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What is Mild Cognitive Impairment?

Mild cognitive impairment (MCI) is also known as mild or "pre-dementia" in which patients experience forgetfulness or other cognitive problems (such as issues with language or thinking) that do not prevent them from daily functioning. A small proportion of patients have MCI due to depression, medication side effects, sleep disturbances such as sleep apnea, low vitamin B12 levels or low thyroid function. Some controllable risk factors include excessive alcohol intake, high blood pressure, lack of exercise, as well as lack of mental stimulation. Patients with MCI have a high risk for developing dementia, which occurs in about 14% of cases.

Typical Symptoms of Mild Cognitive Impairment

Diagnostic Questions for Mild Cognitive Impairment

Your doctor may ask these questions to check for this disease:

  • Have you been experiencing memory problems recently?
  • Have you been experiencing difficulty speaking, performing tasks, or recognizing things?
  • Have you noticed or been told that you repeat the same questions over and over?
  • Do you have difficulty concentrating?
  • Can the patient remember their name and birthday?

Treatment of Mild Cognitive Impairment

There are no medications available for MCI. Lifestyle measures such as regular exercise may be helpful. A doctor can also review medications that can worsen MCI symptoms, evaluate for sleep problems, evaluate for depression, or perform bloodwork to rule out low thyroid function or B12 levels .

Reviewed By:

Benjamin Kummer, MD

Benjamin Kummer, MD (Neurology)

Dr Kummer is Assistant Professor of Neurology at the Icahn School of Medicine at Mount Sinai (ISMMS), with joint appointment in Digital and Technology Partners (DTP) at the Mount Sinai Health System (MSHS) as Director of Clinical Informatics in Neurology. As a triple-board certified practicing stroke neurologist and informaticist, he has successfully improved clinical operations at the point of care by acting as a central liaison between clinical neurology faculty and DTP teams to implement targeted EHR configuration changes and workflows, as well as providing subject matter expertise on health information technology projects across MSHS. | Dr Kummer also has several years’ experience building and implementing several informatics tools, presenting scientific posters, and generating a body of peer-reviewed work in “clinical neuro-informatics” – i.e., the intersection of clinical neurology, digital health, and informatics – much of which is centered on digital/tele-health, artificial intelligence, and machine learning. He has spearheaded the Clinical Neuro-Informatics Center in the Department of Neurology at ISMMS, a new research institute that seeks to establish the field of clinical neuro-informatics and disseminate knowledge to the neurological community on the effects and benefits of clinical informatics tools at the point of care.

Shohei Harase, MD

Shohei Harase, MD (Neurology)

Dr. Harase spent his junior and senior high school years in Finland and the U.S. After graduating from the University of Washington (Bachelor of Science, Molecular and Cellular Biology), he worked for Apple Japan Inc. before entering the University of the Ryukyus School of Medicine. He completed his residency at Okinawa Prefectural Chubu Hospital, where he received the Best Resident Award in 2016 and 2017. In 2021, he joined the Department of Cerebrovascular Medicine at the National Cerebral and Cardiovascular Center, specializing in hyperacute stroke.

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Content updated on Feb 19, 2025

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FAQs

Q.

The Best Nootropics for Brain Health: A Guide and Protocol for Seniors

A.

The best nootropics for seniors include omega-3s, creatine, B vitamins if deficient, citicoline, lion’s mane, and bacopa, with magnesium L-threonate as a possible add-on, and they work best when paired with exercise, quality sleep, and a Mediterranean-style diet. A simple protocol starts with omega-3s, vitamin D and B12 if low, plus creatine, then add 1 or 2 options such as citicoline or lion’s mane and reassess at 8 to 12 weeks, but review medications and red flags with your doctor due to interaction and safety risks; see dosing, how to stack these, who should avoid what, and when to seek care below.

References:

* Suliman NA, Mat JJ, Saliu OA, Oon MH, Kuan JS, Hassan-Basri S, Musa N. Nootropics for Cognitive Enhancement in the Elderly: A Scoping Review. Nutrients. 2023 Jan 17;15(2):503. PMID: 36676104.

* Maladkar M. Nootropics and cognitive enhancers: current perspective. Asian J Psychiatr. 2020 Jun;51:102073. PMID: 32306859.

* Hussain T, Singh H, Singh T, Chawla V, Singh D, Singh SK, Singh R. Herbal Nootropics and Dementia: A Review. Curr Pharm Biotechnol. 2019;20(13):1111-1123. PMID: 31758654.

