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Dementia vs. forgetting stuff

Posted by Dr. Suzanne Koven  September 19, 2012 06:48 AM

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keen-whisper.jpgI was making a mental packing list for a fall weekend at the beach: sweatshirt, jeans, sunglasses, those sandal things--you know, for walking on rocky shoreline? Kind of ugly, but useful? I could picture them clearly--the rubber soles and webbed uppers--but their name escaped me entirely. A person's name, maybe? I started to go through the alphabet letter by letter, hoping for a clue. But it was gone. Not "wait, wait, don't tell me!" Not "on the tip of my tongue." Just gone.

This kind of lapse has always happened to me now and then, especially when I'm very busy, and happens more frequently as I get older. It happens to my patients, too, and they come in concerned that it may be the first sign of Alzheimer's disease or some other form of dementia. It rarely is.

Half of people over 65 notice more frequent episodes such as I've described, where they can't think of a word or a name. Another common complaint is misplacing items like keys, or entering a room and forgetting why you're there.

Normally, these lapses--I hate the term "senior moments" because they happen to non-seniors as well--are isolated, temporary, and not progressive. In other words, that name does come to you, you do figure out where the keys are, and the problem does not spread to other brain functions. Also, the sense that you're having difficulty remembering things is subjective--your friends and family may not notice.

In early Alzheimer's-type dementia (the term is qualified because only those who have specific pathological changes in the brain are said to have Alzheimer's), family and friends may be more aware of a person's memory deficit than he or she is. It's not only word (or key) finding that's affected, but also the ability to do certain familiar tasks such as tying a tie or following a recipe or card game. Recent information, such as what you ate for breakfast, is more likely to be inaccessible than remote data, such as the names of your elementary school teachers.

A nice summary of "normal" memory loss vs. signs of dementia is here.

Some research suggests that older people who have subjective memory loss of any kind are more likely to go on to have dementia in later years. But given the very high percentage of older people who complain of forgetfulness, it's hard to know who should be especially concerned. And since treatments for dementia once it occurs are not very effective, prevention rather than screening seems more valuable, at least for now.

Steps to help prevent dementia are here and include exercise, reducing saturated fat in the diet, adequate sleep, and other measures recommended for general health.

For those seriously concerned about memory loss, a physical exam and blood work may help diagnose conditions such as thyroid disease, vitamin B12 deficiency, and vascular disorders that might be contributing to the problem.

For those, like me, who have occasional forgetfulness, try slowing down, stop multi-tasking, relax, and give it a few minutes...


This blog is not written or edited by or the Boston Globe.
The author is solely responsible for the content.

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About the author

Suzanne Koven, M.D. practices internal medicine at Massachusetts General Hospital in Boston. She writes a monthly column for the Globe's G Health section and her essays have appeared in the More »


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