Why you should care
Because wouldn’t you want to know?
To an extent, memory loss is normal with age; at some undefined point, though, it crosses into the territory of dementia. Exercise and diet are probably the most effective ways to slow cognitive decline, but there’s not much definitive science to back that claim. Indeed, doctors seem to be as much in the dark when it comes to Alzheimer’s disease as the suffering patients they seek to treat.
Such across-the-board cluelessness has led to the disease being wildly under-diagnosed. Of the estimated 5.2 million Americans walking around with Alzheimer’s, roughly half don’t even know they have it, according to the Alzheimer’s Association. Worldwide, the numbers are worse: Alzheimer’s Disease International reports up to 28 million of the 36 million people living with this form of dementia haven’t been diagnosed. And by many accounts, those numbers are conservative.
Signs that Grandma’s memory loss may be more than just old age:
- Trouble remembering recent conversations, names or events
- Impaired communication or difficulty talking
- Behavior changes, apathy or depression
- Confusion or bad judgment
There may be several reasons for the incompetence. For starters, families often think Grandma is just getting old. People, including many general practitioners, don’t know the difference between typical cognitive decline and dementia (not all dementia is a result of Alzheimer’s, either). Doctors don’t have a standardized test to give patients, and many, particularly in rural areas, don’t have access to the expensive brain-imaging technology that detects neurological changes. Plus, some think, what’s the point of going to the trouble of diagnosing and stigmatizing people if there’s no cure? Even among doctors, there’s “a nihilistic attitude that there is nothing that we can do about it anyways,” says Dr. Ron Petersen, the Mayo Clinic’s director of Alzheimer’s research and a member of the federal government’s Alzheimer’s Project Act advisory council.
But Petersen and others say that’s the wrong way to think about it. There may not be a cure, but the disease can worsen over time, so you ought to know if you or a loved one has it. “People are frightened and they’re in denial,” says Dr. Paul Rosenberg, professor at the John Hopkins School of Medicine. Genes account for between 40 and 65 percent of Alzheimer’s cases, and a first-of-its-kind study released earlier this year showed that lifestyle changes can actually stave off intellectual deterioration. Think healthy diet, active lifestyle, normal weight. In general, the wisdom goes, what’s good for the heart is good for the brain. “A lot of it is just common sense,” Rosenberg says.
And hopefully it won’t be too long before doctors have the tools to identify dementia even before patients start experiencing symptoms. When the Global CEO Initiative on Alzheimer’s Disease met in October, it made its first goal to increase diagnosis rates. Let’s hope they’re successful. If not, predictions are that by 2050, Alzheimer’s will be a worldwide epidemic affecting upwards of 135 million people.
This OZY encore was originally published Dec. 10, 2014.