The incidence rises sharply as people move into their 90s. About 5 percent of 71 to 79 people suffer from dementia, and about 37 percent of about 90 live with it.
Older people may worry about their own loss of function, as well as the cost and expense of caring for people with dementia. A 2018 study estimated that the lifetime cost of caring for a patient with Alzheimer’s, the most common form of dementia, would be $ 329,360. This figure will also no doubt increase, placing even more burdens on the family, Medicare and Medicaid.
There has also been a lot of talk and reports of dementia over the presidential election in recent months. Some voters asked if one or both candidates could have dementia. But is this a fair question? When these types of questions are asked ̵1; adding even more stigma to people with dementia – it can unfairly further isolate them and those who care for them. We need to understand dementia and its impact on the more than 5 million people in the United States now living with dementia and their carers. This number is expected to triple by 2060.
First, it is important to know that dementia cannot be diagnosed from afar or by a non-physician. To diagnose a person needs a detailed examination by a doctor. Sometimes brain imaging is needed.
And forgetting a random word – or even where you put the keys – doesn’t mean a person has dementia. There are different types of memory loss, and they can have different causes, such as other illnesses, falls, or even medication, including herbal remedies, supplements, and anything without a prescription.
Older people are surprised and worried about the “older moments” and the loss of memory they feel in themselves and others. I see such patients every week in my geriatric clinic, where they tell me their stories. They forget a word, get lost in history, lose keys or can’t remember a name. The details are different, but the main problem is the same: is it dementia?
Normal memory loss
With age, we experience many physical and cognitive changes. Elderly people often have a decrease in memory. This is normal.
Have you ever had trouble getting a fact from the deep back of your “Rolodex mind”? Let’s say you’ve noticed someone in a grocery store you haven’t seen in years. You may recognize the faces, but you only remember their names later that night. This is normal, part of the expected changes with aging.
Moreover, what is a potential problem is forgetting the name of the person you see every day; forgetting how to get to a place you visit often; or have problems with your daily activities, such as food, clothing and hygiene.
When you have memory problems, but they do not interfere with your daily activities, it is called a mild cognitive impairment. The primary care physician can diagnose this. But sometimes it gets worse, so your doctor should monitor you closely if you have mild cognitive impairment.
You want to specify the timing of any depreciation. Was there a gradual decline? Or did it happen suddenly? This should also be discussed with your doctor, who may recommend MoCA or Montreal Cognitive Assessment, which identifies memory problems and helps determine if additional assessment is needed.
In addition, the Centers for Disease Control and Prevention lists problems in these areas as possible signs of dementia:
● Thinking, judging, and solving problems.
● Visual perception outside the typical age-related changes in vision.
More serious problems
When memory loss interferes with daily activities, talk to 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 progress slowly 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 age.
Dementia, other brain problems
Alzheimer’s is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, loss, forgetting close friends or relatives, or inability to calculate how to balance the checkbook. Some diseases – thyroid disorders, syphilis – can lead to symptoms of dementia, and less common types of dementia can have different types of symptoms.
Alzheimer’s disease has a clear set of symptoms, often associated with certain changes in the brain.
Focusing on safety and proper supervision, especially at home, is critical for all people with dementia. Your doctor or social worker can help you find support.
It is also important to remember two other things that can lead to decreased mental functioning – delusions and depression.
Delirium, a rapid change in cognition or mental functioning, can occur in people with acute medical conditions 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 injuries; symptoms include decreased attention span and memory problems.
Depression can occur at any time, but more often it is aging. How can you determine if you have depression? Here is one simple definition: when your mood remains low and you lose interest or joy in an activity you once loved.
Sometimes people have recurring episodes of depression; sometimes it is a prolonged grief that becomes depressed. Symptoms include anxiety, hopelessness, low energy and memory problems.
If you notice signs of depression in yourself or a loved one, see your doctor. If you have any thoughts of harming yourself, call 911 for help immediately.
Any of these conditions can be frightening. But even more frightening is the unrecognized or unrecognized dementia. You should, openly and honestly, discuss with your doctor the changes you notice in your memory or thoughts. This is the first step to finding out what’s going on and making sure your health is at its best.
And, like any disease or group of diseases, dementia is not a “defect of character”, and this term should not be used to criticize a person. Dementia is a serious medical diagnosis – ask those who suffer from it, loved ones who care for them, or one of us who treats it.
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Lori 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.