Because mild cognitive impairment can be influenced by somatic conditions (hypertension, hyperlipidemia, diabetes mellitus), these conditions should be optimally treated.
General Measures
In the care of individuals suffering from mild cognitive impairment, consideration should be given to:
- Nicotine restriction (abstaining from tobacco use).
- Alcohol abstinence (refrain from alcohol consumption).
- Aim to maintain a normal weight! * Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis.
- Falling below the BMI lower limit (from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight (supply of a fully balanced diet for the dietary treatment of persons with catabolic metabolic state – underweight / malnutrition).
- Use of memory aids
- Memory games or puzzles promote concentration – short simple tasks (do not overtax / frustrate! Forgotten remains forgotten, is not relearned!)
- Adherence to a daily rhythm and everyday structures; change of the usual often causes uncertainty and anxiety
- Physical exercises do not neglect
- Falling asleep and sleeping through affect the regeneration of the brain and nerves. The fall asleep period should not exceed 30 minutes and the sleep through period should be at least four and a half hours.
- Caution: computer or cell phone use before sleep extends the time to fall asleep due to the blue light component.
- Ensure safety
- Observe and respond to excessive demands on caregivers (continuing education for caregivers).
- Psychological counseling, as well as in self-help groups; especially for the relatives of affected patients.
- Review of permanent medication due topossible effect on the existing disease.
- Sleep on and sleep through disturbances affect the regeneration of the brain and nerves. The phase of falling asleep should not exceed 30 minutes and the phase of sleeping through should be at least four and a half hours.
- Caution: computer or cell phone use before sleep extends the time to fall asleep due to the blue light component.
- Review of permanent medication due topossible effect on the existing disease.
- Avoidance of psychosocial stress:
- Avoiding environmental stress:
- Air pollution impairs thinking performance
* Dementia patients lose about four times as much body weight annually as patients of the same age without dementia due to chronic inflammation (inflammatory processes), secondary diseases and the sometimes increased urge to move.
Drug therapy
- Neither antidementia drugs nor dopamine agonists and coxibs showed convincing effects on cognition or dementia conversion rates [see US Neurological Association AAN guideline below].
Phytotherapy
Vaccinations
The following vaccinations are advised:
- Flu vaccination
- Pneumococcal vaccination
Nutritional medicine
- Nutritional counseling based on nutritional analysis
- Dietary recommendations according to a mixed diet taking into account the disease at hand. This means:
- A total of 5 servings of fresh vegetables and fruits daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruits).
- Once or twice a week fresh sea fish, i.e. fatty marine fish (omega-3 fatty acids) such as salmon, herring, mackerel.
- High-fiber diet (whole grain products).
- Observance of the following special dietary recommendations:
- Diet rich in:
- Vitamins (B6, 12, folic acid, C, D).
- Minerals (calcium, magnesium)
- Trace elements (selenium, zinc)
- Omega-3 fatty acids (marine fish)
- Secondary plant compounds (eg beta-carotene).
- Acetyl L-carnitine; coenzyme Q10, phosphatidyl serine.
- Diet rich in:
- Selection of appropriate food based on the nutritional analysis
- See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
- Detailed information on nutritional medicine you will receive from us.
Sports Medicine
- Endurance training (cardio training) and strength training (muscle training) – even moderate physical activity protects against a decline in mental abilities (prevention in mild cognitive deficits and Alzheimer-type dementia; therapy: only minor effects in Alzheimer-type dementia).
- An intervention study of 18 people without cognitive impairment and 17 people with mild cognitive impairment (Mild Cognitive Impairment, (MCI); all were between the ages of 61 and 88 years) was able to show that exercise improves memory and language skills. Participants in this study exercised regularly in the aerobic zone for twelve weeks. Neuropsychological assessments were performed at the beginning and end of the study, among others. The results were positive. CONCLUSION: The results show that incipient dementia can be positively influenced by physical activity; however, further studies are needed.
- Strength balance training for fall prevention.
- Physical training [see US Neurological Association AAN guideline below].
- Preparation of a fitness or training plan with appropriate sports disciplines based on a medical check (health check or athlete check).
- Detailed information on sports medicine you will receive from us.
Psychotherapy
- If necessary, psychotherapy (including stress management).
- Relaxation phases may not be missing in everyday life! Helpful can be relaxation techniques such as yoga, autogenic training or Qigong.
- Detailed information on psychosomatics (including stress management) you will receive from us.
Complementary treatment methods
- Occupational therapy – training or exercises to maintain brain performance and motor skills (for moderate to severe dementia). The therapy shows the following medical effects:
- Cognitive stimulation (training of mental functions such as concentration skills or memory; hardly effective in severe dementia):
- Delays mental decline (in mild to moderate dementia).
- Reduces behavioral problems such as aggression
- Sensory stimulation (sensory stimulation and increased stimulus perception, for example, by light, scent or music):
- Improvement, for example, in daily activities and social behavior (in all three stages of dementia).
- Functional and skills training (physical as well as mental):
- Can improve health status, mood, and quality of life (in combination with other procedures).
- Cognitive stimulation (training of mental functions such as concentration skills or memory; hardly effective in severe dementia):
- Cognitive training [see US Neurological Association AAN guideline below].
Training interventions
- Continuing education for nurses
Rehabilitation
- For mild dementia, “rehab before care” applies. The rehabilitation program should offer cognitive training and exercises for this.
