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Thursday, July 30, 2020

Normal Memory Loss or Dementia?

As you get older, forgetfulness becomes more common and you may ask yourself if it’s normal or the start of a slide into dementia.

You can’t remember where you put the car keys … again. You start to introduce a friend and, embarrassingly, can’t remember her name. You begin to tell someone about that fun movie you watched last night, but you’ve forgotten its title. Argh! Not only is it frustrating, but a thought wiggles into the back of your head: Is this how dementia starts? Am I getting Alzheimer’s?

Memory lapses commonly start in your 50s or 60s, but experts say you can relax: It’s very unlikely to be dementia. The Alzheimer’s Association reports that less than 5% of people get the early-onset type of the disease. In fact, recent studies show that the overall rate of dementia actually went down over the past 10 years.

The primary sign that your age-related memory loss is not dementia is that it is not disabling, according to Amy Ehrlich, associate chief of geriatrics at Montefiore Health System in New York City. “It’s very typical as you age that you have trouble remembering a name, then it will just pop into your head,” says Ehrlich. “That is not a sign of impending dementia.”

Still, it’s true that the risk of getting Alzheimer’s doubles every five years after you turn 65. You can reduce your risk by 30% to 50% when you avoid or treat these four problems:

  • Depression
  • Smoking
  • High blood pressure
  • Obesity 

All of the above conditions are treatable, so don’t hesitate to visit your doctor for advice or referrals if one or more pertain to you.

Who’s Qualified to Diagnose Dementia?

Most patients who suspect they may have a form of dementia go to a family doctor for their initial appointment. If they see changes in thinking, movement or behavior, a visit to a neurologist — a doctor who specializes in the disorders of the brain and nervous system — may be the next logical step. Geriatric psychiatrists, neuropsychologists and geriatricians can also specialize in diagnosing dementia. If there is no such specialist in your community, check with the neurology department of the nearest medical school. An affiliated hospital may also have a dementia disorders clinic where expert evaluation can be found.

Types of Dementia

Dementia actually covers a variety of cognitive disorders, of which Alzheimer’s is the most common, making up 60% to 70% of cases. Another kind is Lewy body dementia, which happens when tiny deposits damage brain cells. Vascular dementia is caused by reduced blood flow to the brain due to heart disease or stroke. 

Getting some baseline testing is a good idea if you think you, or someone you know, is beginning to show signs of dementia. Two assessments can be better than one using practitioners in complementary disciplines, such as a geriatric psychiatrist/psychologist and a neuropsychologist.

Dementia and Drugs

The effects of certain drugs on older adults can mimic early dementia, causing confusion, disorientation and memory loss. These medications include antihistamines and those used to treat Parkinson’s, and belong to a class called anticholinergic drugs. Even some doctors are fooled into thinking patients exhibiting symptoms of mild cognitive impairment have early dementia, and treat them accordingly by mistake. Health care professionals should assess patients for use of anticholinergic drugs before beginning therapy for cognitive decline.

Heavy alcohol use can also interfere with memory and make someone appear to have dementia. And urinary tract infections are often associated with temporarily decreased cognition. Blood clots, brain tumors, vitamin deficiencies, head trauma … the list of causes for problems that resemble dementia is quite long. Rule out any of these possibilities before deciding you may have dementia.

Dementia and Sleep

Recently, sleep apnea has been linked with an increased risk of dementia. Obstructive sleep apnea (OSA) occurs when the sides of the throat relax, narrowing the airway and impeding the flow of oxygen. A recent study found that older adults should be routinely screened for the condition, since the chances of having it increase with age. Low oxygen levels have been linked to reduced thickness in portions of the brain vital for memory. These brain areas change with the onset of dementia. 

Normal Signs of Aging

Ehrlich talks about what she looks for when she’s evaluating patients for signs of dementia. First, she’ll check if they can still learn new technology. It’s normal if it takes a little longer to get the hang of your recently purchased smartphone, but if you can learn an unfamiliar task, you likely don’t have dementia. Multitasking may have become more of a challenge, but semantic memory, or memory involving facts and concepts, tends to remain at the same level or dip slightly with age. And some women find themselves forgetful and distracted while the hormones of menopause rage, then improve dramatically when the hormones flatten back out. 

However, episodic memory, which affects your ability to recall an appointment or remember your favorite new book author, is a hallmark sign of dementia. However, a host of other causes having nothing to do with aging can affect episodic memory as well. 

Certainly, if you suspect that you or a loved one may have dementia, or you just want some assurance that you don’t have the disease, call your doctor. After ruling out a physical cause, they can run a combination of cognitive and neuropsychological tests to assess mental functioning. But odds are, you are just getting older. 

Click below for the other articles in the July 2020 Senior Spirit


Blog posting provided by Society of Certified Senior Advisors