a condition feared as a prodromal phase of dementia, however there is no obvious relationship between age-related memory hindrances and actual cognitive impairments
common experience that as the years go by, especially after the sixty, the memory starts to fail. Particularly evident may be the difficulty in remembering names of people or even objects. A phenomenon that does not fail to worry, not only for the embarrassments it can create, but also because one inevitably questions the meaning of these mnemonic failures: they could be a first announcement of future worsening, clinical forms of cognitive impairment or even dementia? Fortunately, there is no foregone relationship between memory hindrances due to advancing age and actual cognitive disorders. Only some of the people who present these phenomena will later be given a diagnosis of mild cognitive impairment, also known by the English term
Mild cognitive impairment
(MCI) says Diego de Leoemeritus professor of psychiatry at Griffith University in Australia and president-elect of theItalian association of psychogeriatrics. This condition is indeed feared as the prodromal stage of dementia. From a public health point of view, grasping its characteristics in elderly subjects can then be used to implement any prevention strategies.
The diagnosis
For a diagnosis of true Mild Cognitive Impairment to be made, some must be present symptoms precise, formulated several years ago by the neurologist at the Mayo Clinic in Rochester, Ronald Petersen. The diagnosis is based on the fact that the person complains of a decline in his cognitive performance, says De Leo. An impression of decay that must also be confirmed by a relative or cohabitant, but also by specific ones neuropsychological testswhich show an objective cognitive impairment in at least one of the domains explored.
It can be a transitory phenomenon
For it to be Mild cognitive impairment and not more serious forms, at the same time it is necessary for the person to be independent in functional skills, that is have fewer than three impediments in areas such as grocery shopping, using the phone, using medications, and other daily activities. Finally, of course, he must not already have a diagnosis of dementia.
Transient phenomenon
Fortunately, many protracted studies have made it possible to verify that up to about half of the people diagnosed with mild cognitive impairment, this condition is no longer detected at the next visitwhich shows that in many cases there is not only no progression to more severe forms, but even a reduction in symptoms.
Neurology recently published the results of a study on mild cognitive impairment conducted by a group of researchers coordinated by Jennifer Manly of the Taub Institute for Research on Alzheimer’s Disease and the Aging Brain at Columbia University in New York. The researchers looked at a sample of nearly three thousand people over 65 who have undergone over eleven thousand visits since 1992 as part of a program designed to assess the relationship between aging and dementia.
752 people diagnosed with Mild cognitive impairment were identified. Following them over time it was found that approx 60 percent of them on subsequent visits no longer met the criteria for maintaining diagnosi, about 30 percent retained them, and only about ten percent had developed true dementia. Suffering from multidomain mild cognitive impairment was a factor that allowed us to predict who would continue to have the disorder at follow-up visits, says De Leo.
Risk factors
Suffering from other factors associated with the persistence of mild cognitive impairment somatic diseases
, having less access to recreational activities, the use of antidepressants and the presence of depressive symptoms added the expert. The same factors were linked to the risk of progression to dementia. However, it should be emphasized that since these are observational studies, these factors are only associated with the development of Mild cognitive impairment or dementia, and cannot be said to be causal factors.
It should be added that the risk of suffering from mild cognitive impairment also has one genetic basisand that the risk is lower in those who have been able to follow several years of education, have had greater access to recreational activities, like visiting a friend or even going for a walk, and could count on a higher income. According to Jennifer Manly, future research will have to study the course of mild cognitive impairment over longer periods of time, in order to further and if possible more “causally” analyze which factors can best help us understand the development of dementia.
February 22, 2022 (change February 22, 2022 | 13:04)
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