Is misplacing your keys twice in one week normal, or is it signaling the start of dementia? It’s a common concern, and the answer depends on who you are and the kinds of things you’re forgetting.
The cognition spectrum ranges from normal, to age-consistent memory loss, to mild cognitive impairment (MCI) to dementia such as Alzheimer’s disease, explains Susan Carroll, a nurse clinician in the MCI clinic at St. Joseph’s Parkwood Hospital.
"We all forget things from time to time. However, if you start forgetting how to do something you used to be very good at, such as when an accountant forgets how to keep a set of books or a party planner forgets to send out invitations, it could be a sign of early dementia."
MCI occurs when changes in the brain lead to greater difficulties with thinking skills than would be expected for a person’s age and education levels, but are less than those seen in dementia. An individual with MCI can still successfully do their usual tasks like banking, shopping, using a computer and planning meals.
Each year, 10 to 15 per cent of those with MCI develop dementia, but not everyone with MCI is destined to do so. In fact, some individuals’ cognition even improves—particularly if they have depression, says Carroll.
At the MCI clinic Susan screens patients for behavioural changes and disease progression, conducts memory tests and reviews medications to ensure they are not having a negative impact on cognition. As well, patients learn about factors that may slow the progression of MCI to dementia.
"It’s essential to manage dementia risk factors like diabetes, high cholesterol and hypertension by adopting a healthy lifestyle," Carroll says. "We encourage patients to follow the Mediterranean diet and exercise regularly. In fact, if we could prescribe exercise as a pill we’d give it to everyone because it helps open up the small blood vessels in the brain, which increases blood flow, which in turn enhances brain function."
Individuals with MCI are also encouraged to participate in brain stimulating activities such as crossword puzzles or learning a new skill, and to tap into community resources such as Tai Chi classes, mall walking and day programs to help them stay mentally, physically and socially engaged.
If MCI progresses to dementia, there are a variety of dementia care community services and long-term care options provided through organizations such as the South West Community Care Access Centre, the Alzheimer Society London Middlesex and Alzheimer Outreach Services.
"We hope one day soon a disease-modifying treatment will be found for dementia," says Susan. "Until then we are using every strategy to help people slow the progression of cognitive decline."