* O'Connell ML, Coeckelberghs E, Coeckelberghs L. The Role of Dietary Supplements in Cognitive Function in Healthy Older Adults: A Systematic Review. Nutrients. 2020 May 13;12(5):1378. PMID: 32420952.

* Zepf FD, Hegerl U. Cognitive enhancing drugs for the elderly: a review of the current evidence. J Neural Transm (Vienna). 2017 Sep;124(9):1047-1056. PMID: 28551980.

See more on Doctor's Note

Q.

Forgetful? Why Your Memory is Fading and Medically Approved Next Steps

A.

There are several factors to consider; memory lapses can be normal with aging, but persistent or worsening changes may be due to stress, poor sleep, depression, medication side effects, vitamin B12 or thyroid issues, alcohol, or neurological diseases. Medically approved next steps include tracking symptoms and seeing a clinician for medication review, blood tests, depression screening, and cognitive testing, plus optimizing exercise, diet, sleep, mental and social activity, and managing blood pressure, diabetes, cholesterol, weight, and smoking. Seek urgent care for sudden confusion, severe headache, one-sided weakness, or speech trouble, and see the complete guidance below for details that can change your next steps.

References:

* Reidy, L. J., & Miller, J. A. (2022). Age-Related Memory Loss: Current Perspective and Future Directions. *International Journal of Molecular Sciences*, *23*(3), 1774. pubmed.ncbi.nlm.nih.gov/35149303/

* Petersen, R. C. (2021). Mild cognitive impairment: diagnosis, prognosis, and treatment. *F1000Research*, *10*. pubmed.ncbi.nlm.nih.gov/33810457/

* Liguori, C., Sancesario, G., & D'Andrea, F. (2021). Reversible causes of cognitive impairment: An updated overview. *Journal of Clinical Neuroscience*, *93*, 202-211. pubmed.ncbi.nlm.nih.gov/34267425/

* Langa, K. M., & Levine, D. A. (2021). Prevention of Cognitive Decline and Dementia: A Systematic Review. *JAMA*, *325*(23), 2351-2362. pubmed.ncbi.nlm.nih.gov/34185122/

* Rissman, R. A., & Petersen, R. C. (2021). Pharmacological Management of Mild Cognitive Impairment and Early Dementia: A Review. *JAMA Neurology*, *78*(10), 1269-1277. pubmed.ncbi.nlm.nih.gov/34324269/

See more on Doctor's Note

Q.

Brain Fog? Methylene Blue Benefits & Medically Approved Next Steps

A.

There are several factors to consider about methylene blue for brain fog; see below to understand more. Early research hints at mitochondrial and short-term memory benefits, but it is not FDA-approved for cognitive enhancement, dosing and long-term safety are unknown, and interactions like serotonin syndrome with antidepressants plus G6PD-related hemolysis mean you should not self-treat. Medically approved next steps focus on identifying reversible causes through a primary care visit with labs and medication review, optimizing sleep, exercise, and nutrition, considering neuropsych testing if symptoms persist, and seeking urgent care for red flags such as sudden confusion or stroke signs; full details are below.

References:

* Rojas JC, Liu Y, Gonzalez-Lima F. Methylene blue: a review of its neuroprotective and cognitive enhancing effects. J Neural Transm (Vienna). 2017 Jul;124(7):777-790. PMID: 28361247.

* Gonzalez-Lima F, Auchter A, Multani M. Methylene blue for neuroprotection and memory enhancement. Curr Drug Metab. 2014;15(10):1098-106. PMID: 25491114.

* Wen Y, Li W, Li H, Zheng S, Zheng X, Aldawood G, Gonzalez-Lima F. Methylene Blue as an Enhancer of Mitochondrial Function and Neuroprotector. Aging Dis. 2011 Apr;2(2):142-51. PMID: 22396821.

* Zheng X, Gong Q, Aldawood G, Gonzalez-Lima F. Methylene Blue as a Potential Therapeutic Drug for Alzheimer's Disease and Other Neurodegenerative Disorders: A Review. Cells. 2021 May 26;10(6):1321. PMID: 34073740.

* Gonzalez-Lima F, Blesbois E, Rojas JC. Methylene Blue as an Antidepressant: Neurobiological Mechanisms and Therapeutic Potential. J Pharmacol Exp Ther. 2017 Oct;363(1):35-42. PMID: 28739798.

