The incidence increases dramatically as people move into the 90s. About 5 percent of the 71 to 79 have dementia, and about 37 percent of those around 90 live with it.
Older people may worry about their own loss of function as well as the cost and fee of caring for a dementia. A 2018 study estimated that the lifetime cost of a person with Alzheimer’s, the most common form of dementia, was $ 329,360. This number, too, will undoubtedly increase, placing even more burdens on the family, Medicare and Medicaid.
There has also been a lot of talk and reporting about dementia in recent months due to the presidential election. Some voters have asked if one or both candidates may have dementia. But is this even a reasonable question to ask? When this type of question is asked ̵
First, it is important to know that dementia cannot be diagnosed far away or by a person who is not a doctor. A person needs a detailed medical examination to get a diagnosis. Sometimes brain formation is required.
And forgetting an occasional word – or even where you put your keys – does not mean that a person has dementia. There are different types of memory loss and they can have different causes such as other medical conditions, falls or even medications including herbal plants, supplements and everything that is not over the counter.
Older people wonder and worry about “senior moments” and the memory loss they experience in themselves and others. I see patients like this every week in my geriatric clinic, where they tell me their stories. They forget a word, get lost in a story, lose keys or can’t remember a name. Details vary, but the underlying concern is the same: Is this dementia?
Normal memory loss
As we get older, we experience many physical and cognitive changes. Older people often have a decline in memory. This is normal.
Have you ever had trouble retrieving a fact from the deep back of your “mind is Rolodex”? Suppose you spot someone in the grocery store that you have not seen for years. Maybe you recognize the face, but do not remember their name until later that evening. This is usually part of the expected changes with aging.
What’s more of a potential problem is forgetting the name of someone you see every day; forget how to get to a place you visit often; or have problems with your daily activities such as eating, dressing and hygiene.
When you have memory problems – but they do not interfere with your daily activities – this is called mild cognitive impairment. Your primary care physician can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.
You will be aware of the time of any impairment. Was there a gradual decline? Or did it happen suddenly? Also, discuss this with your doctor, who can recommend MoCA or Montreal Cognitive Assessment, which screens for memory problems and helps determine if more evaluation is needed.
The Centers for Disease Control and Prevention also lists problems in these areas as possible signs of dementia:
● Reasoning, judgment and problem solving.
● Visual perception in addition to typical age-related changes in vision.
More serious problems
When memory loss interferes with daily activities, consult your doctor about what to do and how to make sure you are safe at home.
There are many types of severe memory loss. Dementia tends to be a slow progression that occurs over months or years. Delirium is more sudden and can occur within hours or days, usually when you have an acute illness. Depression can also cause memory changes, especially as we get older.
Dementia, other brain problems
Alzheimer’s is the most common type of dementia followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or inability to make calculations like balancing the checkbook. Certain medical conditions – thyroid disorders, syphilis – can lead to dementia symptoms, and less common types of dementia can have different types of symptoms.
Alzheimer’s has a distinct set of symptoms that are often associated with certain changes in the brain.
Focus on safety and appropriate supervision, especially at home, is essential for all people with dementia. Your doctor or social worker can help you find support.
It is also important to be aware of two other things that can lead to impaired mental function – delirium and depression.
Delirium, a rapid change in cognition or mental function, can occur in people with an acute medical illness, such as pneumonia or even covid-19 infection. Delirium can occur in patients in the hospital or at home. The risk of delirium increases with age or previous brain damage; Symptoms include impaired attention and memory problems.
Depression can happen at any time, but aging is more common. How do you know if you are depressed? Here is a simple definition: when your mood remains low and you have lost interest or joy in activities you once loved.
Sometimes people have recurrent episodes of depression; sometimes it is long-term grief that becomes depression. Symptoms include anxiety, hopelessness, low energy and memory problems.
If you notice signs of depression in yourself or your loved one, contact your doctor. If you have any thoughts of harming yourself, call 911 for assistance immediately.
Any of these conditions can be daunting. But even more frightening is unknown or unrecognized dementia. You need to openly and honestly discuss changes you notice in your memory or thinking with your doctor. It is the first step towards finding out what is happening and ensuring that your health is the best it can be.
And as with any disease or disease group, dementia is not a “character flaw,” and the term should not be used to criticize a person. Dementia is a serious medical diagnosis – ask those who have it, the loved ones who care for them, or any of us who treat them.
Having dementia is challenging. Learn what you can do to support those with dementia in your own community.
Laurie Archbald-Pannone, who specializes in geriatric medicine, is an associate professor of medicine at the University of Virginia. This article was originally published on theconversation.com.