Mild cognitive impairment is the intermediate stage between normal cognition and dementia. Mild cognitive impairment refers to the loss of memory and cognition which is not usual to the age and the health status of the patient.[1]
Risk Factors for Mild Cognitive Impairment
There are a number of contributing factors for mild cognitive impairment and the things which risk the people towards the disease.
Age. Age is a major risk factor for mild cognitive impairment. It starts as an early symptom of Alzheimer’s disease. With age people experience physical, emotional and psychological stress contributing to the loss of memory.
Hereditary. There are studies which support mild cognitive impairment is related to the genetics. People carry two types of apolipoprotein E gene e2, e3, or e4. People carrying e4 allele of the apolipoprotein E gene are more likely to develop mild cognitive impairment.[2] Make a note that this gene is a risk factor not only for mild cognitive impairment but also increases the risk of Alzheimer disease.
Decreased Intellectual Activity. The brain should be actively involved in intellectual activities during the early life. People should involve in continuous learning and increased brain activities. A less active brain is a risk factor for mild cognitive impairment.[3] There are brain imaging studies which indicate the active brain has increased the flow of blood providing the nutrients and flushing the toxins from the body. The increased activity provides dense connections between nerve cells maintaining cognitive power.
Cardiovascular Diseases. Heart and brain work in coordination with each other, metabolic diseases such as diabetes, obesity, and cholesterol increases the risk of brain diseases. Increased blood pressure and smoking also increase the risk of mild cognitive impairment.[4] The diseases of the cardiovascular system not only affect the heart but do have impact on brain causing strokes and small lesions in the white matter. The changes in the brain can result in loss of memory power.
Hormonal Imbalance. People suffering from thyroid diseases and imbalanced sex hormones can be a risk factor for mild cognitive impairment.[5] Once the hormonal imbalance is restored, the memory or cognitive power comes to normal and further decline is stopped.
Medications. Intake of certain medications puts the people at risk for developing mild cognitive impairment. Many OTC medicines which we consumed can put at risk of developing mild cognitive impairment which can progress to develop dementia. Mild cognitive impairment is an early sign of Alzheimer’s disease which starts with short term memory loss.
Anticholinergics are the commonly used sleeping aids, which block the release of the neurotransmitter acetylcholine.[6] These medicines work in opposite to Alzheimer’s drug inhibiting the thinking ability of the individuals. There are studies which indicate the use of anticholinergic drugs develops Alzheimer’s. The cognitive decline is proportionate to the anticholinergic activity of the drug.
Sedating antihistamines such as diphenhydramine, over-the-counter analgesics such as Nyquil, Tylenol PM, and Medications for overactive bladder such as oxybutynin and tolterodine are risk factors for mild cognitive impairment. The medicines which are vertigo, motion sickness, or nausea also are contributing factors for Antivert, Scopace, and Phenergan.[7]
Depression. People suffering from depression can develop mild cognitive impairment and such people are vulnerable to cognitive decline. In people with depression, the hippocampal region is damaged. This region is important for cognition and memory.[8] People with other co-morbid conditions including metabolic conditions add to stress on the brain and affect the functioning.
Iron Deficiency. People who are deficient in iron are also at risk of develop temporary mild cognitive impairment. Once the iron deficiency is restored the memory status is restored.[9]
Conclusion
There is no specific treatment for the disease people should work on the risk factors such as age, metabolic diseases, and medications which risk the patients for mild cognitive impairment. Patients should work towards reducing the risk factors by maintaining a healthy lifestyle, exercise and controlling the contributing factors (blood pressure, sugar cholesterol). Avoid the use of over the counter anticholinergic medications which disturb the cognitive function.
In case, individuals have the risk factors, it does not necessarily mean they will have mild cognitive impairment. Certain risks factors can be modified to stop the progression of cognitive decline whereas few risk factors such as age and hereditary factor cannot be modified but only controlled to an extent.
- https://www.mayoclinic.org/diseases-conditions/mild-cognitive-impairment/symptoms-causes/syc-20354578#:~:text=Mild%20cognitive%20impairment%20(MCI)%20is,%2C%20language%2C%20thinking%20or%20judgment.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3726719/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6953955/#:~:text=Medical%20and%20lifestyle%20factors%20that,3%5D%2C%20%5B4%5D.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2672564/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2948659/
- https://www.elsevier.es/en-revista-revista-psiquiatria-salud-mental-486-articulo-effect-anticholinergic-drugs-on-cognitive-S2173505015000035#:~:text=The%20use%20of%20anticholinergic%20drugs%20may%20result%20in%20cognitive%20impairment,also%20initiate%20signs%20of%20dementia.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1621119/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3733566/#:~:text=Studies%20supporting%20the%20role%20of,in%20twin%20studies%20(4).
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8231247/
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