Knowing the Difference: Dementia and Memory Problems

Many of us worry about developing Alzheimer’s Disease. Frequently we hear people say “I must have Alzheimer’s” or “She forgot her keys, she must be developing Alzheimer’s”. Although these things may be said in jest, they reflect an underlying fear that one day we will be stricken with the worst condition possible – forgetting our loved ones and who we are.

Two reassuring facts can help to ease this anxiety:

  • If you realize you are having memory issues, then you probably don’t have dementia and may not ever develop it.
  • Not all memory loss is dementia and not all dementia is Alzheimer’s Disease.
  • Increasingly, studies are showing that people who are aware that they are having memory issues may never develop dementia. Those who do develop dementia lose awareness of their memory issues two to three years before the onset of dementia. In other words, if you know you are forgetting, you don’t have dementia. If you have dementia, you forget that you are forgetting.

    The majority of us also tend to worry that our loved ones are developing dementia when they begin to exhibit different types of memory loss. This can be an exaggerated worry caused by the fear of Alzheimer’s. For example, if your loved one forgets where the keys are, or left the doors unlocked, that is not a sign of dementia. However, if they begin to have trouble with language, concentration and planning, or if they become confused about the day or month, those can be signs of the onset of dementia. Here is a specific example:

  • Normal memory loss: The individual forgets the name of an acquaintance or misplaces the saucepan.
  • Dementia:The individual does not know, or recognize, the names of family members, forgets how to use the saucepan to cook.
  • The good news is that Medicare is now required to cover screening tests for cognitive impairment, such as dementia. The bad news is that family members still have to be vigilant in requesting it and reporting the signs and symptoms exhibited by their loved one. A physician asking an elderly patient “How is your memory?” is not a test for dementia. It can be embarrassing for the elderly person and will not result in a helpful answer. Would you admit that you are increasingly forgetting things? Remember, the person developing dementia won’t realize their memory is deteriorating. As an involved family member you will have to insist that formal cognitive testing be conducted to assess whether what you are observing are the early signs of some type of dementia.

    Early detection of dementia is important. Testing and assessment must be handled respectfully to protect the dignity of the elder. Knowing the difference between an aging memory and the early signs of dementia is critically important to treatment, planning, and helping family members relax about the health of a loved one.

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