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Memory: To Worry or Not to Worry?

Article submitted by Dr. Michelle Winston. She can be reached at 303-444-1655.

You forget to pay a bill once, twice, a dozen times...

...to worry or not to worry?

You forget where you put your car keys, where you parked your car, how to drive the car...

...to worry or not to worry?

With increased attention on Alzheimer's Disease, also known as Dementia of the Alzheimer's Type (DAT), comes increased focus and concern as to whether one has "it" or will get "it".

"Use it or lose it." Our mental faculties are important, in fact crucial. We need them to function and manage at home, work and in the community. Any threat to that 'core', whether real or perceived, becomes worrisome. With age comes a slowing of mental faculties and a tendency to misinterpret and elevate "normal" changes associated with aging to the level of disease and dysfunction. What is normal and what is not normal, here are 4 scenarios:

1. DIAGNOSIS: Normal Aging Aging is marked by expected changes in memory and cognition. The expected changes are more related to a slowing of functions than to actual loss of function. You misplace your car keys or miss an appointment - let's call these "senior moments". Conclusion: Not to Worry

2. DIAGNOSIS: WORRIED WELL A condition in which one complains of failing memory, there is no corroborating objective evidence to support their belief, yet they worry. Conclusion: Not to Worry

3. DIAGNOSIS: MILD COGNITIVE IMPAIRMENT (MCI) A condition involving complaints in a single area of cognitive functioning, such as memory, that is corroborated by impaired performance on standardized testing and is a significant decline from a previous level of functioning. As MCI progresses to dementia, cognitive problems other than forgetfulness become apparent (i.e increased difficulty concentrating, completing tasks and making decisions). Those with MCI are at increased risk for developing DAT. Conclusion: Worry

4. DEMENTIA OF ALZHEIMER'S TYPE (DAT) A disease in which there is widespread and progressive worsening of cognition including memory in addition to one or more other areas of cognition, is a significant decline from a previous level of functioning, and causes significant impairment in social or occupational functioning. You have trouble keeping track of appointments, figuring out and taking your medications and recalling recent and past events (even hints don't help jog your memory). Conclusion: Worry

WHAT TO DO WHEN WORRIED

Seek evaluation. Evaluation can rule out other causes of memory and cognitive impairment (i.e. reversible causes) as well as detect problems early so that maximal benefit can be made of treatments designed to impede the onset of DAT and/or slow down the degenerative process. Seek medical evaluation by an MD or DO to rule-out reversible causes. Then, seek cognitive evaluation by a neuropsychologist (a licensed psychologist with specialty in neuropsychology which is the field specializing in understanding and evaluating relationships between the brain, cognitive function and behavior).

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