Rapid Increase in Patients with Mild Cognitive Impairment Amid Rapid Aging
Early Diagnosis and Appropriate Treatment Can Restore Cognitive Function
Combining Medication with Lifestyle Improvements Is Most Effective
The number of dementia patients is continuously increasing amid rapid aging.
According to related statistics, as of 2024, the number of dementia patients among the domestic population aged 65 and over is estimated to exceed 1 million, reaching approximately 1.05 million (1 in 10 people).
The mortality rate due to dementia (deaths per 100,000 people) has also surged from 17.0 in 2013 to 27.9 in 2023. In particular, Alzheimer's disease, the most common cause of dementia, is considered one of the top 10 causes of death in the country.
▲Important Treatment Target
A notable recent phenomenon related to dementia is the significant increase in patients with mild cognitive impairment.
Jang Junho, Director of the Department of Psychiatry at Centum General Hospital, explained, “Mild cognitive impairment is a pre-stage of dementia that has the potential to progress to dementia. In other words, it means there is an abnormality in cognitive function, but it does not significantly interfere with daily life.”
According to statistics from the Health Insurance Review and Assessment Service, the number of patients treated for mild cognitive impairment increased about fourfold over 10 years, from 85,140 in 2013 to approximately 324,900 in 2023. Major symptoms of cognitive impairment include memory decline, decreased concentration, and reduced language ability.
Director Jang Junho said, “When tracking patients with mild cognitive impairment, 10-15% worsen to dementia each year, which is much higher than the general dementia incidence rate among people aged 65 and over.”
Since mild cognitive impairment can occur due to various causes, professional examination and testing are necessary. “Through such processes, appropriate treatment can often lead to recovery of cognitive function,” explained Director Jang. Furthermore, as the concept of Alzheimer's disease has expanded to include people with normal cognitive function, mild cognitive impairment has become an important treatment target and an appropriate stage for treatment.
▲Diagnostic Process
To diagnose mild cognitive impairment, the patient's and caregiver's medical history is first taken, and a cognitive function screening test can be conducted.
Then, for a more detailed evaluation, neurocognitive testing is performed. A survey is also conducted to assess whether cognitive impairment affects the ability to perform daily activities.
If cognitive decline is confirmed in neurocognitive testing, blood tests are performed to identify the underlying cause, and if necessary, MRI and PET imaging are conducted to examine the brain's structure and functional status.
In this process, if cognitive function is reduced beyond a certain level (1 to 1.5 standard deviations below the average for the general age group), but daily living abilities are normal and dementia is ruled out, a diagnosis of mild cognitive impairment can be made. However, it is important to make a comprehensive judgment considering detailed medical history, test results, and clinical circumstances.
▲Treatment and Prevention
Being diagnosed with mild cognitive impairment does not necessarily lead to dementia. Early management and treatment can slow down or prevent further deterioration of brain function.
Therefore, if symptoms are suspected or evident, it is advisable to seek specialist care and, if necessary, combine medication treatment. Non-pharmacological therapies such as exercise and cognitive rehabilitation can also be implemented together.
Director Jang Junho stated, “More research is needed on drug treatments for mild cognitive impairment. In the case of Alzheimer's disease, a drug that removes the brain’s amyloid beta protein, the causative substance, was developed and approved by the U.S. FDA in 2023 and recently introduced in Korea. However, there are still issues such as high treatment costs and risks of brain edema and cerebral hemorrhage.”
Improving lifestyle habits is important to prevent progression to dementia. Regular exercise helps prevent cognitive decline by increasing cerebral blood flow and reducing stress. Active social activities and brain exercises like puzzles are also effective. Additionally, maintaining a healthy diet and managing chronic diseases such as hypertension and diabetes are necessary.
Jang Junho, Director of Psychiatry at Centum General Hospital, advised, “Mild cognitive impairment is an important stage that can progress to dementia, so early diagnosis and management are crucial to reduce the risk of dementia onset. If there are suspicious symptoms, I hope people consult a specialist to receive appropriate diagnosis and treatment.”
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