I wouldn’t go to a casino, and here’s why not. The odds are stacked completely against me. If I don’t feel I have any realistic chance of winning money, I’m not even willing to try.
But what if the opposite were true? What if some casino said, at our slot machines, you have an 88 percent chance of hitting the jackpot? Man, I’d be there right now, pulling that lever.
Of course, when it comes to casinos, you don’t get odds like that. But when it comes to cognition, you do.
For people dealing with mild cognitive impairment, the odds of slowing or halting or even reversing that cognitive decline are actually pretty good — and getting better all the time. That’s what I want to remind you of today.
For most people, when they get a diagnosis of MCI, they’ve never even heard of it. They have no idea what they’re dealing with. So they go home and they Google it. Because they’ve got a lot of questions, and one of the first ones is, does this mean I’m going to get dementia, and what are the odds of that?
Even a few short years ago, the answer to that question sounded pretty grim. I can remember the back in 2015 or so it was pretty common to see articles that referred to MCI as a “precursor” Alzheimer’s, and claiming that for someone with MCI, the odds of progressing to dementia within 5 years was about 80 percent.
And I would cringe when I saw that. For two reason. The first is that number, 80 percent, just sucked the hope out of people. They felt doomed. Second, it’s because that number is just not true. It’s not even close to true.
By 2016 or early 2017, I really started to see that change. The experts we’re saying, eh, that number is too high. It’s more like 50 percent. Maybe a little less than 50 percent.
Since then, that number has continued to drop. In fact, it’s plummeted.
In late 2017, the American Academic of Neurology issued a new set of treatment guidelines for MCI, and with that came a new estimate. Dr. Oscar Lopez, a University of Pittsburg neurologist who helped write those guidelines, told me that based on the best evidence we had then, a person with MCI had about a 30 percent chance of progressing to dementia.
That was then. Now we even have better evidence, and it’s even better news for people with MCI. Some colleagues of Dr. Lopez at the University of Pittsburg, led by Dr. Mary Ganguli, followed nearly 900 people with MCI and found that only 12 percent of these people progressed to dementia over 5 years. The rest either saw their cognition stabilize or they returned to cognitively normal.
That’s amazing, and really encouraging. In a very short period of time, we’ve gone from telling people that progressing to dementia is nearly inevitable to telling them that their chances of slowing or halting their cognitive decline is actually pretty good.
And you know what? That number is only going to continue to go down. We have much better evidence now that adopting healthier habits can all help protect against the risk of dementia.
These are the things I talk about every week in these brain health videos. These are the “what.” But every now and then I need to remind myself to step back and remind you what the “why” is.
Because these things can really help. People with MCI are getting diagnosed sooner now, and more often, and they’re getting treatments, and they’re adopting healthy lifestyles and they’re seeing results.
I often like to quote Dr. Joel Salinas, who recently told the Harvard Health Letter than he is now seeing many of his patient “stay in the MCI stage for many years, even when we presume it was a neurodegenerative disease.”
He went on to observe that: “The people who spend the most time cognitively stable are often the ones who stick to lifestyle recommendations.”
If you’re inspired to do that, just pick one healthy habit you want to work on, and start there. If you’re not sure how to begin, I invite you to watch this two-part video series I did at the beginning of the year, showing you a simple, effective way to change a health habit.
I hope you find it helpful, and I look forward to seeing you again next week. Until then, as always, be kind to your mind.