Memory Screenings showcase fundamental issues with cognitive impairment treatment

RIO RANCHO — A local doctor is taking over a conference room at the Loma Colorado Main Library Tuesdays and Thursdays, but it has nothing to do with books.

Retired physician Stephen Hightower is offering a quick memory screening to assess how well a person’s brain is functioning on multiple levels. This free screening is available on a first-come, first-served basis from 12:30-2:30 p.m. Tuesdays and Thursdays into October.

At his Jan. 23 screening, he explained why he’s doing it.

“I retired from practice a couple of years ago and got called back when COVID came. What I began to notice was when I interacted with people, there were some challenges in cognitive function. So we kind of do a little more research on that. I was a geriatrician, so I saw a lot of Alzheimer’s disease and I saw mild cognitive impairment. But it seemed like there was an upswing in the number of people that I began running into. So, I found online that the Alzheimer’s Association would support ... having places for people to go to get testing for mild cognitive impairment,” Hightower said.

He wanted to make testing available to the community, and the library obliged.

“We set up a time that works for them, and so I just come and do the testing for mild cognitive impairment, which takes about 20 or 30 minutes,” he said.

He said he’s had days when all four appointments had the signs of cognitive impairment and days when none did.

“The concept is that the incidence of mild cognitive impairment is increasing or is it that it actually has been this much all along, but no one’s been testing for it? Kind of a catch-22 in that regard,” he said.

The reality is the volume of people who have mild cognitive impairment (MCI) can go in three directions, according to Hightower, and depending on where that goes, it can be expensive.

“It can stay as mild cognitive impairment. It can improve and go away. That’s great, and about a third — or if you really go through the data, it’s more like 25% or so — will go on to a dementia or the Alzheimer’s type. Well, that’s a really big deal, but the resources required to try and identify those folks is costly, very costly,” he said.

He added that doing the test to find MCI costs nothing, but if people were to go further and look for genetic markers of dementias, it can add up. It won’t be a one-stop shop, either.

“You’re going to basically be treating them for the rest of their life. Who could afford that? Not with the therapies. These things would be monoclonal antibodies, and the PET scans you have to do and the spinal taps you have to do and everything else — these are incredibly expensive treatments,” Hightower said.

For example, blood test for genetic markers can cost around $300, he noted.

His goal is to inform as many people as possible about the available avenues for treatment and testing so the mainstream medicine will take more people on and eventually costs will go down.

One resource Hightower shares with people is a book by Dr. Sanjay Gupta, an expert in the medical field on MCI. His books on MCI challenge people to protect their mind from decline.

“I do the test for the people; if they have or don’t have the mild cognitive impairment, I provide them these five areas, six areas that they can work on that really can make a difference. His book is just outstandingly so well detailed that it’s still very easy to read that people can really get an idea what they can do to try to keep from this progressing, or maybe even improving to getting cognitive function to go up,” Hightower said.

He said there are simple things people can do from exercising to eating right to socializing. With 14 types of dementia, he added, self-treatment can be necessary and helpful. Another resource he suggests is the Mayo Clinic.

“If you’re going to go Mayo, though, go to Rochester,” he said.

A commonality he notices in this current uptick in MCI is the age and generations experiencing it.

“The Boomers or just this segment of the population is just the hot one of the highest numbers all in one timeframe. All the dads came home from the war, everybody started having kids, and I think the Boomers are a bigger group,” he said.

He includes himself in that group and notices a lot of his patients are in that group. He added that he thinks that group is used to making excuses for their decline or ignoring it all together.

“Normally we would just say, ‘Oh, you know Bob; he just lost it,’ or, ‘Bob’s just going nuts,’ or, ‘He’s 78. Everyone goes nuts at 78.’ No one thought about it,” he said.

He added that it was common medical practice to give temporary solutions.

“I think the most important thing for us to have is awareness. People need to be aware,” he said.

However, Hightower stressed that there is nothing a person does to cause mental decline like that. MCI can be a genetic precursor to dementias or, at the worst, Alzheimer’s disease, which is tied to plaque buildup in the brain. While there are things people can do to help, it’s not something that just goes away, either. He said that people can’t just make new proteins in their brain, but they can treat what exists.

That being said, if people are scared of an MCI diagnosis, Hightower says to remain positive. “I always say, ‘Let’s stay positive. Let’s work on these areas to try to help you,’” he said.

Next steps look different for everyone, whether it’s meeting with a neurologist, starting a simple at-home exercise or nothing at all. Hightower added that Rio Rancho is a good place to be for stimulating the brain. “The high altitude will help build stamina,” he said.

Hightower only has the capacity to see a few people each week and suggests people go through their doctor if they have concerns.

“I can’t have 50 people show up at the same time because it’s going to take me two months to get to all you guys,” he said.

He added that people can use other avenues to look into their cognitive function. “I’m just trying to help,” he said.

For information on the library memory screenings, visit rrnm.gov‘s calendar or visit the Loma Colorado Library.