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March 21, 2022

This brain condition could be an early sign of Alzheimer's—but many Americans don't know they have it

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    One in seven people ages 60 and older have mild cognitive impairment (MCI), a brain condition that could be an early sign of Alzheimer's disease. But a recent report from the Alzheimer's Association found many people know very little about it.

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    What is MCI?

    MCI is defined as changes to a person's memory and thinking that are noticeable both to the person and those around them but aren't serious enough to affect the person's everyday activities, NPR reports.

    "Mild cognitive impairment really has gaps in memory or thinking that go beyond the normal aging process," said Morgan Daven, VP of health systems at the Alzheimer's Association. "This could be forgetting conversations or having a hard time finding your way around a familiar place."

    According to Maria Carrillo, chief science officer at the Alzheimer's Association, around a third of patients with MCI will be diagnosed with Alzheimer's within five years. But tests before then can reveal whether MCI is the result of brain processes associated with Alzheimer's.

    "We're rapidly zooming into an era where we can use imaging or blood or spinal fluid tests to establish likely causes" of memory and cognitive problems, said Pierre Tariot director of the Banner Alzheimer's Institute.

    But because it can often be misconstrued as normal aging, MCI can be difficult to diagnose, Tariot added. That's why, after Tariot talks to a patient, he then asks to speak with their spouse or a close family member.

    For example, a patient's wife might notice her husband is able to maintain his appointments, Tariot said, but add that "a year ago, he had it all locked and loaded in his brain. And now, unless he writes it down 12 times and then asks me to double check, he's not going to get there."

    Still, it's hard to tell whether that would be a case of MCI or dementia, Tariot said.

    Americans know very little about MCI, and don't want to see a doctor about it

    Despite being a common condition affecting about 10 million Americans, many don't know about MCI. According to the Alzheimer's Association's report, a survey found that 82% of Americans are unfamiliar with MCI or know very little about it, and more than half said the symptoms of MCI sound like "normal aging."

    According to Carrillo, getting diagnosed with MCI requires a visit to a doctor, but just 40% of respondents to the survey said they'd see a doctor right away if they experienced any of MCI's symptoms. The remainder said they'd either wait or not see a doctor at all.

    Of those who said they wouldn't go to a doctor right away, 28% said they were concerned about receiving an incorrect diagnosis, 27% said they were worried about learning they have a serious problem, 26% said they were worried about receiving unnecessary treatment, and 23% said they believed their symptoms would resolve on their own in time.

    The problem is, if patients avoid seeing a doctor, "they're not going to open the door to finding out what the underlying cause is," Carrillo said.

    A number of factors can cause MCI, many of which are treatable, like sleep apnea or depression. "If there's a vitamin B-12 deficiency, it does actually mimic mild cognitive impairment or even early Alzheimer's dementia," Carrillo said. "And that can be solved with vitamin B12 injections."

    And if a patient's MCI is determined to be caused by Alzheimer's, patients have an ever-growing number of treatment options, Tariot said.

    For example, Aduhelm, a drug approved last year by FDA, has shown to remove sticky plaques associated with Alzheimer's disease from the brain, however it isn't yet clear whether it slows memory loss, NPR reports.

    According to Tariot, patients with MCI could also enroll in a clinical trial of an Alzheimer's drug. "They're all scientifically sound, ethically sound, approved by the FDA, done under FDA oversight," he said.

    And in the future, patients will have even more treatment options for Alzheimer's, Tariot said. "There's a whole wave of other therapies coming forward, so we'll have many more choices than we have now and that's great news," he said. (Hamilton, "Shots," NPR, 3/18; Hiller, WBRE/WYOU, 3/17)

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