Every year, you resolve to get more exercise. And every year, you stay stuck on the couch.

The American Academy of Neurology is here to help. The experts on brain health are out with new guidelines that say exercising twice a week may help preserve memory and thinking skills in people with mild cognitive impairment.

At least 2.4 million Americans are estimated to have mild cognitive impairment, or MCI, and that figure is projected to grow to at least 5.7 million by 2060, according to a report this month in the journal Alzheimer’s and Dementia.

The prevalence of MCI increases with age. The new guidelines say it affects 6.7% of people ages 60 to 64, 8.4% of those ages 65 to 69, 10.1% of people 70 to 74, 14.8% of those 75 to 79, and 25.2% of those 80 to 84.


Unlike people with dementia, those with MCI are able to cope with routine tasks like getting dressed and preparing meals. But they have more trouble remembering appointments and keeping track of their car keys than other people their age.

Mild cognitive impairment is sometimes — but not always — a waystation to Alzheimer’s disease. Since there are no proven treatments for Alzheimer’s, doctors are eager to have patients do what they can to slow its advance.

That’s where the exercise advice comes in. In a report published this week in the journal Neurology, an expert panel recommends that people with MCI be sure to work out at least twice a week.

The authors of the new clinical guidelines acknowledged that there are no long-term studies to support this advice. However, studies that tracked people for six months “suggest a possible benefit of twice-weekly exercise for cognition in MCI,” they wrote. What’s more, “exercise also has general health benefits and generally limited risk.”


If the evidence to back exercise sounds thin, consider what the experts said they know for sure: You can’t medicate your way to better brain health, and you can’t count on food to boost your cognitive skills either.

In fact, doctors should tell their patients with MCI that “there are no pharmacologic or dietary agents currently shown to have symptomatic cognitive benefit in MCI and that no medications are FDA-approved for this purpose,” the panel members wrote.

Sometimes, symptoms of MCI can improve by taking fewer medications, the authors noted. Cognitive problems can be a side effect of certain drugs, so doctors should wean patients off of them if it’s safe to do so, the guidelines suggest.

Sleep problems, depression and other medical conditions can also cause mild cognitive impairment. Treating those problems may be an effective way to treat MCI, the experts wrote.


Cognitive training may help too, though the evidence for this is weak, they added.

The new guidelines don’t include recommendations for specific kinds of exercise that would help people with MCI. Short-term studies suggest that both aerobic exercise and resistance training may be useful.

karen.kaplan@latimes.com

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