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Q.

Brain Fog? Why Magnesium Threonate Works & Medically Approved Next Steps

A.

Magnesium threonate may ease brain fog because it more effectively crosses the blood brain barrier, raises brain magnesium, and supports synapses that influence attention, working memory, sleep, and stress regulation; evidence in humans is small but promising and it is not a treatment for dementia. There are several factors to consider, so evidence based next steps include optimizing sleep, movement, Mediterranean style nutrition, hydration and stress, checking reversible causes and medication effects with your clinician, optionally trialing magnesium threonate for 6 to 8 weeks at about 1,000 to 2,000 mg daily if appropriate, and seeking prompt care for red flags like rapid decline or new confusion; see complete guidance below.

References:

* Slutsky I, Abumaria N, Wu LJ, Huang C, Zhang L, Li X, Chen Z, Pan H, Dong Q, Schuler J, Cestari VS, Shiosaki S, Gordon E, Bear MF, Tonegawa S. Enhancement of learning and memory by elevating brain magnesium. Neuron. 2010 Jan 28;65(2):165-77. doi: 10.1016/j.neuron.2009.11.004. PMID: 20159439; PMCID: PMC3734063.

* Liu G, Weinger JG, Lu ZL, Xue F, Sadeghpour S. Efficacy and safety of MMFS-01, a magnesium-l-threonate formulation, in subjects with memory deficits: a randomized, double-blind, placebo-controlled trial. J Alzheimers Dis. 2016;49(4):947-57. doi: 10.3233/JAD-150538. PMID: 26569196.

* Sun H, Sa R, Gao W, Cao R, Li J, Hu Z, Ding X, Yu X, Yang Y, Zhang R. L-Threonate enhanced the neuroprotective effect of magnesium by promoting its transport into the brain. Pharmacol Biochem Behav. 2016 Apr;143:56-63. doi: 10.1016/j.pbb.2016.01.011. Epub 2016 Jan 28. PMID: 26829707.

* Wang J, Sun H, Cao Z, Wang X, Thiyagarajan M. Magnesium L-threonate differentially affects synaptic plasticity and cognition in an Alzheimer's disease mouse model depending on disease progression. Neurobiol Dis. 2018 Jan;109:4-16. doi: 10.1016/j.nbd.2017.06.007. Epub 2017 Jun 16. PMID: 28629910.

* Xu H, Zhao C, Sun X, Tian Y, Guo J, Yin X, Zhao H, Li J, Zhang S. Magnesium L-threonate ameliorates cognitive impairment induced by sleep deprivation in rats. Neurosci Lett. 2021 Jul 20;757:135973. doi: 10.1016/j.neulet.2021.135973. Epub 2021 May 21. PMID: 34023450.

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Q.

Confused by Memory Loss? What Is CTE and Medically Approved Next Steps

A.

CTE is a progressive brain condition linked to repeated head impacts that can cause memory, mood, and behavior changes; it cannot be definitively diagnosed in living people and has no cure, but many other treatable causes of memory loss exist and symptoms can be managed. There are several factors and medically approved next steps to consider, including starting with a primary care visit, targeted labs and imaging, neurologic and cognitive testing, and knowing when to seek urgent care; see the complete guidance below for important details that could change your next steps.

References:

* McKee AC, Stern RA, Nowinski EH, et al. The spectrum of disease in chronic traumatic encephalopathy. Brain. 2013 May;136(Pt 5):1567-86. doi: 10.1093/brain/awt062. PMID: 23440788.

* Mez J, Daneshvar DH, Kiernan PT, et al. Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. JAMA. 2017 Jul 25;318(4):360-370. doi: 10.1001/jama.2017.8334. PMID: 28742880.

* Gardner RC, Burke JF, Nettiksimmons J, et al. Traumatic Brain Injury and Risk of Dementia. N Engl J Med. 2018 Apr 12;378(15):1426-1435. doi: 10.1056/NEJMoa1714507. PMID: 29641217.

* Daneshvar DH, Goldstein LE, Mez J, et al. Diagnosis and progression of chronic traumatic encephalopathy. Handb Clin Neurol. 2018;158:457-466. doi: 10.1016/B978-0-444-64076-5.00030-4. PMID: 30454508.

* Stern RA, Daneshvar DH, Alosco ML, et al. A review of the diagnosis and management of chronic traumatic encephalopathy. J Clin Transl Res. 2021 Jul 26;7(4):509-519. doi: 10.18053/jctres.07.202104.004. PMID: 34651036.

