thorough medical evaluation of memory-loss symptoms and other changes in thinking skills. Causes such as drug interactions and depression are reversible, so a thorough look at the possible explanations is key. An exam also establishes a baseline against which future cognition can be measured.
Share your insights with the doctor. Remember that a key to diagnosis of MCI is a change in the individual. The symptoms of MCI are subtle but unmistakable. Everyone has some trouble with memory now and then, and many people get lost or have poor judgment. What's relevant here is seeing a decided change -- in either occurrence or frequency -- in your loved one.
Consider getting a second opinion. You may also want to get the perspective of a specialist, such as a geriatrician, geriatric psychiatrist, neurologist, or neuropsychologist.
Ask about medications to retain cognitive ability. Although dementia drugs can't reverse symptoms, as maintainers of ability they've been shown to be most effective early in the disease process. Your loved one may be eligible for medications now.
Ask about clinical trials. Nearby universities may enroll patients in studies for new memory-loss treatments. Bonus to participants: All care costs are usually free.
Counter forgetfulness with memory aids. There are two kinds of mild-cognitive impairment: amnestic, referring to memory loss, and nonamnestic, in which other cognitive changes are more prominent. The former is most common. There's occasional loss of immediate memory (those short-term memories that help us function through the day: what we came in the room to get, names and numbers, what was for breakfast, a 3 p.m. appointment), while longer-duration memories of the past stay sharp. Many tools can help your loved one compensate for short-term memory loss, preserving confidence and productivity.
Action steps
Rely on such reminders as a centralized calendar and bulletin board, digital clocks in every room, and medication reminders.
Encourage your loved one to carry a small notebook and write down "to-do" items, questions, shopping lists, parking locations, and other often-forgotten details that might fail to get stored in short-term memory.
Switch as many bills to auto-pay as possible.
Explore cognitive training programs, often offered at universities and memory clinics, to boost specific thinking skills. Home software programs are also available.
Reduce household clutter, which can be distracting.
Buy multiples of commonly mislaid objects (sunglasses, keys, umbrellas) and leave them in their most-used locations.
Consider a corded telephone for the home if a cordless unit keeps getting lost.
View the use of these tools and other memory tricks as signs of strength, not weakness. Your new motto: whatever works!
Expect language glitches. Increasing trouble finding the right word or remembering what you were just about to say are classic symptoms of mild cognitive impairment.
Action steps
Give it time. You don't need to rush in to "cover up" your loved one's communication slow-down -- that can make him or her anxious. If the word or thought doesn't come, change the direction of the conversation.
Offer reassurance. Chances are, these changes are upsetting to your loved one. "We'll get through this together" is a powerful, calming message.
