Senior Moments or Dementia?

First posted on June 3, 2009 in the PolkVoice by Bill Andrew

Regardless of age, we all occasionally experience episodes of forgetfulness. As we age, we tend to call those episodes “senior moments” — something that we tend to equate with the beginnings of Alzheimer’s disease or other dementias. But there are important differences between simple forgetfulness and dementia. A third state, called mild cognitive impairment, falls in between normal memory function and dementia. A recent Harvard Medical School publication provided a good analysis of the differences which I would like to share with you.

Normal forgetfulness
Normal forgetfulness is neither progressive not debilitating. Such memory problems often occur when you are under stress, tired, sick, distracted, or overloaded. Typically, you will remember the forgotten information sooner or later. If this happens to you, perhaps you rely on written reminders or lists — as well as other memory-jogging techniques (string around your finger?) — to overcome such forgetfulness.

As we age, there seems to be a correlation between the aging process and increased forgetfulness. This apparent normal by product of the aging process may be a result of changes in the brain that seems to begin around age 50 — perhaps a gradual loss of receptors on brain cells or a decline in certain neurotransmitters. Researchers often disagree with how much deterioration is normal.

Memory loss is not inevitable, however. There are many things that you can do to preserve or sharpen your memory such as memory-enhancing techniques (books are available on this topic), reducing stress in your life, getting enough sleep, staying well, reduce your workload, etc. You can also improve your organizational skills by writing down your appointments and keeping lists or, perhaps, having a specific location for your keys or eyeglasses. You can challenge your mind by reading, doing crossword puzzles, playing chess, or taking classes in a subject of interest to you. Many experts believe that such activities help to build and maintain the synapses in your brain, the gaps between the neurons that enable them to communicates with each other which is normal brain activity.

Mild cognitive impairment

Mild cognitive impairment (MCI) is now considered a transitional state between normal forgetfulness and dementia. People with mild cognitive impairment are at increased risk for developing Alzheimer’s-type or other dementias. In MCI, at least one cognitive (thinking) domain — usually memory — is below normal or is in decline.

A person with MCI is usually able to carry on with their routine daily activities without difficulty. However, a particular subset of cognitive skills may be compromised or diminished. A person with MCI may show some of the following signs:
* Increased difficulty with remembering things or, perhaps, subtle problems in other cognitive domains such as language, attention, spatial skills, and problem solving.
* Clinical confirmation of impairment on neuropsychological tests often manifested as difficulty in learning and delayed recall of information when compared with others of the same age and education level. Often, memory is normal but is less reliable than previously.

Dementia

In the case of dementia, memory loss is severe enough to interfere with a person’s ability to function socially and in the work environment. The most common type of dementia is Alzheimer’s disease. But there are many other causes of dementia — many of them reversible through appropriate treatment. Some of the more common dementias include vascular dementia (caused by multiple strokes that interrupt blood flow to the brain), dementia with Lewy bodies, and frontotemporal lobar degeneration.

Some of the indications of dementia include:
* Decline in intellectual function from a previous level. This change in mental ability differentiates dementia from mental retardation.
* The afflicted person is alert and aware of their surroundings, which differentiates dementia from delirium.
* More than one type of thinking is affected. In addition to memory problems, at least one of the following is also impaired: personality, abstract thinking, judgment, use of language, ability to perform complex physical tasks, or ability to recognize objects or people. Known as global cognitive impairment, this characteristic distinguishes dementia not only from mere forgetfulness but also from such conditions as amnesia (memory loss only) and speech deficits (caused by stroke, for example).

Over 5 million Americans have Alzheimer’s disease — my late wife, Carol, suffered for 14 years with the disease before she died. Alzheimer’s is the fifth leading cause of death in the United States — and moving up. It is bound to become more common as the baby boomers turn 65 — the age at which Alzheimer’s becomes a major risk — and the age at which my wife was first diagnosed with the disease. Because the disease is progressive, coping with it requires significant foresight and careful advance planning. Make sure that your doctor is aware of any of the indications referenced above for either yourself or your loved ones.

In my next column, I will provide criteria developed by the American Medical Association to help differentiate between normal aging and dementia.

If you have any comment on the above, I can be reached at 863/294-5513 or wfandrew@verizon.net.

I am the President of Polk County Family Caregivers, a 501(c)(3) not-for-profit Florida Corporation, and the voice of advocacy for Polk County family caregivers for over 12 years I also facilitate an Alzheimer’s Support Group on the fourth Saturday of each month at 10:00am in the Family Life Center, Door #2, St. Joseph Catholic Church, 532 Avenue M, NW, Winter Haven. A version of this online column is also published periodically in the print edition of the Polk Voice.

Contributed by Bill Andrew, former 24/7 Alzheimer’s family caregiver, Winter Haven

This article was reproduced courtesy of Polk County Family Caregivers – A Voice of Advocacy for Family Caregivers

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