Commentary

Try to Remember …

In absentminded moments, our editorialist's wry joke has been "Of all the things I've lost, I miss my mind the most." But now she wonders when memory lapses signify a more serious problem.

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How often do you misplace your keys or forget why you walked into a room? When I was younger, I dismissed things such as losing my train of thought (my nephew calls that a brain fart), a neglected errand (probably not important enough), or getting lost trying to go somewhere (never was good at directions anyway).

Know that I was never a “list maker.” I gave that up—because I often could not remember where I’d put it. Usually, once I wrote something down, I would eventually (in the same day) recall whatever was on it, so I wouldn’t fret about where I left that list.

Names? I could always tell you where we met, what you were wearing, and where you were sitting. But your name? Forget about it. (Those who have met me know the truth in that statement!)

During particularly stressful or busy times, if I found myself a bit more “absentminded” than usual, I would joke, “Of all the things I’ve lost, I miss my mind the most.”

Now I wonder: Just how serious are those instances of memory lapse? Yes, occasional memory lapses are part of normal aging. Just like our joints, our brains are not as young as they used to be. Even a 90-year-old with a healthy brain has experienced a loss of 10% brain cell volume.1 And let’s be honest, in celebrating major accomplishments (or failures), some of us have killed a few additional brain cells along the way (wink, wink).

We know that as we age, just as our stride has slowed, so too has the sharpness of our recall dulled. However, at what point are those misfires of our brain no longer a minor nuisance?

Data from the Administration on Aging document that in 2013, an estimated 44.7 million US residents were 65 or older.2 An estimated 5 million of them had Alzheimer disease. That translates to one in nine people—scary! This number, researchers predict, will increase to 13.8 million by 2050.3

Moreover, these statistics become more startling as we recognize that the cost of providing long-term and hospice care to people with Alzheimer disease (and other forms of dementia) is estimated to increase from $203 billion in 2013 to $1.2 trillion in 2050 (in 2013 dollars).4 Therefore, it is imperative for us, both as individuals and as health care professionals, to know the warning signs of dementia and be attentive to even seemingly subtle changes in behavior.

Early recognition that these changes are more than minor lapses in memory is important. Delays in diagnosis can result in a reduction of access to available treatments and resources. Yet, at what point do we start to consider those minor instances of forgetfulness not as normal but as indications of developing cognitive problems? My colleagues in gerontology tell us it is when those changes negatively affect activities of daily living and ability to function.

Continue for the difference between my lifelong “geographic handicap” and a form of dementia >>

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