Determining What’s Normal and When It’s Time to Seek Help
by TERESA SCHIFFER
Forgetting a name or where you put something is a fairly normal, if annoying, part of life. As you age, these memory slips can occur more often. After all, changes happen throughout the body, including the brain. However, occasional forgetfulness isn’t the same as having cognitive impairment or dementia.
“If you think of aging on a continuum, you have these normal, age-related changes,” explains Dr. Aryn Harrison Bush, a research professor and co-director of the USF Optimal Aging & Brain Health Research Laboratory who works with progressive neurological conditions.
“One of the things I hear the most often is, ‘That word, or that name is on the tip of my tongue. I’m having difficulty with proper nouns,’ things like that. Those complaints are typically – not always – considered normal, age-related changes.”
Some degree of forgetfulness is a natural part of the aging process. As we get older, we start having difficulty encoding and retrieving information in our memory. Changes in our sleep cycle patterns will also impact memory as we age.
When Is It a Problem?
Beyond the ordinary decline in memory associated with aging, there are degrees of impairment that can indicate more serious issues.
“Mild cognitive impairment is when something has changed,” Bush says. “There’s been a decline that could be in an area of memory, or it could be in an area of language and memory is relatively spared. There’s a significant change or decline in one or more cognitive functions that’s noticeable, but not to the extent of dementia.”
Such an impairment can cause frustration, but it generally does not have a major, negative impact on day-to-day functioning. Nonetheless, experiencing even mild cognitive impairment indicates a visit to the doctor for screening is in order.
“Dementia is where one or more cognitive domains are affected and negatively impacting daily functioning,” she says.
“With dementia, one key differentiating factor is that in clinical diagnosis, this is something that will progress or worsen over time,” Bush clarifies. “With mild cognitive impairment, it really depends on what is causing it, what is the etiology of that impairment. Some etiologies are reversible, some are not and are progressive. So mild cognitive impairment could be due to a progressive neurological condition, like Alzheimer’s disease, and in that case we would expect it to progress, but it could also be due to an infection, or it could be due to poor sleep, or undiagnosed sleep apnea, for example.”
It is often family members who notice the reduction in an individual’s abilities and bring it to the attention of healthcare providers. She urges all healthy seniors to get baseline cognitive and memory screening during annual exams. This gives physicians a point from which to note any progression of decline. Noting the types of changes and their magnitude helps healthcare providers assess to what degree a condition may be worsening and provide clues as to what could be causing any impairment.
There are at least 50 different causes of dementia, some of which are reversible while others are not. The term “dementia” is used to describe a number of symptoms that tend to occur together and progress in a certain pattern, but it does not indicate the cause of the symptoms. Alzheimer’s disease is the most common cause of dementia.
It can be very difficult to differentiate between types of dementia, and Alzheimer’s disease itself is further classified into a few subcategories. It is also possible to be affected by Alzheimer’s and vascular dementia simultaneously.
While people are far more aware nowadays of the issues associated with dementia and Alzheimer’s disease than in decades past, many are still unfamiliar with the current understanding of how the choices we make throughout our lives can affect our chances of developing these conditions.
“Be aware of what can increase or reduce your risk. Take action,” Bush cautions. “And if symptoms do emerge, at the first sign of symptoms that seem to be progressing, be evaluated by a healthcare professional to discuss these concerns because early intervention is key.”
Bush is currently involved with the PACT (Preventing Alzheimer’s with Cognitive Training) study being conducted by USF in conjunction with several other institutions.
This study examines whether computerized brain training exercises can reduce the risk of cognitive impairment and dementia such as Alzheimer’s disease.
The PACT study is recruiting volunteers aged 65 and older with no signs of cognitive impairment or dementia. Those interested in the study may participate in initial testing at the USF Tampa or St. Petersburg campuses or at Reliance Medical Centers in Lakeland or Winter Haven. For more information on the PACT study, go to pactstudy.org, or call 813-974-6703.