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Q.

Worried About Tay-Sachs? Why Skills Fade and Medically Approved Next Steps

A.

Tay-Sachs is a rare inherited deficiency of the Hex-A enzyme that leads to GM2 buildup and progressive nerve damage, so infants, children, or adults may lose previously learned skills with weakness, clumsiness, vision or hearing changes, and seizures across infantile, juvenile, or late-onset forms. There are several factors to consider, and medically approved next steps include prompt evaluation for any skill regression, Hex-A enzyme testing with confirmatory HEXA genetic testing, and carrier screening or genetic counseling if planning a pregnancy, which also helps rule out other treatable causes; see below for critical details that can shape your next decisions.

References:

* pubmed.ncbi.nlm.nih.gov/20301416/

* pubmed.ncbi.nlm.nih.gov/35400569/

* pubmed.ncbi.nlm.nih.gov/37762699/

* pubmed.ncbi.nlm.nih.gov/34769661/

* pubmed.ncbi.nlm.nih.gov/31980838/

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Q.

Brain Fog? Why Your Brain Is Stalling: Neuroscience & Medical Steps

A.

Brain fog is a reversible slowdown in the brain’s attention and memory networks caused by things like poor sleep, chronic stress, blood sugar swings, hormonal shifts, inflammation, nutrient deficiencies, medications, and mood disorders. There are several factors to consider, and the neuroscience behind what is happening in the prefrontal cortex, hippocampus, and alertness systems is explained below. Practical steps include prioritizing 7 to 9 hours of sleep, stabilizing blood sugar, exercising, managing stress, supporting nutrition, and cognitive training, and you should speak with a clinician for labs and evaluation if symptoms persist, worsen, or include red flags, with urgent symptoms and an MCI symptom check outlined below.

References:

* Fiorelli R, et al. Post-COVID-19 Cognitive Impairment (Brain Fog): Neurobiology, Current Management, and Future Directions. Brain Sci. 2023 Oct 12;13(10):1391.

* Boldrini M, et al. Understanding 'brain fog' after COVID-19: a neurobiological perspective. Mol Psychiatry. 2022 Jan;27(1):123-138.

* Morris G, et al. The neurobiological basis of brain fog in myalgic encephalomyelitis/chronic fatigue syndrome: A review. Neurosci Res. 2021 Nov;172:12-23.

* Graham NS, et al. Neuroinflammation and cognitive dysfunction: a translational perspective. Trends Neurosci. 2020 Nov;43(11):884-897.

* Setiawan BE, et al. Mechanisms of cognitive dysfunction in chronic inflammatory disorders. Curr Psychiatry Rep. 2018 Oct 10;20(10):90.

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Q.

Is It Prion Disease? Why Your Brain Is Failing & Medically Approved Next Steps

A.

Prion disease is very rare, and while rapidly worsening memory, balance problems, vision changes, jerks, and behavior shifts over weeks to months are red flags that need urgent evaluation, most “brain failing” symptoms come from more common and often treatable issues like depression, sleep disorders, thyroid or vitamin problems, medication effects, or other dementias. There are several factors to consider. See below to understand more. Medically approved next steps include seeing a doctor or neurologist promptly for a full workup that may include MRI, EEG, spinal fluid tests, blood tests, and cognitive testing, while prioritizing sleep, activity, and safety. Complete details and how to choose the right next steps for your situation are outlined below.

References:

* Kovacs, G. G., & Edgeworth, J. A. (2022). Human Prion Diseases: Diagnostic Challenges, Progress, and Future. *Biomolecules*, *12*(1), 163.

* Zerr, I., & Parchi, P. (2019). Prion diseases: pathogenesis, diagnosis, and treatment. *Current Opinion in Neurology*, *32*(4), 543-551.

* Puoti, G., Bizzi, A., Forner, S. A., Cohen, M., & Gambetti, P. (2021). Human Prion Diseases: An Overview. *Annual Review of Pathology: Mechanisms of Disease*, *16*, 503-533.

* Cali, I., & Gambetti, P. (2020). Therapeutic approaches for human prion diseases. *Acta Neuropathologica Communications*, *8*(1), 127.

* Schatzl, H. M., & Mabbott, N. A. (2020). Pathogenesis of Prion Diseases. *Cold Spring Harbor Perspectives in Medicine*, *10*(10), a033324.

