Is it Dementia, or Aging?

When are lapses in memory a cause for concern, and when are they simply a frustrating inconvenience? If you have noticed changes in the cognitive abilities of yourself or someone you know, getting a proper diagnosis is important.

What is Dementia?

Dementia refers to a decline in a person’s memory and other cognitive abilities that interferes with normal daily life. An estimated five million people in the U.S. are currently living with dementia. While age is the greatest risk factor, dementia is not a normal part of aging. Beyond your age, your cardiovascular health is the most important indicator of dementia risk.

The most common cause of dementia is Alzheimer’s disease, accounting for more than 80 percent of all cases. “Alzheimer’s is a progressive disorder,” says Christopher Weber, Ph.D., director of Global Science Initiatives for the Alzheimer’s Association. “This means the signs of dementia start out slowly and gradually get worse, so it’s important to watch for subtle changes that are more than normal aging and could indicate dementia.” Other conditions can also lead to cognitive changes, including a brain tumor, sleep disturbances, severe vitamin B12 deficiency, dementia with Lewey bodies, frontal-temporal dementia, and Parkinson’s disease.

Beyond Normal Aging.

“We all forget things at times—misplacing car keys, forgetting the name of a person you just met and recalling it later,” says Richard M. Dupee, MD, MACP, AGSF, a gerontologist and clinical professor of medicine at Tufts University School of Medicine. “We might even need to make lists more often as we get older. Minor memory problems such as these, as well as decline in other thinking skills, are what we call age associated memory impairment, and are of no concern.” These lapses are manageable, and do not interfere with function and normal day-to-day activity, he explains.

With dementia, things that were once commonplace mental activities become difficult. For example, if someone who always balanced their checkbook or followed recipes can no longer do so, that could be a sign of dementia’s onset. (This would not be a sign of dementia for someone who was never good at these tasks.). Getting lost while driving in a familiar place is another example of a common warning sign. If you find your lost keys by the refrigerator and suddenly remember you set them there when your arms were full of groceries, that’s normal. If you have no recollection of how they got there, that’s a warning sign for the onset of dementia.

Early Detection.

“Some causes of memory problems are treatable,” says Dupee. “And if not, such as in the case of Alzheimer’s, there are medications that may slow down the loss of memory.” Early diagnosis is essential for determining and starting treatment. It is also an opportunity for people with dementia and their care partners to get information and support as quickly as possible. “People who are diagnosed early have more time to make decisions regarding their care plan,” says Weber, “including building a care team, budgeting, receiving counseling, outlining their advanced directives, enrolling in clinical trials, and addressing driving and other safety concerns.” Knowing what’s coming empowers people to make decisions for themselves while they still can.

What to Do.

If you notice consistent changes in your cognitive abilities that seem beyond the normal changes of aging and interfere with your normal daily activities, talk to a doctor. If you notice these changes in a friend or loved one, have a trusted person approach that person at a quiet time and place to discuss these concerns and next steps.

No matter what your current situation, take steps to protect your brain. “Lifestyle behaviors that benefit heart health, like exercise, quitting smoking, and consuming a healthy dietary pattern, will also benefit the brain,” says Weber. “In general, it is best to eat a hearthealthy diet low in saturated fats and high in vegetables and fruits.” It’s also beneficial to keep the brain stimulated by learning something new, doing puzzles you find challenging, and staying socially engaged. Additionally, minimize the risk of head injury by using a safety helmet when appropriate and practicing fall prevention, and try to get seven to nine hours of sleep a night.

Be familiar with the warning signs of dementia, trust your perception of changes in your abilities, take the concerns of family and friends seriously, and don’t be afraid to talk with a healthcare provider.

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