Memory Loss

Memory loss disorders encompass a spectrum of conditions that are not necessarily part of a continuum. An important senior health concern, memory loss is among the most alarming changes of aging. Word finding delays, increasing absent-mindedness, and decreasing concentration are symptoms that make us wonder, “Is it Alzheimer’s.?” While most of us experience a decline in cognitive function as we age, in most instances, the decline of normal aging does not progress beyond just that. When declines in memory and thinking processes reach the point in which one is no longer able to function normally, then an individual can be said to have “dementia”.

Dementia is a condition that is characterized by a loss of cognition that impairs function. Dementia can be caused by a number of factors, whether environmental, infectious, hereditary or primary and it is the role of the physician to determine the type of dementia. Types of dementia include Alzheimer's , vascular or multi-infarct, alcoholic, hypothyroidism, vitamin deficiency, parkinsonian, frontotemporal and others. Blood tests, physical and neuropsychological exams, and imaging studies all have some role in making the diagnosis.

Alzheimer's Disease is a type of dementia characterized by the accumulation of neurofibrillary tangles in the neurons and amyloid plaques in the brain. Memory loss, starting with recent memory loss and followed by memory loss of the past, may be accompanied by changes in personality, increasing difficulty with word finding, and loss of the ability to plan and execute activities. A great cook might cook only simple recipes; a former accountant may have difficulty balancing a checkbook. Many of these symptoms can be symptoms of depression, sometimes called “pseudo-dementia” because of depression’s ability to mimic the symptoms of dementia. Many patients with Alzheimer's disease are placed on antidepressants to ensure that this important and confounding diagnosis is not missed. Aricept, Namenda and other agents are prescribed to mitigate the effects of progressive cognitive losses. Many new agents are being studied which may have a positive effect on memory or the progression of the disease. Unfortunately, at this time there is no consensus regarding the cause of the disease and how it progresses, so most interventions currently being tested are based on observations by clinicians that a certain treatment may have an effect, often without clearly understanding why.

Mild cognitive impairment is the diagnosis given to the individual who presents with memory loss beyond what would normally be expected for his age and educational level, and which is not attributed to conditions described above. Those with mild cognitive impairment or MCI, have a greater risk of progressing to Alzheimer’s disease than others of their same age. Often medications like Aricept or Exelon are prescribed in order to delay the time to the diagnosis of overt dementia. Not all patients with mild cognitive impairment progress to dementia.

The memory loss of normal aging is a frustrating part of growing older and affects some of us more than others. Word finding delays, decrease concentration and attention are part of the symptom complex that has one going from room to room in search of ….what? Clinical trials are ongoing to determine if medication can help this condition. The FDA does not recognize memory loss associated with aging as part of a disease state and currently no medications are approved for this purpose.

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