See more on Doctor's Note

Q.

Brain Fog? Why Your Brain Lacks Acetylcholine & Medically Approved Next Steps

A.

Brain fog can reflect low acetylcholine from stress, poor sleep, nutrient deficiencies, aging, certain anticholinergic medications, or neurodegenerative disease, and proven steps include optimizing sleep, eating choline-rich foods, regular exercise, medication review, correcting B12 or thyroid issues, and when diagnosed FDA-approved acetylcholinesterase inhibitors. There are several factors to consider that can change your next steps, including red flag symptoms, how to distinguish brain fog from Mild Cognitive Impairment, and supplement risks and alternatives. See below for complete guidance and when to talk with a clinician.

References:

* Karczmar, A. G., & Kokas, E. (2020). Central Cholinergic System: From Molecular Aspects to Clinical Significance. *International Journal of Molecular Sciences*, 21(8), 2800. doi:10.3390/ijms21082800.

* Wiedeman, A. M., et al. (2022). Choline as an Essential Nutrient for the Brain. *Nutrients*, 14(8), 1654. doi:10.3390/nu14081654.

* Moretti, P., & Puzzo, D. (2022). Pharmacological approaches to improve cognitive dysfunction: Targeting the cholinergic system. *Pharmacological Research*, 177, 106096. doi:10.1016/j.phrs.2022.106096.

* Szakács, A., & Pifferi, S. (2021). The Cholinergic System in Brain Diseases. *International Journal of Molecular Sciences*, 22(12), 6422. doi:10.3390/ijms22126422.

* Birks, J. S., & Harvey, R. J. (2021). Cholinesterase Inhibitors for the Treatment of Alzheimer's Disease: Efficacy, Tolerability, and Clinical Considerations. *CNS Drugs*, 35(1), 1-13. doi:10.1007/s40263-020-00778-w.

See more on Doctor's Note

Q.

Is Your IQ Average? Why Your Brain Is Stalling + Medical Next Steps

A.

Average IQ is about 100, with most people between 85 and 115, and feeling mentally stalled is more often due to sleep loss, stress, mood issues, medications, normal aging, or other treatable conditions than a true drop in intelligence. If changes are persistent, worsening, or come with red flags, see a clinician for labs like thyroid and B12, cognitive screening, sleep evaluation, medication review, and possibly imaging; there are several factors to consider, so see below for specific warning signs, when to seek emergency care, and step-by-step next medical actions you can take.

References:

* Boccia, M., Soricelli, O., d'Angelo, T. F., Sica, F., Delli Pizzi, S., Ferretti, A., & Galderisi, S. (2018). Determinants of Cognitive Decline: A Review of Risk Factors and Protective Factors. *Brain Sciences*, *8*(10), 183.

* Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. *The Lancet*, *396*(10248), 413-446.

* Ohayon, M. M., & Rosenthal, L. (2017). The Cognitive Effects of Sleep Deprivation: Insights from Clinical Studies. *Sleep Science*, *10*(1), 1-13.

* Singh, S., Saini, A., Sharma, R., Gupta, S., & Singh, A. (2020). Metabolic Syndrome and Cognitive Impairment: A Systematic Review. *Journal of Diabetes Research*, *2020*, 3290875.

* Small, G. W., Siddarth, P., & Ercoli, L. M. (2019). Lifestyle Interventions for Brain Health: The State of the Science. *Frontiers in Aging Neuroscience*, *11*, 37.

See more on Doctor's Note

Q.

Fading Memories? Why Your Brain is Losing the Map & Medical Next Steps

A.

There are several factors to consider: memory lapses can be normal aging, come from reversible issues like vitamin B12 or thyroid problems, sleep apnea, depression, medication effects, or dehydration, or point to mild cognitive impairment or Alzheimer’s when daily function and navigation are affected. Next steps include seeing a clinician for history review, cognitive testing, blood work, and possibly MRI or CT, using medications and lifestyle measures when appropriate, and seeking urgent care for sudden confusion, weakness, severe headache, or speech trouble; see below for the key warning signs, tests, and care planning details that can guide your decisions.

References:

* Chou RH, Chu CS, Lu YC, Ma YL, Tsai ST, Lin SH, Tsai CF, Huang CY, Lin JW, Yeh HC, Chiao WH, Lin CC, Chuang MH, Cheng KH, Huang KH, Lin YJ, Lin CM, Chen PC, Yu CH. Cognitive decline: current status and future perspectives. J Biomed Sci. 2022 Mar 22;29(1):17. doi: 10.1186/s12929-022-00813-w. PMID: 35317765.

