Diet and medication for MCI

I have been diagnosed with Mild Cognitive Impairment…21 on SLUMS score…MRI showed no acute intracranial abnormality….my neurologist described it as “not bad, not much worse than I would expect for a normal 73 year old.” And P-tau217 was negative for a surrogate marker for beta amyloid pathology. My neurologist says I do not have dementia at this point but that it could progress to that.

It is my understanding that now at this early stage is the time to take action. So, I want to establish a regime that will do everything I can to stave it off. Among 6 primary factors my initial focus is on diet. Doc has told me that good gut health has been linked in numerous studies to reducing the risk or delaying the onset of dementia. As a result I have been adding fermented foods as well as those heavy in Omega 3 and 6.

Here’s where it gets complicated. In 2011 I had a cellulitis infection in my left lower leg and ankle that went septic and I spent a week in the ICU. I was treated by an Infectious Disease Specialist who raised the concern that this type of infection had a reoccurrence rate of 35-50% and was potentially fatal. Suspected source of infection was chronic tinea pedis and lower leg edema. For treatment to prevent reoccurrence he instituted an indefinite penicillin therapy of twice daily 500 mg penicillin, twice daily use of 500mg Florastor probiotic, use of compression stockings and topical treatment of the toes, all of which has been continued to date under the guidance of my PCP with no cellulitis reoccurrence.

My concern is whether or not the use of penicillin is adversely affecting my ability to establish a healthy gut. As I mentioned I have been taking Florastor with the penicillin and have altered my diet to include probiotics in the form of fermented foods (kefir, kimichi and sauerkraut). My question is can all these components reside in my gut and still accomplish the desired result.

If not that leaves me with a tough decision.

We obviously have two goals here. One is to prevent the reoccurrence of cellulitis(and possibly sepsis)and the other is to promote healthy gut bacteria which has been linked to a substantial risk reduction for dementia.

Mayo says in deciding to use a medication , or combination thereof, the risks of taking the medicine must be weighed against the good it will do. Which is a decision for me and my doctor. I have received varying opinions. I would be curious if anyone might add something from their knowledge base or personal experience.