By Markham Heid
Your father keeps misplacing his keys, or your mother repeats herself. Should you be worried about dementia? If those seemingly minor issues are new ones, you’re right to be concerned.
“People tend to attribute too much to normal aging and are a little dismissive of cognitive loss,” says Dr. Paul Fishman, a professor of neurology at the University of Maryland School of Medicine and a neurologist at UMD’s Medical Center. “Dementia is very common, and in general it is under-diagnosed, rather than over-diagnosed.”
which is a blanket term for a loss of intellectual function that is severe enough to interfere with day-to-day life. That interference often takes the form of memory loss or confusion, but it could also manifest as poor hand-eye coordination, problems with tasks like cooking or operating a computer, or mood and behavioral changes ranging from depression to hostility.
“Driving issues, especially struggling to find their way around areas they know, or not judging distance between cars, or making turns inappropriately, are all symptoms,” Fishman says. “Responding to telemarketers when that’s out of character for them or struggling with finances are also worrying things.”
But the number-one red flag a child or caregiver needs to watch out for is change. If someone is acting differently than they used to, that’s good reason for them to see a doctor for an evaluation, Fishman says. That evaluation will include some form of cognitive assessment—either quick or in-depth, depending on the person’s symptoms—and may also
tests to rule out non-Alzheimer’s factors.
In the majority of dementia cases—at least 60%—the loss of cognitive function will be caused by Alzheimer’s disease, says Gary Small, a professor and director of geriatric psychiatry at the University of California, Los Angeles’s Brain Research Institute. “Alzheimer’s is a neurodegenerative process in which abnormal plaques or deposits accumulate in brain regions controlling thinking and memory and other functions,” he says. “As that process progresses, it causes dementia.”
While some drug treatments and lifestyle adjustments may slow the development of Alzheimer’s disease, there is no cure for the condition, Small says.
Still, prompt diagnosis is critical. It’s easier to protect a still-healthy brain than it is to repair a damaged one. “If you can get an accurate Alzheimer’s diagnosis early, we may be able to put off severe effects for years,” he adds.
Even if your parent is relatively young—in her 50s or 60s—don’t ignore memory slips or new symptoms. While rates of dementia really balloon once a person reaches age 80, about 10% of dementia cases are diagnosed by age 65—and for some, the loss of function sets in earlier, Small says.
At the same time, there are also other triggers of cognitive decline that are treatable and in some cases reversible. These include everything from an undiagnosed stroke to a thyroid condition or medication side-effects. This fact—that many cases of dementia are caused by fixable, non-Alzheimer’s sources of impairment—may be a good way to coax a parent into visiting a doctor for an assessment, which can be a tricky conversation for kids and caregivers, Fishman says.