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Published on: April 12, 2012
by Darla Carter for USA Today
Some memory problems are par for the course, especially with aging.
“Our ability to take in new information and to remember it over time does decline a little bit as we get older, and we call that age-associated memory impairment,” said Brad Folley, a clinical neuropsychologist with the Norton Neuroscience Institute in Louisville, Ky.
But how can you tell whether your memory lapses — or a relative’s — are normal “senior moments” or something more serious?
“I see so many individuals in the community who are worried about their memory function,” said Folley, the institute’s director of medical psychology and neuropsychology.
Many conditions — from Parkinson’s disease to vitamin B12 deficiency — can lead to memory problems, Folley said. Other culprits can include alcoholism, Parkinson’s disease and, of course, dementia and Alzheimer’s disease.
“You want to rule in or out these different causes because it’s so important to know if it really is dementia or if it’s something else,” Folley said. “Sometimes, it’s something very treatable.”
A good first step is to see your family physician, who can check you out and possibly recommend testing, such as a neuropsychological evaluation.
During that evaluation, a psychologist “can examine things like memory, attention, language, planning, thinking, behavior — all those things — and compare your results to people who do not have any suspected neurologic dysfunction,” Folley said. “We can see if your memory — if your ability to learn new information and to recall it over time — is essentially where it should be or if it’s worse than you think it might be.”
Other testing options include getting a brain imaging study such as an MRI, which stands for magnetic resonance imaging, to pick up on problems like an undetected stroke, that could be affecting memory, said Dr. Brendan Kelley, director of the University of Cincinnati Memory Disorders Center.
“We will often want to kind of take a picture of the structure of the brain and make sure that everything looks as it should,” Kelley said.
Earlier this month, the federal Food and Drug Administration approved a radioactive agent called Amyvid for Alzheimer’s disease testing. The drug, which is used in brain imaging, is for the detection of plaques that build up in the brains of cognitively impaired patients and that may be an indication of Alzheimer’s disease.
However, it is not a definitive test and is intended to be used in combination with other diagnostic tools.
Any time memory problems begin to affect your daily activities, it’s a good idea to talk to a health-care provider, Kelley said.
Possible indicators of a significant memory problem include difficulty remembering the details of conversations, repeating questions and forgetting recently learned information, Kelley said.
For example, Folley said, if you have dementia, you may have trouble remembering “what you did this past weekend, particularly major events.”
“What’s most concerning is if the patient can’t recall those things when you cue them. … That’s what you get with things like Alzheimer’s disease,” he said. Eventually, an Alzheimer’s patient develops more severe problems, such as losing the ability to recognize people and wandering off.
Memory problems from dementia can occur so slowly that you might not notice them at first.
“We call it insidious,” Folley said. “Sometimes other people might notice it before you do, particularly people you don’t live with every day.”
Beyond dementia, psychological problems can affect memory, Kelley said.
For example, “depression in older adults can sometimes cause some difficulties with thinking and concentration, and it’s a potentially treatable condition that, as physicians, it’s important for us to try to pick up on,” he said.
Medications also can lead to memory problems.
Dr. Malaz Boustani, an associate professor of medicine at the Indiana University Center for Aging Research, suggests watching out for anticholinergic drugs, because they can lead to memory and concentration problems as well as sudden delirium under certain circumstances, he said. Examples of these drugs range from prescription medications, such as the antidepressant Paxil (paroxetine) and the bladder-control drug Detrol (tolterodine) to over-the-counter drugs such as Benadryl (diphenhydramine).
If you have to take an anticholinergic drug, try to take the minimum dose and get off it as soon as you can, unless you need to be on it long-term for a condition, such as hypertension, Boustani said.
If you have a condition that doesn’t need to be treated, such as a cold, consider toughing it out or asking for an alternative drug, Boustani said.
“When you go and see a doctor and the doctor prescribes a medicine … say, ‘Doctor, what are the (potentially) negative effects of this medicine on my brain?’ and take it from there,” said Boustani, director of the Wishard Healthy Aging Brain Center in Indianapolis.
The Food and Drug Administration recently announced a labeling change for statins, a popular group of drugs for high cholesterol, to note that some people have experienced memory loss and confusion.
Kelley said there isn’t strong evidence of an association between statins, such as Lipitor (atorvastatin), and memory problems, but he suggests that people who are concerned about the issue get personalized advice from their doctor.
“Your brain is a very, very precious organ,” he said. “Protect it, save it, make sure nobody injures it.”
Stay physically active, getting 30 minutes or more of physical activity several days a week, Kelley said. “We think €1/8 it improves our circulation, which, of course, improves the circulation to the brain.”
Kelley also recommends watching your blood pressure; getting screened for diabetes; following a Mediterranean-style diet chock-full of fruits, vegetables and whole grains; keeping the brain mentally active through activities such as puzzle-solving; and staying “socially connected.”
“Those people that report low levels of satisfaction with their social interactions and those people who are becoming more withdrawn have a higher risk of developing significant cognitive decline,” Kelley said.
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