A very common concern among my patients aged 45 and older is a fear that they are losing their memory and may be on their way to Alzheimer’s disease or other dementias.
Although these are possibilities, some memory loss is common as we age and not associated with a degenerative dementia. This kind of memory loss is called benign and frequently reflects changes in an aging nervous system.
Simple aging is the most common cause, but memory loss can also be a symptom of treatable disorders such as depression, anxiety or substance abuse. Memory loss can also occur as a side effect of some medications.
In early stages, it can be difficult to differentiate between the various kinds of benign memory loss or the more ominous memory loss associated with dementias such as Alzheimer’s disease.
Typically, people first notice impairment of recent memory. More frequent misplacement of keys, wallet or watches is often the first complaint. Sometimes, difficulty retrieving information such as names of acquaintances is also a problem.
These symptoms may not hugely affect a person’s life, but are often distressing to the individual because they are viewed as the preliminary stages of something more serious.
In reality, most people experience some memory loss as they get older. Almost all elderly people report memory loss when they are asked to compare their current memory with that of their younger years. Only 10 to 20 per cent of elderly people will actually have objective evidence of memory problems that suggest brain disease.
When a normally aging person is tested for cognitive function, there is usually some decline in processing and retrieval of new information. It may feel as though it is more difficult to learn new information than it used to be, but in a normally aging brain, some training and tips can often help to bring memory back to normal levels.
However, in a brain with early Alzheimer’s disease, there is a severe, progressive problem with moving newly-learned information into long-term memory. Unlike a healthy individual of the same age, the memory loss in Alzheimer’s is relentless and disabling. Even in early stages there is little or no improvement with training.
Other cognitive changes are also present with Alzheimer’s disease. Doctors can test the patient’s language and communication abilities. Patients with early Alzheimer’s have difficulty expressing themselves and often take a long time searching for words.
Depression is a common disorder in the aging population and can cause some memory impairment that can be mistaken for degenerative dementia. This is often overlooked as a possible cause in the doctor’s office, but should be ruled out as a contributing factor or recognized and treated. Associated memory symptoms are often reversible.
If you, or a loved one, is experiencing some trouble remembering things, visit your doctor. There are screening tests that can determine cognitive function and can help to differentiate between normal memory loss from aging and more serious brain diseases.
One such test is called the mini-mental state examination (MMSE). Patients with benign memory loss will have scores that remain relatively constant at annual checkups. Individuals with Alzheimer’s disease will see an average decline of two points or more per year as the disease progresses.
Dr. Latimer is president of Okanagan Clinical Trials and a Kelowna psychiatrist.