By Deborah Bier
Do you know someone who lives with dementia through your profession or personally? If so, it's likely at some point their cognitive health has made you concerned for your own. You forget an old friend's birthday... you can't find your car keys, again... you forget the very item you went to the grocery store to buy. Do you wonder if there is something seriously wrong with you? When is forgetting part of the normal course of life? When does forgetting become a reason to worry? How can we tell the difference?
Here are seven ways to look at normal, age-related memory changes versus signs of impaired cognitive health. Nothing below is intended to diagnose, but rather to help guide your understanding of the difference between normal (but aging) memory and dementia.
Three Things You Should Know About Dementia
“Dementia” and “Alzheimer’s” are not interchangeable terms. Dementia is an umbrella term for a condition involving cognitive impairment. There are many types of dementia, each with its own pattern of disability and ability and course of development. Alzheimer’s is the most frequently diagnosed type of dementia, but all dementia is not Alzheimer’s.
Dementia is not normal aging. Dementia is not an inevitable outcome of aging, though risks for dementia do rise with age. Dementia is a result of impaired brain function.
Dementia causes loss of abilities in many spheres, not just memory. Each type of dementia (and each person who has dementia) varies, but as a generality, losses include motor abilities, language use, self-care, orientation, decision-making, problem-solving, immune function, continence, emotional control and more.
- Do reminders work? We all forget names, dates and items on our “to do” list. However, can you be reminded successfully? If being prompted with facts reconnects you to them, your forgetfulness is probably part of normal aging. If reminders do not work, and you are still unable to recall with a reminder, this can be a sign of dementia.
- Can memories be recalled? Are you able to recall events or information, including with reminders, to stir your memory? Recall takes longer as we age, but a normal brain should be able to remember eventually. If so, this is likely normal aging. If all the reminders in the world will not help you recall, then this can be a sign of dementia.
- Do memory tools work? Few people can remember all the phone numbers they need. This is why we have telephone books and contact lists. If you can successfully use a memory tool like a phone book (or calendar, internet search, etc.), then your forgetfulness is presumably normal aging. If memory tools can no longer be used successfully, this can be a sign of dementia.
- Is there a repetition of forgetfulness? You have been reminded of someone’s name, and with normal memory, you have better recall next time you need this information. However, if the same reminder must be repeated again and again, this can be a sign of dementia.
- Is there a stable personality? It certainly is frustrating to have to work to recall information. Despite that, with normal aging, your personality is generally stable and recognizable. If you’ve always had a short fuse or always stayed calm, it is probable you will continue to do so. If there are personality changes—loud, hot anger in someone who has always been mild mannered, for example—coupled with any of the concerns above, this can be a sign of dementia.
- Are habits and tasks performed? Can you perform customary daily tasks and meet your basic needs in bathing, dressing, eating, paying bills and health care? If yes (even though you might have trouble bending or reaching due to arthritis or other medical issues), then likely you are aging normally. If daily tasks and activities you used to do have now become impossible, this can be a sign of dementia.
- Reaction to stress or fatigue? It is common for your memory to struggle when you are highly stressed or fatigued. However, you generally do not forget your nearest and dearest and other familiar information. If stress and fatigue cause out-of-proportion dysfunction mentally, physically and/or emotionally, this could be a sign of dementia.
As you can see from these seven areas, dementia is more than just memory loss. Dementia is a loss of function beyond momentary memory lapses. After you read this, if you have a reason for concern or you continue to be worried about your cognitive health, please make an appointment to be screened for cognitive impairment. A good place to start is with your primary care physician.
Deborah Bier, PhD, is a member of ASA’s Mental Health and Aging (MHAN) Council and is the director of special populations for ComForCare Home Care, a premier provider of in-home care with nearly 200 locations in the U.S., Canada and the U.K. She holds a certificate in gerontology and is a Certified Alzheimer’s Educator, a Certified Dementia Practitioner and a certified Dementia Care Partner. For more information, go to www.ComForCare.com.
This article is brought to you by the Editorial Committee of ASA’s Mental Health & Aging Network (MHAN)