Published on: April 16, 2019
by Lauren Cahn for Reader’s Digest:
In our twenties, we find it hilarious when we can’t remember our neighbor’s cat’s name or that adorable actor who starred in that movie—whatever it was called. In our thirties, we jokingly call it “brain freeze.” In our forties, we laugh it off as a “senior moment” and follow up with one of these old-age jokes. But the reality is that there comes a point when being forgetful stops being funny and starts to seem a bit, well, sinister. You think, “Am I losing it?” Or worse: “Is this a sign of Alzheimer’s?”
Well, rest assured – the fact that you recognize your own forgetfulness may be a very good sign, at least in terms of the likelihood of your developing Alzheimer’s or other forms of dementia. This is the difference between dementia and Alzheimer’s. That’s the news out of Canada’s Centre for Addiction and Mental Health, whose 2017 study, published in the Journal of Clinical Psychiatry, demonstrates that it’s not forgetfulness we should fear so much as not being aware that we’re forgetful. Or to put it another way: being aware of your own memory loss can be a good predictor that you won’t develop Alzheimer’s.
The study authors began with the premise that one common feature of Alzheimer’s disease (AD) is an impaired awareness of illness (clinically, it’s called “anosognosia”) and wanted to test their theory that the lack of awareness can be used to predict whether someone with “mild cognitive impairment” will progress to full-on AD. For the study, “mild cognitive impairment” was defined as someone whose mental state was essentially the same as someone considered healthy but who had either complained of memory loss or had suffered objective memory loss (as reported by a caregiver).
The researchers used existing data for 1,062 people between the ages of 55 and 90 that had been recorded over a 12-year period (the data came from the Alzheimer’s Disease Neuroimaging Initiative). The data included brain scans, which the researchers used to look for visual signs of reduced glucose uptake, which is an objective marker of the sort of reduced brain function that goes along with AD. As expected, glucose uptake was reduced in those with AD. What the researchers also discovered was that glucose uptake was reduced in those with mild cognitive impairment who also showed evidence of impaired illness awareness. Finally, the researchers found that those who had impaired illness awareness were more likely to develop AD than those without.
“The absence of anosognosia may be clinically useful to identify those patients that are unlikely to [develop AD],” the study authors report. As a follow-up, the researchers will track older adults who are receiving interventions to prevent AD, such as brain training exercises and brain stimulation, to determine if intervention improves illness awareness and can help prevent progression to full-on AD.
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