How does MCI relate to Alzheimer's?


Both my 80-year-old parents are diagnosed with Mild Cognitive Impairment. They have become impulsive, disorganized, argumentative, and forgetful. They can no longer maintain their train of thought or follow the thread of a conversation. They regularly forget to take their medicines (even though I visit weekly to dispense into pill containers) and they miss Dr appointments. They show very poor judgment and they're overwhelmed by making decisions or planning a task. And they have recently started to have trouble finding their way around familiar locations. My dad is in worse shape and was diagnosed with MCI about five years ago. He no longer knows what year it is or what city he is in. My mom's diagnosis was last year and doctors can't say whether it is truly an intermediate dementia stage, or caused by the stress of caring for my father. I'm 60 miles away. I call daily and make weekly visits to check on them and refill their pill containers. I have arranged for nursing and PT home visits, as well as placing a home health caregiver in their house 40 hours a week. But they fired the first caregiver and ran the second off. I'm nearing my wit's end. My question is about what I can expect as time passes. Does MCI always develop into full dementia? Will they get Alzheimer's? Is it possible for them to get better? (They are both on Namenda and Donepezil.) I need to know what to expect or at least what to prepare for. Thanks for whatever advice you can provide.

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Shlomo MCI is a diagnoses. It helps for people that don't understand the diagnosis, to look at it like this.... if you are coughing and sneezing, you go to the dr. ..... dr. asks your symptoms, you tell him, dr. Checks the usual health physical exam, ruling out, various causes, infections, other issues you may be experiencing or not and says you have these due to allergies let's just say. He doesn't know why, or what your allergies is caused from, but he treats the symptoms. Allergy is a wide term with a unidentified cause or cure. It could be a combo of things, it could be a particular cause, etc. So now go back to your question mild or moderate dementia is not a spot on diagnosis. Drs cannot pin point a specific ... 100% brain disorder, diagnosis. If they could, there would be an exact treatment and a cure, I would imagine. Therefore all they can do is treat the symptoms, trial an error. Unlike an allergy, this is something a person needs 24/7 assistance and supervision. Cognitive impairment, unfortunately,as I describe it, "lost in the real world". Reality is warped, thoughts are unfocused, unreasonable, irrational, very mixed up. Reasoning isn't as typical. Would you touch a hot stove? Go out in 20 degree weather with out dressing for the cold? Or... Leave the house to go to Chicago on foot, when you are in NewYork? Not bathing for a month and thinking that is ok? If a person doesn't know what day of the week or what time it is how can they be trusted to take meds on time on certain days. Etc. This is all Cognative Impairment mild or moderate, Alziemers is the highest percentage of the cause for dementia. There are many types of Dementia. Many times it is a combo of types or causes. I must say this to you, you need to plan. It is not safe in the real world.
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Reply to wuvsicecream

Sholomo, sure sounds like it is time for them to be in assisted living/memory care. Mild Cognitive Impairment diagnosed five years ago? Yes it will get worse and it sounds out of control now. Have you started to shop facilities? Many have waiting lists. Hopefully you can get some cooperation, but that would be highly unusual. So often a medical crisis is what leads to placement. If that happens, your choices will be severely limited.
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Reply to gladimhere

Thanks for your responses. My only brother was their primary caregiver until Feb this year when he died of a heart attack. Since then I've been their only family member caregiver and I've discovered that they are in much worse shape than my brother ever let on. I've started the discussion with them about moving and they are absolutely against it. I've met with an attorney and am activating the PoA that my parents created many years ago when they were capable and competent. This should prevent the need for guardianship. If they are unlikely to get better, once I have PoA's, I may find myself in the position to force their relocation closer to me, to a managed care facility.
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Reply to Shlomo

As JeanneGibbs said, MCI doesn't necessarily morph into Alzheimer's but it doesn't get better either. It gets worse.

From the description you gave us your parents' situation sounds very precarious and out of control. They need more care as you know since you've tried to get it for them in the past. Do you have siblings that can lend support? Have you considered a skilled nursing facility? It may not be possible for your parents to be on their own anymore.
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Reply to Eyerishlass

Read read read EVERYTHING!  And take notes on EVERYTHING!   I would suggest that you get someone to shop for groceries and clean.   Get all the help you can before the proverbial shit hits both fans and hold on tight. 
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Reply to Lostinthemix

MCI does not always progress into dementia.

Some doctors (I think) tend to use "MCI" as a more gentle diagnosis that the patient can accept. My mother was not bothered about having MCI and she recognized she had "some memory problems," but she would have been devastated to think she had dementia. He geriatrician never used that term with her, but she did, in fact, have dementia.

MCI can be the beginning stage of ALZ or LBD or other kinds of dementia. If it really is dementia in the brain it will definitely progress into other symptoms.

Frankly, it really sounds like that train has left the station for your parents. Assume they have dementia. Read up on it. Ask questions here about it. Join a support group for persons caring for a loved one with dementia. If they get better that will be a huge gift, but it is highly unlikely -- for either MCI or dementia.

I am so sorry you are in this situation. Welcome to the club no one wants to join!

No matter what label you give their behaviors and symptoms, you have to cope with them as they appear. You have to figure out a way to manage their medications whether they forget because of MCI or because of ALZ or vascular dementia or Lew Body. Having a more specific diagnosis can be useful, but it doesn't necessarily point the way to better treatment.
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Reply to jeannegibbs

Unfortunately, Schlomo, the future has come. Your parents are proving daily that they cannot live by themselves. It’s only a matter of time until they get themselves into deep trouble. Adding to this is the fact that they won’t accept help, which isn’t unusual but difficult for those of us who want to keep them safe.

Would it work to speak with them and tell them how very worried and stressed you are over them and they need to accept help for your sake? There are lots of good articles on this site to help you with that. Check them out and let us know how it goes.
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Reply to Ahmijoy