As we age, concern about memory function increases. These days, thanks to increased attention in the popular media and the baby boom generation reaching their late 60s, we seem to hear a lot more about Alzheimer’s or dementia.
We recently offered a free memory assessment clinic and were somewhat surprised by the number of people who contacted us. It was a reflection of this increased awareness and concern about memory function and deterioration with age.
Most people over the age of 60 become aware of deterioration in their memory and develop concerns about the possibility of Alzheimer’s—this is appropriate because the prevalence of dementia increases exponentially with age and doubles every five years starting at one percent at age 60 and reaching 30 percent by age 85. Ninety percent of diagnosed dementia is related to Alzheimer’s disease, which remains largely a diagnosis by exclusion.
In spite of this, memory assessment is not a routine part of a typical general medical practice. A family doctor can conduct a brief memory test when dementia is suspected, but these tests will typically only detect fairly large deficits and often do not detect the more subtle changes people notice before dementia would be diagnosed.
In our clinic, many of the people we met had discussed memory concerns with their family doctor but had not received convincing reassurance. Some had fairly large impairments but had not received a realistic appraisal of their significance.
In reality, gradual memory loss is significant. Although a certain amount of decline of memory function is normal with aging, Alzheimer’s also begins with small memory changes that gradually get worse.
With normal aging many people have difficulty remembering details of conversations or events that took place a year ago or more whereas with dementia they may not be able to recall details of very recent events or conversations. Age-related memory loss may mean difficulty recalling the name of an acquaintance whereas a person with Alzheimer’s may not recognize or recall the names of family members. A person with age-related memory deficits may have occasional difficulty finding words whereas a person with Alzheimer’s will have frequent pauses and substitutions when finding words.
With this in mind many Alzheimer research centres have begun offering regular memory assessments so that people can track the progression of their memory difficulties. These services are typically not covered by provincial medical services plans but are relatively low cost and usually take only about 30 minutes. Just as most of us have to get our eyes checked periodically, so it may be appropriate for people over the age of 60 to have a regular assessment of their memory – particularly if they or their loved ones have concerns that their memory is failing.
Just like vision—memory tends to change so gradually that fairly significant impairment can develop insidiously.
Mild memory problems are typically labeled mild cognitive impairment and defined by a combination of: concern over a change in cognition; evidence of lower performance in one or more cognitive domains that is greater than would be expected due to age or educational background; and objective evidence of cognitive decline. This last one can only be determined if cognitive abilities have been periodically assessed over time.
Impairment is considered mile as long as an individual is able to function independently for every day tasks like paying bills, preparing meals and shopping.
Memory assessments that can be repeated annually or more often can be obtained through our Memory Clinic at 250-862-8141. We are also actively recruiting for a clinical trial on Alzheimer’s disease.