Tuesday, June 8, 2010

The Changes of Aging

Source: http://discovermagazine.com

If you ask people over 60 what they dread most, dementia is almost always in the top three on their list of health concerns. After all, it is memory that makes us who we are; without it we are forever trapped in the moment, with no window on the past or the future.

There is some discussion among experts over what exactly constitutes early dementia, but they generally agree that it includes both a decline in memory (learning and recalling new information like “Where did I put those keys?” or “What did we do yesterday?”) and a decline in at least one other area of intellectual functioning. Among those areas are language (breadth of vocabulary, complexity of sentences), calculation (balancing a checkbook, figuring a tip), judgment (Is this a legitimate bill or a mail scam?), and visual-spatial orientation (becoming disoriented while walking or driving). Faulty memory alone is not enough to diagnose dementia, and the cognitive impairment must be a decline from a previously higher level of functioning.

A basic diagnosis can be done after reviewing the patient’s vital signs and performing a basic physical exam, followed by formal tests. Extensive formal testing tools exist to evaluate memory, but most clinicians rely on the Mini-Mental Status Exam (MMSE) in their offices to screen for dementia. The test takes just a few minutes and is commonly used for detecting cognitive impairment. It includes a series of questions that test orientation to place and time, recall, calculation, reading, and executive function—carrying out a complex task, such as copying a drawing of two overlapping pentagons.

Most patients display a characteristic lack of insight into their deficits that can be an early sign of dementia. Patients forget what they don’t know and so gain no self-awareness. The corollary is that patients who go to Doctors worried that they might have Alzheimer’s generally do not (There are exceptions, of course.) Alzheimer’s is the illness that is most often brought to a doctor’s attention by family members and friends rather than by the patients themselves.

There is currently no way to reverse Alzheimer’s disease. There are, however, drugs that can treat its symptoms. It is also important for the family to understand the disease and support the patient through it – generally an Alzheimer’s support group is recommended for the same. The key really is to increase awareness so that timely diagnosis and treatment can be administered.

Here’s a heart warming example of an old couple’s life and detection of Alzheimer’s disease:


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