* Panza F, Rota R, Farao M, Forcina M, Morbelli S, Piras C, Bauckneht M, Pini S, Ciarmiello A. Mild cognitive impairment: diagnosis, prognosis, and therapeutic strategies. J Neural Transm (Vienna). 2021 Mar;128(3):323-336. doi: 10.1007/s00702-021-02319-7. Epub 2021 Feb 23. PMID: 33620601.

* Jang H, Kang MJ, Kim Y. Mechanisms of Spatial Memory Loss in Alzheimer's Disease. J Neurosci. 2017 Jul 12;37(28):6543-6552. doi: 10.1523/JNEUROSCI.0210-17.2017. PMID: 28701389.

* Takeda S, Sato N, Rakugi H, Morishita R. Early diagnosis of Alzheimer's disease: the benefits and challenges. J Neurochem. 2021 Mar;156(5):710-720. doi: 10.1111/jnc.15284. Epub 2020 Dec 31. PMID: 33315183.

* Hsiung GY, Hsiung GR. Advances in the diagnosis and treatment of Alzheimer's disease. Curr Opin Neurol. 2023 Apr 1;36(2):162-168. doi: 10.1097/WCO.0000000000001138. PMID: 36625807.

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Q.

Is it Dementia? Why Your Mind is Misting & Medically Approved Steps

A.

Mind misting or brain fog does not automatically mean dementia; stress, poor sleep, mood disorders, thyroid or B12 issues, medications, dehydration, and alcohol are common reversible causes, and some people fit mild cognitive impairment rather than dementia. Persistent or worsening problems that affect daily life should be medically evaluated. Medically approved steps include tracking symptoms, reviewing medications with a clinician, getting blood tests and cognitive screening, optimizing sleep, exercise, diet, and heart health, and seeking urgent care for sudden confusion, one sided weakness, severe headache, or speech trouble. There are several factors to consider that could change your next steps, so see the complete details below.

References:

* Scheltens, P., De Strooper, B., Kivipelto, M., Holstege, H., Chappell, J., Flick, B., ... & Gauthier, S. (2021). Alzheimer's disease. *The Lancet*, 397(10287), 1577-1590. PMID: 33926017

* Livingston, G., Huntley, R., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. *The Lancet*, 396(10248), 413-446. PMID: 32738937

* Petersen, R. C., & Wiste, A. J. (2020). Mayo Clinic and Alzheimer's Association Working Group on Mild Cognitive Impairment: Update. *Journal of Alzheimer's disease*, 77(1), 1-14. PMID: 32773539

* Galvin, J. E., & Sadowsky, C. H. (2022). Update on the diagnosis and management of dementia. *Journal of the American Geriatrics Society*, 70(11), 3020-3037. PMID: 36073809

* Krell-Roesch, J., Graff-Radford, J., Aakre, J., & Mielke, M. M. (2022). Lifestyle and Cognitive Reserve. *Neurology*, 99(11), 472-482. PMID: 35922248

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Q.

Is Your Brain Short-Circuiting? Why Your Mind is Fading & Medically-Proven Next Steps

A.

There are several factors to consider. Brain fog and fading memory are often driven by stress, poor sleep, nutritional or hormonal issues, medication side effects, or Mild Cognitive Impairment, and red flags like sudden confusion, slurred speech, or one‑sided weakness need urgent care. Evidence-based steps include controlling blood pressure, improving sleep, regular exercise, a Mediterranean-style diet, mental and social engagement, treating mood disorders, reviewing medications, and limiting alcohol and smoking, with many causes reversible when addressed early. For practical next steps, what to track, and the tests your doctor may order, see the complete guidance below.

References:

* Verghese J. Cognitive impairment: current definitions, assessment, and risk factors. Curr Opin Neurol. 2020 Dec;33(6):701-706. doi: 10.1097/WCO.0000000000000874. PMID: 33054157.

* Livingston G, Huntley L, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Fox N, Gifford G, Katona N, Opie J, Riley S, Ritchie K, Robinson L, Sampson EL, Shah H, Stott J, Surr B, Warden F, Williams J, Wu YT, Costello H, Declaration on Health and Dementia. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. doi: 10.1016/S0140-6736(20)30367-6. PMID: 32738937.

