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Is It Just Forgetfulness or Is It Dementia?
The saying goes, “If you forget you have a doctor's appointment, it's just forgetfulness, but if you forget you have a doctor, it's Alzheimer's dementia.” We all become forgetful now and again, even very young people. Usually it is related to stress or too much on our minds. Usually when you lose your keys or glasses, it just takes some quiet thinking to remember where you were the last time you used them or what coat you were wearing, or you can think back to actually laying them down somewhere. But, what if you cannot remember even using them or the last time you saw them? Is that senility sneaking up on you? Probably not; probably your mind was on something else, so the recognition of where you set them down didn't really register actively in your mind.
It does seem that forgetfulness is becoming more and more prevalent as we reach and pass middle age. Is it that we are becoming senile or are we just more concerned about it? After all, as we get older, our lives are supposed to be less hectic, the kids are grown and pretty much on their own, we have more time to ourselves and more time to relax, right? So what is happening to our memories?
Dementia (formerly called senility) is defined by Wikipedia as “de”=apart, “ment”= mind,” so literally it means to be apart from the mind. Dementia is not just forgetfulness, it is the loss of ability to reason, problem-solve, deduct, plan, and remember. It is the loss of memory and logic. Loss of time and place are common in dementia.
Aging does not cause dementia. It is a brain disorder that can affect young people, although it is more common among the elderly. After all, the longer you live, the more chance you have of developing any condition or disease.
Diagnosis is extremely important. Some conditions can mimic dementia; conditions such as overmedicating (intentional or accidental), abuse of alcohol or other drugs, or an oxygen, vitamin, or mineral deficiency. MRI and brain scans can help pinpoint organic brain disease, tumors, or vascular compromise, all of which may be treatable.
Blood tests can help diagnose deficiencies of minerals or vitamins, alcoholism, and the overuse of medications. Oxygen deprivation can be caused by vascular compromise in the brain or anemia in general from poor diet or a dysfunction of the blood.
Whatever the cause, diagnosis allows the medical team to determine the best treatments available and the best assistance for the patient and caregivers if it is dementia.
The most common type of dementia is Alzheimer's, which is a degeneration of the neurons in the brain. The brain cells develop plaque and tangles and eventually shrink and die. The brain of an Alzheimer's patient will become noticeably smaller and withered.
According to Fisher Center for Alzheimer's Research Foundation lists 10 warning signs of Alzheimer's on its website www.alzinfo.org. These symptoms are compared to normal age-related memory changes and behaviors below, along with my comments and interpretations:
- Memory loss – a person begins to forget more than remember as compared to the normal occasional forgetfulness
- Difficulty performing common everyday tasks such as cooking compared to the normal situation of forgetting what you came into the room to do.
- Forgetting the name of everyday items such as a toothbrush and not being able to describe it compared to the norm of occasionally stumbling for the right word.
- Being disoriented to time and place, getting lost in a very familiar area and not knowing how to get home compared to the normal occurrence of forgetting where you parked in a parking lot (happens to me all the time!)
- Poor judgment evidenced by inappropriate dressing or inappropriate spending compared to the normal process or occasionally making a questionable decision.
- Problems with abstract thinking evidenced by inability to figure things out or process complex problem-solving tasks compared to the normal difficulty of balancing a checkbook or deciphering a technical manual.
- Misplacing items in unusual places, such as putting a watch in the sugar bowl or the iron in the freezer compared to the normal misplacing of keys or wallet.
- Changes in mood or behavior as evidenced by rapid mood swings for no apparent reason compared to the normal process of occasional moodiness.
- Changes in personality, especially becoming fearful, suspicious, distrusting, and very dependent on family members as compared to the normal personality changes that occur with normal aging.
- Loss of initiative as evidenced by passive behavior, sitting without activity or stimulation, sleeping more than usual compared to the normal processes of occasionally feeling weary of work or social obligations.
The chart below shows the difference between Alzheimer's and normal age-related memory changes. It was taken from the Fisher Center website in its entirety:
Someone with Alzheimer's disease symptoms |
Someone with normal age-related memory changes |
Forgets entire experiences |
Forgets part of an experience |
Rarely remembers later |
Often remembers later |
Is gradually unable to follow written/spoken directions |
Is usually able to follow written/spoken directions |
Is gradually unable to use notes as reminders |
Is usually able to use notes as reminders |
Is gradually unable to care for self |
Is usually able to care for self |
For more information, go to the Alzheimer's Disease Education and Referral Center website at www.nia.nih.gov/alzheimers or do an online search with keywords such as dementia, senility, or Alzheimer's.
Watch for next quarter's newsletter article on practical tips for assisting Alzheimer's patients and their caregivers and what community resources have to offer.
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