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Memory loss may be early sign of dementia - 10 warning signs to look for

2013-07-18 12:16
Frequent forgetfulness could be early sign of dementia

Many Baby Boomers joke about having a “senior moment”, often dismissing brief memory lapses as a normal part of the aging process. However, if you forget more than someone’s name or find yourself increasingly misplacing your car keys, it could be an early sign of Alzheimer’s disease, according to new studies from several research teams.

Even doctors frequently dismiss a patient’s complaint about memory loss as the “worried well”, but the new studies show they may well have reason to worry, said Maria Carrillo, a senior scientist at the Alzheimer's Association.

In one such study, participants who initially reported memory changes then progressed to broader mental decline six years later. Another study confirmed that dementia was setting in, as evidenced by changes on brain scans.

"Maybe these people know something about themselves (that their doctors don't), and maybe we should pay attention to them," said Dorene Rentz, a psychologist at Massachusetts General Hospital who was involved in one of the studies presented Wednesday at the Alzheimer's Association International Conference in Boston.

In a significant shift highlighted at the conference, leading Alzheimer’s researchers identified a new category called “subjective cognitive decline,” which refers to an individual’s own sense that their memory and cognitive skills are getting worse even when no one else notices.

“The whole field now is moving to this area, and saying ‘Hey, maybe there is something to this, and maybe we should pay attention to these people,’ ” said Dr. Ronald C. Petersen, chairman of the advisory panel to the federal government’s new National Alzheimer’s Project.

Dr. Petersen, who also serves as director of the Mayo Clinic’s Alzheimer’s center, said that preliminary results of a Mayo study of healthy older adults in Minnesota confirmed something similar.

“Lo and behold, those who had a concern about their memory in fact had more likelihood (of later developing mild cognitive impairment, an early phase of dementia),” said Peterson, adding that study participants with memory concerns were 56 percent more likely to be diagnosed with such impairment, even when results were adjusted for factors, such as education, genetic risk and psychiatric issues like anxiety and depression.

“These people are sensing something, and there’s some biological signals that correlate,” Dr. Petersen said. “I think it’s real.”

However, experts stress that not everyone who experiences memory lapses or temporary cognitive decline will develop dementia. Some memory loss is just normal aging, they point out, and some may be due to psychological factors and stress.

For example, if you forget what you wanted in the kitchen or the name of someone you just met, you’re likely aging normally. But if you forget important details from recent events, or get lost in familiar places, you may have more of a problem that could lead to the progression of dementia.

About 35 million people worldwide have dementia, which causes a slow decline in cognitive and reasoning skills. Loss of memory is just one symptom of dementia, and Alzheimer's disease is the most common type.

According to Creighton Phelps, a neuroscientist with the U.S. National Institute on Aging, dementia is about real memory loss, in which the information doesn't come back to you later, not even when people remind you of what you forgot. It’s not, he emphasized, about "senior moments" that nearly everyone experiences as brief bouts of forgetfulness from time to time.

Only if the decline in memory is a change in your normal pattern should you be concerned.

"You're starting to forget things now that you normally didn't – doctor appointments, luncheon engagements, the kids are coming over ... things that a year or two ago you wouldn't," explained Petersen.

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"If you notice a change in your pattern of either yourself or a loved one, seek a health care professional's evaluation," said Heather Snyder, the Alzheimer's Association's director of medical and scientific operations. "It could be a lack of sleep or nutritional, but it may be something more than that."
But don't worry about small, common memory slips, said Dr. Reisa Sperling, director of the Alzheimer's center at Brigham and Women's Hospital.

"Every time you forget someone's name, you don't need to go running to the doctor," she said.

The Alzheimer's Association lists 10 warning signs of the disease:

1. Memory changes that disrupt daily life.

2. Challenges in planning or solving problems.

3. Difficulty completing familiar tasks at home, at work or at leisure.

4. Confusion with time or place.

5. Trouble understanding visual images and spatial relationships.

6. New problems with words in speaking or writing.

7. Misplacing things and losing the ability to retrace steps.

8. Decreased or poor judgment.

9. Withdrawal from work or social activities.

10. Changes in mood and personality.

SOURCE: Alzheimer’s Association Neuroscience Conference in Boston, MA (July 13-18, 2013).