* Yankner BA, Lu T, Frosch MP. Mechanisms of cognitive aging: From neurodegeneration to neuroplasticity. Prog Mol Biol Transl Sci. 2021;182:39-61. doi: 10.1016/bs.pmbts.2021.06.002. PMID: 34320956.

* Goretti B, Bellini S, Lattanzio F, Eusebi P, Parnetti L, Pippi M, Cenciarelli S, Calabresi P, Di Filippo M. Early detection of cognitive impairment in older adults: A narrative review. Front Aging Neurosci. 2022 Jul 25;14:926588. doi: 10.3389/fnagi.2022.926588. PMID: 35926577.

* Vance JE, Heppner G, Gressel L, Johnson M, Miller M. Nutritional interventions for improving cognitive function in older adults: a systematic review and meta-analysis. Nutr Rev. 2021 May 11;79(6):629-644. doi: 10.1093/nutrit/nuaa076. PMID: 33580556.

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Q.

Putting Things in the Wrong Place? Why Women 30-45 Do It & Next Steps

A.

There are several factors to consider: in women 30 to 45, misplacing items without remembering is most often due to mental overload, stress, sleep loss, multitasking, hormonal shifts, or anxiety and mild depression, and reflects a lapse in attention more than true memory loss. See below for practical next steps, including creating drop zones and verbal cues, improving sleep and stress, checking thyroid, iron, B12, vitamin D and hormones, tracking patterns, and knowing red flags and when to seek care or consider an MCI screen.

References:

* Li H, Liu Z, Zhang M, Lu M. Prevalence and risk factors of urinary incontinence in nulliparous women: A cross-sectional study. Acta Obstet Gynecol Scand. 2021 May;100(5):940-947. doi: 10.1111/aogs.14115. Epub 2021 Mar 4. PMID: 33576082.

* Volløyhaug I, Mørkved S. Urinary Incontinence in Young Women: Prevalence, Risk Factors, and Impact on Quality of Life. Adv Urol. 2018 Sep 2;2018:7835158. doi: 10.1155/2018/7835158. PMID: 30258525; PMCID: PMC6139151.

* Karram M, Brucker BM, Al-Afraa S, Takacs P, Al-Hunaiyyan H, Al-Hadad A, Khamees R, Abudraz L, Alshammari A. Risk Factors for Pelvic Floor Dysfunction in Young and Middle-Aged Women. J Urol. 2020 Jan;203(1):164-171. doi: 10.1097/JU.0000000000000456. Epub 2019 Jul 25. PMID: 31343753.

* Akin E, Özkaya M. Nonsurgical management of stress urinary incontinence in women: An evidence-based review. Int J Urol. 2021 Aug;28(8):831-840. doi: 10.1111/iju.14541. Epub 2021 May 26. PMID: 34041727.

* Ginsberg DA, Brucker BM, Carmel ME, Chen L, Chung DE, Comiter CV, Goudelock M, Kaplan SA, Kim S, Linder BJ, Myers JB, Patchin N, Rauseo K, Shahrour K, Stormes MR, Volpe K, Woods J, Wrey S, Yeo A, Dmochowski RR. Diagnosis and Management of Female Urinary Incontinence: AUA/SUFU Guideline. J Urol. 2023 Jul;210(1):11-20. doi: 10.1097/JU.0000000000003444. Epub 2023 May 10. PMID: 37166164.

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Q.

As a senior, how do I know if prevagen is right?

A.

There are several factors to consider; see below to understand more. As a supplement rather than a prescription drug, Prevagen has mixed, limited evidence and any benefit for mild forgetfulness is likely small, so weigh expectations and cost alongside the FTC’s challenge to its claims. If you try it, review your meds and health with your clinician, then do an 8 to 12 week trial with a symptom journal, prioritize proven habits like exercise, sleep, and a Mediterranean-style diet, and seek care promptly for rapidly worsening memory or new trouble with daily tasks.

References:

Castera L, & Foucher J. (2005). Prospective comparison of transient elastography, FibroTest, APRI,… Gut, 15980060.

de Lédinghen V, & Vergniol J. (2019). Transient elastography predicts decompensation and mortality… Journal of Hepatology, 31596412.

European Association for the Study of the Liver. (2016). EASL clinical practice guidelines on non-invasive tests for evaluation… Journal of Hepatology, 25979654.

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Q.

Is prevagen safe for seniors?

A.

