Columns Opinion — 21 August 2014
Senior corner: Separating normal aging from dementia

By Russel Hunter

“Are my memory problems because of dementia or just age?”

It’s a question I get frequently. We all experience forgetfulness and word-finding difficulties from time to time. Unsuccessfully trying to remember the name of an actor is a perfect example.

You might also forget where you put your keys or even lose track of time and run late to appointments. These are all normal experiences.
Mental processing slows down with age. Older adults may experience more difficulty with multitasking.

Dementia, though, is not part of normal aging and is distinguished by a set of symptoms that cause significant impairment in social, occupational or daily functioning (paying bills, cooking, cleaning, etc.). The onset of dementia depends on the cause of the symptoms (Alzheimer’s disease or a stroke, for example) but typically occurs late in life, after the age of 65. Symptoms of dementia are pronounced and occur over a shorter span of time.

These include cognitive impairments as well as changes in personality and behavior. The Diagnostic and Statistical Manual of Mental Disorders indicates that a diagnosis of dementia requires that a person experiences memory impairment and at least one of the following:

• Aphasia, or language disturbances, is noticeable when an individual has problems finding words and their speech is vague or lacking substance.

• Impaired executive functioning. Normally, this skill helps individuals connect past learning with present action by performing activities such as paying attention, remembering details, planning, organizing and managing time.

• Agnosia, which is an inability to recognize familiar objects such as a clothespin, kite or keys.

• Apraxia, which is an inability to perform tasks or movements when asked — even though the request is understood. They are willing to perform the task, the muscles needed work properly and the task may have already been learned.

Individuals also can experience psychiatric symptoms such as depression, anxiety, delusional thinking and hallucinations. These psychiatric symptoms are — in a few cases — caused by dementia. In other cases, these symptoms occur in the absence of dementia, but may cause dementia-like symptoms.

Depression and anxiety, for example, tend to interfere with an individual’s ability to pay attention and remember new information necessary for making informed decisions. When depression and anxiety are treated, these cognitive symptoms improve.

There are symptoms of dementia to be aware of, including forgetfulness of recent events, repetitive speech or questioning, changes in personality, odd or inappropriate behavior, getting lost in familiar places, repeated falls or loss of balance, decline in planning and organization, changes in eating habits and changes in hygiene as well as in language abilities and comprehension.

The type of dementia, its onset and the prognosis can be determined by looking at a person’s medical history, their symptoms, CT and MRI scans, and neurocognitive testing. The most common type of dementia is Alzheimer’s and the second most common is vascular dementia. Risk factors for developing dementia include family history, age, high cholesterol, hypertension, diabetes, obesity, alcohol abuse and smoking.

Remember that dementia is not a part of normal aging. Contact a primary care physician if you suspect that you or someone else may have dementia.

The writer is a licensed 
clinical psychologist with the 
City of Alexandria Older 
Adult Clinical Services.

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