What Happens After Mild Cognitive Impairment?

Washington DC

Since I was originally diagnosed with Mild Cognitive Impairment (MCI) almost a year-and-a-half ago, I’ve read that some people with MCI get better, others stay about the same, and the rest go on to develop dementia, but I’ve never read any definitive statistics.  The Mayo Clinic, however, just released a large study of people with MCI.  There were two findings that were significant for me.

• When the people with MCI returned for their follow-up visit, over a third (38%) of them who had been cognitively impaired were now not impaired.  Their tests were normal.
• However, the study continued to follow up on that subgroup of now-cognitively-normal people for about five years.  During that time, almost two-thirds (65%) of them had became impaired again, either to MCI or to dementia.

Simply stated, it’s not unusual for cognitively impaired people to become normal again.  Wait a while, however, and the majority of those people will eventually become impaired once more, with either MCI or dementia.

My own situation is not completely comparable to the study subjects. 

• First, unlike the study subjects who initially reverted to normal, my impairment has not reverted completely since my diagnosis in the fall of 2012; I do, however, feel somewhat less confused. 
• Second, my normal PET scans demonstrate pretty conclusively that I don’t have Alzheimer’s.  Does that change the odds of my getting worse again?

The research also raises some questions that need to be studied, for instance: 

• What happens if you follow people for more than five years?  Presumably more will become impaired, but we don’t know.
• There are many causes of cognitive impairment.  Are there some in which MCI doesn’t revert to normal … or revert back?

So this Mayo Clinic report doesn’t resolve any of the uncertainty about my future.  The chances are good, says the study, that I’ll get worse, but there’s also a chance I won’t.  The reality is that, like anyone else, I don’t know my future. 

The most important thing for me, however, is not to allow my emotional or spiritual balance to yo-yo up and down with each new research fact that bears upon my future.  I certainly am not going to ignore studies like this; I want to be  more informed, and I’m convinced that knowledge is almost always better than ignorance.  In fact, the study helps me a great deal: I know I’m not alone in feeling confused about what’s happening to me. 

Statistics are only one kind of information: they only tell you what the odds are that something will or won’t happen, not what the future holds.  So I’m doing my best to put the statistics in their proper place: helpful but relatively unimportant in how I choose to live.  I won’t ignore facts that concern my future, but I won’t be dominated by them.  Life goes on!