Early Interventions for mild cognitive impairment can slow functional decline

Individuals diagnosed with mild cognitive impairment have a 50% risk of developing Alzheimer’s within five years.

A new Baycrest study is offering hope to older adults with mild cognitive impairment who are at a high risk of developing Alzheimer’s disease. The findings indicate that an early intervention program providing practical memory strategies and lifestyle education has the potential to delay the onset of dementia.

“Individuals with MCI do have a decline in cognitive skills, particularly memory, but they’re able to carry out normal activities of daily living and remain independent,” explains psychologist Dr. Kelly Murphy who leads the Memory Intervention Program at Baycrest. “Our evaluation shows that participants increase their knowledge and use of everyday memory strategies, indicating the program has potential to assist individuals in maintaining functional abilities longer and thereby delay the onset of clinical dementia.”

Mild cognitive impairment is considered an intermediary stage between normal aging and dementia. Individuals diagnosed with MCI have a 50 per cent risk of developing Alzheimer’s within five years.

“It’s important for people with MCI to know that starting interventions early on can slow their functional decline,” says psychologist Dr. Angela Troyer, lead author of the study (funded by the Alzheimer Society of Canada, Desjardins Financial and Richter, Usher and Vineburg), which was recently accepted for publication. Dr. Troyer explains that the program was developed in 2002 based on strategies from the successful Memory and Aging Program for healthy, older adults experiencing normal memory changes.

10 to 15% of individuals with mild cognitive impairment (MCI ) develop dementia each year, compared to 1 to 2% of the general older population.

“We wanted to offer a multi-disciplinary intervention program that would help these people and their families cope with the management of their day-to-day lives,” she adds. In addition to memory strategies, the program offers information on the effects of stress, relaxation, nutrition and leisure activities on memory ability, as well as information and support to family members.

“The biggest and best thing to come out of this program I’m carrying with me,” says Mary Sayers emphatically as she pulls a small, brown leather diary from her purse. “It’s my memory book and I take it everyehere I go.” Program participants are instructed to purchase a portable day planner that includes space to write appointments and notes, names and phone numbers, and other important information. Then they learn how to make it an integral part of their lives.

“Whatever you have to remember, you write it down and you can’t go wrong,” Sayers explains. “I had a calendar on my fridge but a calendar is useless if you don’t know what day it is.”

Sayers is 76 and noticed she was having memory problems about two years ago. “My friends would say they were forgetting things too, but I knew this was different.” Minutes after making plans to go shopping with a friend, she’d forget the conversation ever took place. She couldn’t find things like her keys and would later discover them right where she’d left them. She also had trouble getting organized.

Individuals diagnosed with mild cognitive impairment have a 50% risk of developing Alzheimer’s within five years

Since taking the Memory Intervention Program once a week for eight weeks, including doing homework assignments to practice remembering names and numbers, Sayers is more in control of her life. “I haven’t lost my smarts,” she says, “I just forget what they’ve led me to do.” Her children check on her but Sayers lives on her own in a seniors’ residence and has to keep track of taking her medications, going to appointments and calling her grandchildren on their birthdays. “I’ve learned to organize better and how to cope,” she adds.

Sidney Cohen, 74, who took the program last year, says the techniques he uses to remember things have become almost routine. “I ‘see it and say it’ in order to remember and I never lose my keys because I always put them in the same place. I’m much better organized than I ever was before, but I know my limitations. I know I have to record things.” He also swims daily, practices deep breathing exercises to relax and tries to eat healthier. “I’ll do anything that might retard any further development in my condition.”

His wife, Judy, is grateful to the Baycrest program, especially for giving her husband confidence. “There’s no cure for this ailment yet, but we know how to slow it down. I’m thankful for every month and every year that Sid is still enjoying life fully.”