Dementia is a frightening condition. It’s not surprising that many elderly people express concern about it – particularly if they find themselves becoming forgetful. But how worried should they be?

The first thing to keep in mind is that most people – of all ages – are forgetful at times. Think how often parents have to remind their children to take all the kit they need to school. And memory declines as we get older, simply as part of the ageing process. Memory loss certainly isn’t the same as dementia, although it is one of the symptoms.

Indeed, there’s a lot of confusion about what dementia actually is. For a start it’s not due to a single disease as many people think. Alzheimer’s disease is the best known, but it is only one of the causes. Unfortunately, we still don’t have an easy way to diagnose dementia as a whole, let alone the different variants.

What sets dementia apart from normal ageing is the loss to a greater or lesser extent of a range of ‘cognitive skills’, such as reasoning ability and use of words. Memory loss is often the symptom that is spotted first, partly because it interferes with social functioning and partly because this is the symptom most easily noticed by the sufferers themselves, as well as their friends and family.

So how can you tell whether memory loss is simply part of a decline with age or a sign that someone is already marked out for dementia?

Unfortunately, it seems we can’t. One recent study suggested that memory generally does not decline much before the age of 60. Memory loss before this age might therefore have been a useful marker for dementia. However, this has been questioned by the results of an extensive long-term UK study* that showed a general decline in memory and other cognitive skills even at the age of 45.

In the United States, a long-term study** carried out by phone survey – the Behavioral Risk Factor Surveillance System – has shown the scale of the issue. The results suggest that 1 in 8 people aged over 60 living at home have experienced confusion or memory loss in the previous 12 months to the extent that one third of them sought help from friends and relatives. Few, though, had sought professional advice.

These results highlight the need to find ways to differentiate those with memory loss who go on to develop dementia from those others where it is simply an inevitable result of ageing. This is important for those individuals, and also for society more widely in planning potentially expensive treatment and social needs.

We now have a significant population of people over 65, with their number increasing rapidly. All forms of dementia increase with age, especially in those over the age of 80 years. Differentiating people with normal ageing from those who are developing dementia is going to become increasingly important.

Until reliable diagnosis and effective treatments are available, the best bet is to take steps known to avoid dementia or delay its onset such as regular physical activity (especially during middle life), maintaining a lively mind, continuing manual and mental skills into older life, and keeping an active social life.

 

*Link to study:  http://www.bmj.com/content/344/bmj.d7622

**Link to study: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6218a1.htm?s_cid=mm6218a1_w

 

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