It’s very scary to feel like your memory is slipping and you can’t think as clearly as you once did…and to wonder whether you’ve started down the path toward dementia. This condition is called mild cognitive impairment (MCI). And unfortunately, within two years of an MCI diagnosis, an estimated 11% to 33% of patients do progress to full-blown dementia.
So it’s no wonder that a growing number of people with MCI are asking for prescription drugs in an attempt to keep their minds sharp. These drugs, called cognitive enhancers, support the production and performance of memory-related neurotransmitters, and they sometimes help patients who already have dementia. And doctors in some countries, including the US and Canada, are giving these drugs to patients who don’t have dementia.
The hope is that the medications might help MCI patients in the short term by enhancing memory…and in the long term by reducing dementia risk.
Is the strategy working? Or are the drugs doing more harm than good for patients with MCI? A new study has the answer…
EXAMINING THE EVIDENCE
Researchers from Canada examined existing studies that involved a total of more than 4,500 patients with MCI who were given either a placebo or one of the cognitive-enhancing drugs. They identified eight high-quality studies that were conducted between 1999 and 2007 in various parts of the world.
The goal was to gauge the safety and effectiveness of four medications—donepezil (Aricept), rivastigmine (Exelon), galantamine (Razadyne) and memantine (Namenda). These drugs are widely prescribed for dementia patients to improve mental functioning—memory, attention, mood, reasoning, language and ability to perform activities of daily living. The drugs work by increasing the amount of naturally occurring neurotransmitters in the brain or by decreasing abnormal brain activity.
Disheartening results: Not a single one of the medications brought about significant improvement in short-term cognitive performance for MCI patients…nor did any of the drugs help in the long term to help stave off the progression to full-blown dementia. What the drugs did do was cause unpleasant side effects, including diarrhea, nausea, vomiting and headaches. Worse, the researchers found a link between the medications and an elevated risk for cardiac problems—specifically, the drug galantamine was associated with a higher incidence of bradycardia (slow heart rate), which can be dangerous.
Bottom line: It’s understandable that people with MCI would be desperate to try just about anything that might reduce their risk of progressing to full-blown dementia…but this study shows that taking what are essentially Alzheimer’s drugs is not the answer, because they don’t help with MCI and can cause harm. What does help: Anyone who wants to reduce dementia risk is best off living a healthy lifestyle—eating properly, exercising, and staying mentally and socially active. A plethora of studies show that these measures really can help keep us fit in both body and mind.