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Posted: March 25, 2008

One-Third of All Elderly Suffer Serious-to-Modest Memory Loss

It may not always be Alzheimer’s or dementia, but more than a third of all Americans over the age of 70 suffer some degree of memory loss, ranging from the fatal path of Alzheimer’s disease to more modest memory impairment that causes confusion but is not debilitating, researchers say.
 
In fact, a new study reports, one out of every five Americans age 71 and older – 5.4 million people in all – suffer memory lapses that disrupt their daily routine but which are not severe enough to affect their ability to complete daily activities.
 
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This group is added to the more than five million older Americans estimated to have Alzheimer’s and 3.4 million others with dementia to reach the estimate that one-third of all over-70 seniors are memory impaired. The findings, drawn from a study conducted by several universities, are published in the March 18 issue of the journal Annals of Internal Medicine.
 
"These findings illustrate that nearly every family will be faced with the challenges of caring for a family member with some form of memory impairment," said Brenda Plassman, Ph.D., associate research professor of psychiatry at Duke and the study's lead author. "Even among the people age 71-79, a sizeable number had cognitive impairment. This is an age at which most people expect to have many productive years ahead."
 
Researchers from Duke were joined in the study by teams from the University of Michigan, the University of Iowa, the University of Southern California and the RAND Corporation. The project was described as the first population-based study to determine the number of people who have some form of cognitive impairment, with and without dementia.
 
In reviewing the impact of non-dementia memory impairment, the scientists found that the frequency of memory loss without dementia increased with advancing age and with fewer years of education -- similar to the trends seen in dementia.
 
Plassman explained that throughout the course of the study, individuals with cognitive impairment without dementia progressed to dementia at a rate of about 12% each year. On average, the number dying each year among the study group was 8%, but it varied across the subtypes of cognitive impairment without dementia.
 
"While the overall rate of progression to dementia is in line with findings from other studies, the surprising finding here is that some subtypes of cognitive impairment without dementia progressed to dementia at much higher rates, around 20%, within one year," Plassman said.
 
Nearly a quarter of those with memory loss without dementia also had a chronic medical condition, such as diabetes or heart disease, which appeared to be the cause of the cognitive impairment. The researchers speculate that this group is one of the most under-diagnosed subtypes of cognitive impairment because doctors are likely focusing on the primary health issue.
 
"Given how common cognitive impairment without dementia is, physicians should be alert to this problem as they evaluate and treat the patient for other medical problems," said Dr. Robert B. Wallace, the study's senior author from the University of Iowa. "This may have significant ramifications because it means that patients may not be able to accurately portray their symptoms and may not retain important information about their treatment."
 
The team’s research data originated with the Aging, Demographics and Memory Study, which is part of the larger Health and Retirement Study conducted by the University of Michigan Institute for Social Research and funded by the National Institute on Aging (NIA).
 
"As the population ages and works longer, understanding the extent of cognitive impairment in the older population is critically important," notes Richard Suzman, Ph.D., director of the NIA’s Behavioral and Social Research Program. "Research is now beginning to suggest that interventions -- such as controlling hypertension and diabetes or perhaps cognitive training -- might help maintain or improve mental abilities with age. As such interventions are tested and widely applied, we should be able to track their impact through this type of research."
 
A total of 856 study participants were assessed by a healthcare team in their home. During the assessment, the participants completed a neuropsychological examination, and family members were asked to evaluate their loved one's memory, ability to complete daily activities and medical history.
 
A team of experts reviewed the information and assigned a diagnosis based on the general pattern and severity of the symptoms. This information was used to group patients together into subtypes for further analysis. Participants were followed from July 2001 through March 2005.
 
"With such a sizable number of Americans with some form of cognitive impairment, many of whom will get dementia, it's imperative to increase research funding that could lead to breakthroughs in Alzheimer's diagnosis, prevention and treatment," said William Thies, Ph.D., vice president of medical and scientific relations for the Alzheimer's Association.

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