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Saturday, July 2, 2022

Forgetfulness is not necessarily a warning of dementia

Dr. Gabe Mirkin

One of every five North Americans at age 45 can expect eventually to develop dementia, a progressive brain disorder that interferes with normal daily living and is marked by memory loss, personality changes and impaired reasoning (Alz Dementia, 2015;11(3):310-320). Aging is the major risk factor for dementia, but forgetfulness among the elderly does not necessarily mean the person is headed for dementia.

When people are tested after they complain about minor memory problems, they may receive a diagnosis of Mild Cognitive Impairment (MCI) and may fear that this means they are about to become demented. People diagnosed with MCI can maintain their daily activities, but may have difficulty shopping, taking their medications, and remembering names and places. Common problems for people with MCI include:
• losing their train of thought during a conversation
• being unable to stay on a thought or a task such as paying a bill
• being unable to find their way in a familiar place

A new study from Columbia University followed more than 2,900 adults in their seventies (Neurology, published online Dec 1, 2021). Over six years, 752 were diagnosed with MCI and 480 of those with MCI were tracked for an additional two years. The results after two years should encourage seniors who think their occasional memory lapses are a forecast of dementia:
• Nearly half of those 480 seniors no longer had MCI when they were retested and were “cognitively normal”
• 30 percent still suffered from MCI but had not shown any further decline
• 10 percent had suffered some further decline in mental functioning but were still in the range of MCI
• Only 13 percent had descended into full-blown dementia
The researchers noted that a weakness in the study was the short follow-up period, but they felt that their findings suggest that a diagnosis of MCI should be viewed only as a “higher risk classification,” and not as an early stage of dementia.

Of the 480 participants, those who had become demented were more likely to have an Alzheimer’s-associated gene called APOE4, have a history of depression, taken antidepressants, and/or had severe loss of memory, language and spatial relations in their initial testing. The participants who did not progress towards dementia were more likely to have more years of formal education, have higher income, participate in more leisure activities, visit friends regularly and/or go for walks.

Dr. Gabe Mirkin is a Villager. Learn more at www.drmirkin.com

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