Older people often worry about ‘senior moments’ but while that is a normal part of aging, it can sometimes point to cognitive impairment. Here is how to tell the difference.
Forgot your keys in the car? Can’t remember the name of your favorite niece? Missed a scheduled lunch date with a longtime friend? Before you start panicking that this ‘brain fog’ would eventually would eventually go down the dreaded dementia road, take a deep breath. Forgetfulness is perhaps the most natural part of aging, and doctors say not all memory loss ends up as dementia.
According to the Alzheimer Society of Canada, almost 40% of us will experience some from of memory loss after we turn 65. “But chances are still unlikely that we have dementia. For the most part, our memory loss mild enough to live our daily lives without interruption.” The World Health Organization says only 5-8% of people aged 60 and above will live with dementia. However, incidence increases with age — about 5% 9f those aged 71 to 79 have dementia, and about 37% of those about 90 live with it.
But how do you know if it’s just age catching up with you or a deeper neurological malaise? If forgetfulness disrupts daily routine, comes in the way of finishing familiar tasks, and makes loved ones sit up and take notice, those are warning signs. “With age, there’s a natural decline in attention span, multi-tasking ability and recall of information stored in the brain. This decline does not compromise autonomy.” But in dementia, this impairment is more pronounced than what is expected for one’s age, education, and it begins to affect a person’s functionality. For instance, forgetting why you came into a room is normal but if the room itself feels unfamiliar, then that could be a sign.
Dementia, can be due to many causes, but the most common in India are Alzheimer’s disease and vascular disease of the brain. “Hence, physicians take a note of a patient’s history, carry out cognitive tests, compare results to age and education based normal, look at functionality, and only then make a clinical diagnosis of dementia.”
The biggest reason for forgetfulness in our everyday life is multitasking. “We’re checking our phones, being distracted by noises on the street. These really degrade our capacity to remember. And when under stress, we often have trouble forming new memories.”
PERSONALITY CHANGE A SIGN:
But dementia is a completely different ballgame, changing one’s personality in unexpected ways. Families don’t even realize the memory loss is serious. Where family members have attributed forgetfulness and behavioral changes to aging, stress and retirement, failing to recognize it could be the onset of dementia until it’s too late.
BLOOD TESTS MAY BE FUTURE:
What makes it even more tricky is that there is no single test to diagnose people living with Alzheimer’s or other causes of dementia. “We mostly diagnose patients on the basis of clinical exams. If their forgetfulness progresses and impairs daily activities, and the person is found negative for other common treatable causes such as vitamin B12 deficiency and thyroid dysfunction, we consider them for dementia.”
In case of Alzheimer’s disease, there’s high deposition of a protein called amyloid in the brain. “Developed countries like the US and UK can use PET scans to detect the protein. But currently, this test is not available in India as it requires high-tech labs. Some blood-biased biomarkers have also been identified to diagnose Alzheimer’s, but they are still at the early developmental stage.”
Between natural aging and dementia, there’s another stage known as mild cognitive impairment (MCI). “At this stage, the person is able to function independently but needs effort. All patients with MCI do not progress to dementia.”
TREATMENT OPTIONS:
Despite evidence to classify different type of dementia, there’s a huge gap in treatment options. “We have therapeutic agents to slow down progression of Alzheimer’s — the most common cause of dementia — if diagnosed early. We advise lifestyle changes and cognitive behavioral therapy, also referred to as brain exercise, to manage the condition. “It’s labor-intensive and expensive, since there are very few trained cognitive behavioral therapists available in the country.”
WHAT CAN WE DO TO PREVENT IT?:
The bane for dementia is advancing age, which we cannot change. But studies have shown other risk factors that could be eliminated to reduce half of the dementia cases worldwide. The Lancet Commission recommends providing kids with quality education and being cognitively active in midlife, reducing harmful noise exposure, treating high LDL (bad cholesterol) and depression, improving social connectedness, and smoking bans among others.
A healthy lifestyle with regular exercise, not smoking, and avoiding excess alcohol cannot only lower dementia risk, but may also push back dementia onset. “So, if people do develop dementia, they are likely to live less years with it. This has huge quality-of-life-implications for individuals as well as cost-saving benefits for societies.”
