It’s not all downhill from here

One in four older people with mild cognitive impairment - a precursor to dementia - naturally 'reverts' to normal cognition, research from the University of New South Wales (UNSW) in Australia shows.

The findings challenge the popular belief that older people with mild cognitive problems always have a downhill course. The study, published in PLOS One*, shows that some in fact get better. "While it is not always possible to predict who will get better, there are some indicators," said the paper's first author, UNSW Medicine neuropsychiatrist Professor Perminder Sachdev.

In the study, people who reverted were generally more robust , seemed to be ageing "better", were more likely to have controlled their high blood pressure and were generally more physically and mentally energetic. "It seems that both enriching mental activity and physical exercise may be very important factors," said Professor Sachdev.
Researchers looked at 223 people aged 71-89 diagnosed with minor cognitive impairment and found that participants with greater openness to experience were more likely to revert, indicating that a more flexible personality is an advantage.

The group underwent a series of tests to measure brain functioning, including memory and language tasks. After the two-year period, there were 66 reverters to normal cognition and 157 non-reverters.

Professor Sachdev said both mental and physical exercise give direct benefits to the brain but regular exercise also offers many secondary effects, correcting other risk factors associated with cognitive decline, such as reducing obesity and blood pressure, and controlling diabetes.

Importantly, 'reverters' also had better ability to smell and had better vision. "There is some deterioration in smelling capacity as we age. People with dementia have greater decline and so do people with Parkinson's. It's a marker of brain change," Professor Sachdev said.

While the research gives hope to people with mild cognitive problems, Professor Sachdev cautioned that any benefits could be limited over time. "Some people may still go on to develop dementia eventually. It's a matter of how long they can keep it at bay. So for this reason it's important for people to know that they can improve the quality of their life for some time through exercise and good health care," he said.

*PLOS One is an open access peer-reviewed scientific journal published by the Public Library of Science