What are the measures that can be adopted to improve mild cognitive impairment (MCI)?

Supervised by Atsushi Iwata, Associate Professor, Department of Neurology, Graduate School of Medicine, University of Tokyo

Mild cognitive impairment caused by Alzheimer's disease (MCI-AD) is a pre-stage of Alzheimer-type dementia. At present, there is no cure for this most common type of dementia, namely, Alzheimer-type dementia. Under this situation, can MCI-AD be cured? This section explains in details the measures that can be taken to improve MCI.

Early detection at the stage of MCI-AD and early countermeasures may delay the rate of progression.

MCI-AD is the stage before the development of Alzheimer-type dementia. Alzheimer's disease is considered to be caused by the accumulation of amyloid beta in the brain. However, the current view in the medical community is that the accumulation of amyloid beta begins before the onset of MCI, as early as 20 years before the onset of Alzheimer-type dementia. It is considered that MCI-AD, if left unattended, would lead to the onset of Alzheimer-type dementia within a few years.

For diseases presenting with dementia symptoms, such as vitamin deficiencies and idiopathic normal-pressure hydrocephalus, the dementia symptoms may be cured by treatment of the underlying disease. However, currently there are no treatments available for complete cure of dementia caused by neurodegenerative diseases, such as Alzheimer-type dementia and dementia with Lewy bodies.

This may sound hopeless for people with MCI-AD. However, it does not rule out the possibility that the onset of dementia can be delayed by promptly taking appropriate measures. This explains why “early detection of MCI is important.” There are cases where progression to the last-stage symptoms of dementia can be prevented by early detection and prompt institution of appropriate measures.
Then, what are the specific measures that should be taken? The following explains the measures that are considered to be effective in improving MCI. Please note that these measures are not only for MCI-AD, but also for MCI as a whole.

Measures to improve MCI: (1) Exercise

Aerobic exercises, such as walking and jogging.
There are two types of exercises: “anaerobic exercise,” performed with short breathholds, and “aerobic exercise,” performed with deep breathing. Research has shown that air continuously introduced into the body through aerobic exercise allows blood to actively flow into the brain. As a result, blood flow to the brain increases, and the brain stays young.
To further enhance the effect of the exercise, it is recommended to incorporate dual-tasking into exercise. The dual-tasking means performing two activities at the same time. Examples are walking while calculating in the head, foot stepping while playing word chain game, etc. Doing two things at the same time is said to allow the blood flow in the brain to increase further, and therefore is expected to be highly effective in preventing dementia.

Measures to improve MCI: (2) Meals

Diet review is one of the basic considerations in health management, and prevention of progression to dementia is no exception.
In regard to the diet, it is important to eat a variety of foods from each food group, and consume a balanced diet. In addition, the following nutrients are especially important.
Eat vegetables and fruits (vitamins C and E, β-carotene) often.
Eat fish (DHA, EPA) often.
Drink red wine (polyphenol).

Measures to improve MCI: (3) Cognitive training

Dementia can not only impair memory, but also the ability to concentrate and make calculations. One can be trained in these abilities by cognitive training. There are many types of training, such as playing games and playing musical instruments, which can stimulate the brain while also allowing the subject to have fun. On the other hand, if a person is unable to enjoy such training, he/she may get stressed and discontinue it. As under such a circumstance, it may have an undesired effect, it is better to start with activities that the person has always shown interest in. In addition to playing games and musical instruments, as mentioned above, mere dosing calculations, maintenance of a diary and having conversations with other people also serve as cognitive training.

There are many measures that can be implemented at home. Let us start with what one can do.

The stage of MCI is a very important period for instituting measures to prevent the progression to dementia. Bear in mind that one should not become pessimistic about MCI. It is important to take proactive measures. The methods introduced here can also be practiced at home. Start little by little with what you can do, under the guidance of your doctor.

Posted jointly with “Dementia-NET.”