What Treatments Do Patients with MCI and their Partners Want?

Perhaps a long time overdue, the field of medicine has started to ask patients and their families what they want in terms of treatments and what outcomes they hope for in treating their illnesses.  In one of our recent studies, we did the same.  We asked our former HABIT Healthy Action to Benefit Independence & Thinking® participants what they wanted when seeking treatment for MCI.  We asked their loved ones, too.

Here's what we found:

Desired Outcomes

#1 Quality of Life

Both individuals with MCI and their loved ones ranked patient Quality of Life as the most important outcome out of 13 possible choices of outcomes related to cognitive ability, functional ability, psychological outcomes, and care partner outcomes.

Rounding out the top 3 outcomes:

#2 Self-Efficacy (feeling you can accomplish the things you want to despite your memory problem)

#3 Patient Mood (managing and treating depression)

Desired Therapies

We give 5 different therapies during HABIT:  1) memory compensation training with a calendar system, 2) brain fitness training on a computer, 3) wellness education, 4) yoga, and 5) support groups.  In this study, we also asked our alumni what interventions they found most important.

The most important?

#1 Memory Compensation Training

#2 Support Group

The least important?

Brain Fitness training on the computer.

Yoga and wellness education fell in the middle in the rankings.

What Do We Take Away from This?

Doctors tend to focus on treating the immediate symptoms of a disease.  In the case of MCI, memory loss is often the most immediate symptom of the disease. Thus, many of the treatment programs and interventions that exist for MCI focus on rebuilding or addressing the memory problem.  While this may be significant, our patients with MCI and their loved ones tell us what is most important is that they have a good quality of life, feel a sense of self-accomplishment, and are in good spirits.  In terms of our HABIT Program, they found the individualized cognitive rehabilitation hour (the memory compensation training) and the emotional processing in support groups to be essential.

Moving forward, we are listening to our alumni, and holding quality of life as the highest priority of patient outcomes.  Over the years, we also have run a lot of studies where we randomly offer some of the therapies and not others (to research their effectiveness).  Due to your feedback, and because we have good evidence now of their effectiveness, we will always offer the memory compensation training and support groups from now on.

Thank you to all of our research participants who allowed us to conduct this study, as well as many others over the years!  This particular study was just published in the Journal of Alzheimer's Disease if you'd like to read more:

A Survey of Patient and Partner Outcome and Treatment Preferences in Mild Cognitive Impairment.

Smith GE, Chandler M, Fields JA, Aakre J, Locke DEC. J Alzheimers Dis. 2018 May 18. [Epub ahead of print]