Minor memory lapse or sign of dementia? How to tell the difference – NJ.com

There I stood in the elevator with a colleague, staring at him like an imbecile.

I was telling him about a book I’d just finished, a gripping account of an attorney who fights courageously to free wrongly convicted inmates from death row. It was the stuff of “To Kill a Mockingbird,” except the stories were real, and the injustice was shocking.

You’ve got to read this book, I told him. Sounds interesting, he said. What’s it name? Who wrote it?

That’s when my brain went blank. Hard as I wracked my mind, I could not remember the name of the author. Or the title of the book.

Awkwardness filled the elevator like Muzak. I was embarrassed and my colleague was embarrassed for me. The door opened and we hurried off in different directions.

When your brain abandons you in that way, you feel more than stupid. You feel addled. You wonder if you’re losing it. Could it be an early, ominous sign of dementia?

Probably not, says Dr. David Libon, a geriatric neuropsychologist at the New Jersey Institute for Successful Aging.

“That’s not a memory problem,” Libon says. “It’s an age-related word retrieval problem. It’s a very common type of problem we all experience as we get older.”

That’s a relief to me, and perhaps to you. I know many people my age, and even much younger, who find they’re becoming more forgetful and worry what that might portend.

My mission: To fend off dementia

I can’t help but worry. It’s been barely a year since I lost my mother to dementia. Her death left me with many regrets — first and foremont being how slow I was to recognize the warning signs in her. I don’t want to make that mistake again. I’m constantly scanning myself for little blips that might sound an alert.

I am hardly alone in my angst. One study showed that Americans are twice as worried about losing mental function as they are about a decline in physical health, and 60 percent say they are somewhat or very anxious about memory loss as they age.

“It’s endemic,” Libon says. “The aging of the Baby Boom population has served to make what was already a public health problem even more acute. This is going to be increasingly something that individuals are going to need to deal with.”

The challenge, experts says, is to recognize the difference between the mental hiccups that occur naturally as we age, and more serious memory lapses that affect our ability to function and can signal the onset of Alzheimer’s disease or other forms of dementia.

All of us experience the former. Call it a “senior moment.” Call it a brain fart. You forget where you put your car keys. You can picture the face of a former schoolmate, but his name escapes you. You open a kitchen drawer and then can’t remember what utensil you’re looking for.
Dr. David Libon(Photo from Rowan University)

These are examples of what experts call “strategic” memory, and such forgetfulness is not an indicator of dementia — or even of old age. “What really declines with age is not necessarily memory, but overall speed of information processing,” Libon says. “That process of so-called decline can begin as early as the late 20s or early 30s.”

Minor lapses in memory are benign, as long as they don’t inhibit you from living a normal life. You might forget the name of a street you drive every day, but you have no trouble getting to your destination. Or perhaps you’re in animated conversation with a friend, and you can’t summon a familiar word, though it’s on the tip of your tongue. So you rephrase the sentence and make your point.

You shouldn’t fret exceedingly about such things, but you should stay vigilant. Sometimes when we worry, we have good reason. The number of people with dementia is expected to double over the next 20 years. And as the Alzheimer’s Association notes, deaths caused by Alzheimer’s increased more than 70 percent between 2000 and 2013, while deaths from every other major disease in the U.S. declined. None of us can hide from that dire reality.

“There have been polls that say for adults in mid-life, their biggest fear is to develop Alzheimer’s disease,” says Dr. Christian White, a geriatric psychiatrist at the Institute for Successful Aging, based at Rowan University. “I don’t think you can ever have too big of a concern about this.”

White says by some estimates, 50 percent of adults will develop Alzheimer’s by the age of 85.

“That’s one out of two of us,” he says. “There is no other disease that’s this prevalent and is guaranteed to kill you in eight to 10 years. That just tears apart families as you watch your loved one go through this terrible condition. So therefore, if you’re worried, if you’re anxious, I don’t think you can over blow it or make too big of a deal about it.”
Dr. Christian White(Photo by Rowan University)

I cringe at how little I knew about the warning signs of frontotemporal degeneration as the disease took my mother into its grip.

At first she seemed a little cranky and forgetful, but I attributed that to her getting older. As her mind steadily waned, I found it hard to face. If anything, I preferred to look for signs that it wasn’t dementia. That’s how much I hoped it was something else, something treatable. White says that’s fairly common in families facing the specter of dementia.

“They don’t come in right away, because family members think it’s normal, or mom is having a bad day,” he says. “We sometimes make an excuse.”

As for me, I’m done making excuses. What I know now — too late for my mother, but not too late for me — is that denial is no defense against dementia, and neither is lack of knowledge. I’d like to think I wouldn’t miss those signs again, and there’s no reason you should either. But you have to know what to look for.

Memory loss may be what we notice first and worry about most, but White says that’s only one element of cognition. The others are language, executive function, personality and visual/spatial ability. A diagnosis of dementia requires two or more of these functions to be impaired.
Frank Langella stars in “The Father,” a play about a man who furiously rejects any suggestion his mind is slipping. Denying your loss of memory and becoming angry when loved ones try to point it out to you is a serious warning sign of dementia. (Photo by Joan Marcus)

That diagnosis should be made by a medical professional, ideally one who specializes in dementia. Usually, that occurs because family members see troubling changes in a loved one’s behavior, and decide it’s time to bring mom or dad in for an evaluation. White tells me that over the past five years, he can only remember a couple of times when the family suspected cognitive impairment and was wrong. If it looks like the early signs of dementia, it probably is.

That’s why it’s so important to get educated and remain diligent. There are many good resources out there to help you understand the warning signs of Alzheimer’s and other forms of dementia. See links to a couple of them at the bottom of this post.

Drawing from these and other resources, here’s a summary of some of the more common warning signs. Whether it’s yourself or a loved one, it’s time to be concerned if you see the following behaviors:

• Repeating the same story several times or asking a question over and over.
• Getting lost in a familiar setting.
• Not remembering to take medications.
• Not being able to perform routine tasks, such as paying household bills.
• Changes in personality, a loss of interest in a favorite activity, or uncharacteristic displays of compulsive or socially inappropriate behavior.
• Memory lapses that put others in danger, such as leaving the stove on.
• Inability to recognize faces or familiar objects.
• Dropping weight because of failure to eat, or losing the ability to take care of personal hygiene.
• Denying that you’re having memory problems, and getting angry when someone suggests you might be.

Even now, that list chills me. It’s all still too raw. As dementia plundered our mother’s mind, we suffered with her through most of these cruelties, and many others.

60 is the new 40; baby boomers redefine aging

I’m wisened and hardened now. I know what dementia looks like, and it’s not about forgetting a book title. Sure, I felt moronic not being able to conjure the name of something I’d just read. But an hour later, it popped into my head. The book was “Just Mercy” by Bryan Stevenson. I shot my co-worker an email with the title and a link to it on Amazon. I hope he finds the book as powerful and moving as I did.

And I hope any future memory lapses are that inconsequential. But if they aren’t, at least I’ll know the difference. You need to know the difference, too.

When I say that, I’m speaking from experience I wish I didn’t have. You owe it to yourself to know the signs.

Everything about dealing with dementia becomes that much worse if you never see it coming.

Want to know more about the warning sings of dementia? Read “Forgetfulness: Knowing When To Ask For Help,” a resource guide from the National Institute on Aging, or this detailed post on “Memory Problems: Normal or Serious?” from the Brain Be Fit blog.