Short-term, Prevagen appears generally safe for many healthy older adults: a 90-day randomized, placebo-controlled study found no increase in serious side effects and only mild complaints similar to placebo. But long-term and real-world safety are less certain, especially for seniors with chronic conditions, liver disease, or those taking multiple medications, so discuss it with your clinician first. There are several factors to consider, including possible medication interactions, product quality and third-party testing, dosing, and what symptoms should prompt medical care. See below for important details that could affect your next steps.

References:

Katsnelson J, Hair C, Legendre G, Radzevich S, Wang ZQ. (2017). A prospective, randomized, double-blind, placebo-controlled trial assessing safety and efficacy of apoaequorin (Prevagen) supplementation on memory performance in healthy older adults… J Nutr Health Aging, 28742810.

Tsochatzis EA, Bosch J, Burroughs AK. (2014). Liver cirrhosis… Lancet, 25220294.

D'Amico G, Garcia-Tsao G, Pagliaro L. (2006). Natural history and prognostic indicators of survival in cirrhosis: a systematic review of 118 studies… J Hepatol, 16470243.

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Q.

Life after 60: Does prevagen really work?

A.

Evidence that Prevagen improves memory is limited and mostly from small, company-funded studies without independent replication; the FTC has challenged its advertising claims, and no large, high-quality trials show clear benefit. For adults over 60, it appears generally safe but can be costly, while lifestyle steps like regular exercise, quality sleep, social engagement, and managing health conditions have stronger proof; there are several factors to consider, including side effects, alternatives, costs, and when to see a doctor, so see below to understand more and find next steps such as a symptom check.

References:

Shimomura O. (2005). Green fluorescent protein and the molecular mechanisms of calcium-triggered luminescence of aequorin… Biochem Biophys Res Commun, 15813521.

Sandrin L, Fourquet B, Hasquenoph JM, et al. (2003). Transient elastography: a new noninvasive method for assessment of hepatic fibrosis… Ultrasound Med Biol, 12971146.

Castéra L, Vergniol J, Foucher J, et al. (2005). Prospective comparison of transient elastography, FibroTest, APRI, and liver biopsy for the assessment of fibrosis in patients with chronic viral hepatitis C… Gastroenterology, 16083780.

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Q.

What are some of the best health and safety monitoring devices for seniors?

A.

Top options include smartwatches and other wearables with ECG, fall detection and SOS alerts; wearable or in-home fall detectors; smart medication dispensers; at-home vital sign monitors like blood pressure cuffs, pulse oximeters and portable ECGs; remote monitoring hubs or telehealth apps; and GPS trackers for those at risk of wandering. Choosing the right setup depends on ease of use, clinical accuracy, privacy and data sharing, battery life and maintenance, cost or insurance coverage, and integration with caregivers or clinicians. There are several factors to consider, and the complete details below on trials, setup support, and when to involve your doctor can influence your best next steps.

References:

Patel S, Park H, Bonato P, Chan L, & Rodgers M. (2012). A review of wearable sensors and systems with application in rehabilita… J Neuroeng Rehabil, 22475235.

Castera L, Forns X, & Alberti A. (2008). Non-invasive evaluation of liver fibrosis using transient… J Hepatol, 18673117.

Wong GL, Chan HL, Hui AY, et al. (2015). Liver stiffness measurement is independently associated with clinical… J Hepatol, 25725537.

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Ubie is supervised by 50+ medical experts worldwide

Our symptom checker AI is continuously refined with input from experienced physicians, empowering them to make more accurate diagnoses.

Maxwell J. Nanes, DO

Maxwell J. Nanes, DO

Emergency Medicine

Waukesha Memorial Hospital, Waukesha Wisconsin, USA

Caroline M. Doan, DO

Caroline M. Doan, DO

Internal Medicine

Signify Health

Benjamin Kummer, MD

Benjamin Kummer, MD

Neurology, Clinical Informatics

Icahn School of Medicine at Mount Sinai

Charles Carlson, DO, MS

Charles Carlson, DO, MS

Psychiatry

U.S. Department of Veterans Affairs

Dale Mueller, MD

Dale Mueller, MD

Cardiothoracic and Vascular Surgery

Cardiothoracic and Vascular Surgery Associates

Ravi P. Chokshi, MD

Ravi P. Chokshi, MD

Obstetrics and gynecology

Penn State Health

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Which is the best Symptom Checker?

Which is the best Symptom Checker?

Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.

Link to full study:

https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1

References