DEAR DR. DONOHUE: Will you please discuss mild cognitive impairment? A family member, 78, is forgetful. He took a battery of tests and was diagnosed as having MCI. Which medical specialist cares for MCI patients? Should other tests be done to be sure of the diagnosis? Are there vitamins one should take? Activities? Which medicine works best? Where do we go for support? Can a patient have MCI for years without developing dementia? — J.C.

ANSWER: Mild cognitive impairment is many steps below dementia illnesses such as Alzheimer’s, and a few steps above the memory problems that happen to just about everyone your relative’s age. People with MCI function quite well. They carry on daily activities without great impairment. They’re able to reason, to have insight into what others say and to display the proper emotional reactions to life’s many difficulties. Memory isn’t what it used to be. MCI might make a person forget a medical or dental appointment or a phone conversation, or not remember the outcome of a sporting event in someone who is a sports aficionado.

Not every MCI patient is doomed to the dementia of Alzheimer’s disease. Around 5 percent of those diagnosed with it do progress to Alzheimer’s every year.

The family doctor takes care of MCI patients. If a specialist is preferred, a neurologist fits the bill. Your relative has had enough tests to make a reasonable diagnosis. More esoteric tests are limited to centers doing research in dementia. No Food and Drug Administration-approved medicine exists for MCI. Some doctors put their MCI patients on drugs used for Alzheimer’s disease, such as Aricept (donepezil). Others wait until a person has obvious signs of Alzheimer’s.

No vitamin works. Keep your relative as active as possible. If he has hobbies, encourage him to stay active in them.

A person can have MCI for years and years, and not develop Alzheimer’s. You can contact the Alzheimer’s Association at 800-272-3900 or online at www.alz.org. I didn’t check with the association, but I’m sure it can provide you with information on MCI.

The booklet on Alzheimer’s disease also is helpful. To obtain a copy, write: Dr. Donohue — No. 903, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please wait four weeks for delivery.

DEAR DR. DONOHUE: On a local TV show, a couple of doctors answered questions about using the antibiotic azithromycin for COPD (chronic obstructive pulmonary disease — chronic bronchitis and emphysema). One treated man with emphysema said he used to get winded waking to his garage, but after taking azithromycin he could walk five miles without a problem. Have you heard of this? — D.L.

ANSWER: I have heard of it. Azithromycin reduces the number of episodes when COPD worsens. During such events, COPD patients are very short of breath, cough more intensely and produce greater amounts of sputum. Daily azithromycin reduces the number of such flare-ups. Don’t expect the transformation that the radio patient spoke of. Do expect better control of COPD.

DEAR DR. DONOHUE: I have a friend who is absolutely skeletal, but she sees herself as being fat.

Is this caused by bad vision? Is there a name for it? — K.H.

ANSWER: Your friend’s image of herself is more likely distorted by a psychological problem rather than by a vision problem.

Her assessment of her body fits the kind of assessment those who suffer from anorexia have of themselves. They are positive that their body has far too much fat when, in reality, they are close to starvation.

I don’t know the age of your friend. Anorexia rarely appears after the age of 40. Even if she’s older than 40, she needs to see the family doctor and get an unbiased opinion of why she thinks the way she does. The family doctor might refer her to a mental-health professional as well as guide her to healthy nutrition.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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