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July 23, 2009
Early Indicators, Warning Signs of Alzheimer's Disease


July 9, 2009
And Now, for the Rest of the Story!


June 17, 2009
Differential Criteria: Normal Aging vs Dementia


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Posted: June 04, 2009

Caregiving Lessons Learned

Is It a Senior Moment -- or Dementia?

Regardless of age, we all occasionally experience episodes of forgetfulness. And as we age, we call those episodes "senior moments" -- something we tend to equate with the beginnings of Alzheimer's disease or other forms of dementia. But there are important differences between simple forgetfulness and dementia.

For example, there’s a third state, called mild cognitive impairment, which falls between normal memory function and dementia. A recent Harvard Medical School publication provided a good analysis of the differences that I’d like to share with you.

Normal Forgetfulness

Normal forgetfulness is neither progressive nor 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.

With advanced age, there seems to be a correlation between the aging process and increased forgetfulness. This apparent normal byproduct 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, cutting back on 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 communicate 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. While the most common type of dementia is Alzheimer's disease, 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).

More than 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 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 requires significant foresight and careful advance planning. If this applies to you, make sure 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. I know you’ll be interested in the possible peace of mind this information might contain.

Please e-mail me at ASKBill@caregivershome.com with your comments and/or reactions. I will include them in a future column with your permission. Please provide your full name and address. In the column, I will only use your first name and the initial of your last name as well as your city and state. Thank you.

WORDS TO CARE BY . . .

"One should count each day a separate life."

Seneca (5BC-65AD)


Bill Andrew identifies himself as a former “nutritionally-empowered Alzheimer’s caregiver” who attributes the slow-down in the progression of the Alzheimer’s Disease in his wife, Carol -- and the growth of his own personal emotional, mental, physical, and spiritual capability and strength to provide quality 24/7 care for her in their own home -- to the targeted nutritional supplements they both took on a daily basis. Carol went to her Heavenly reward on June 9, 2008 -- Bill continues on to advocate for family caregivers. Contact Bill with your caregiving questions and comments via email at ASKBill@caregivershome.com.

© 2009 Pederson Publishing, Inc. All Rights Reserved.
Commercial use, redistribution or other forms of reuse of this information is strictly prohibited without the prior written permission of Pederson Publishing.
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