Those "senior moments"
that plague so many aging Baby Boomers may or may not be a sign of more serious
problems down the line.
New research finds that losing your
train of thought or forgetting where you placed your keys may be a fairly
benign -- albeit annoying -- sign of age. But having trouble remembering what
happened a few minutes ago, or getting lost in familiar places, may be more serious.
The information, published in the
September issue of the Journal of the American Geriatrics Society,
should help primary care physicians sort out the mundane from the more
troublesome when they see elderly patients.
"They should be asking their
patients if they have any complaints [about memory or thinking skills],"
said study lead author Rebecca Amariglio, a neuropsychologist with Brigham and
Women's Hospital and Harvard Medical School in Boston. "When you're
getting old, it's common to ignore these complaints."
President Obama's Affordable Care
Act includes a provision for screening for these types of problems, called
cognitive problems, at a person's annual physical exam.
So researchers are trying to find
simple ways to sort out which patients can go home (relatively) reassured, and
which might need further testing for Alzheimer's disease or another form of
dementia.
For this study, researchers quizzed
almost 17,000 women, average age about 74, over the telephone about their own
recollections of memory lapses. The investigators then correlated this data
with how the women scored on standard cognitive tests, including delayed recall
of sets of words and numbers, also administered over the telephone.
The researchers used a set of
questions -- seven in all -- which asked the participants if they had recently
experienced a change in their ability to remember things, whether they had
trouble remembering a short list of items (such as a shopping list), whether
they had trouble remembering recent events, and whether they had trouble
remembering things from one second to the next.
The women were also asked whether
they had difficulty following spoken or written instructions, whether they had
more trouble than usual following a group conversation or TV program due to
memory problems, or whether they had trouble finding their way around familiar
streets.
"Getting lost," in
particular, was highly associated with cognitive impairment. Women who reported
they had gotten lost in familiar neighborhoods tended to score significantly
lower on cognitive tests similar to those used to detect signs of Alzheimer's.
Having trouble keeping up with a group conversation and difficulty following
instructions were also strongly associated -- though not as highly -- with
cognitive impairment.
On the other hand, forgetting things
from one moment to the next was not associated with any decline in measure of
cognitive function.
But the more complaints a woman had,
the more likely she was to score poorly on the test administered by
investigators. Each additional complaint was associated with a 20 percent
increase in cognitive impairment. (The complaint of forgetting one moment to
the next had a score of zero since it was not associated with impairment.)
The authors noted that the
participants were all women and mostly white, however, which means that the
findings may not be generalizable to other populations.
Another expert pointed out other
limitations of the study.
The "senior moments"
reported by the study participants were only related to how well they did on
the telephone tests, not to whether or not the person had actual dementia,
according to Mary Sano, professor of psychiatry and director of the Alzheimer's
Disease Research Center at Mount Sinai School of Medicine in New York City.
"This may overstate the
problem, which also is not a good thing," she said, adding that the study
does not trace the source of any problems it uncovered.
"The next step going forward
would be to develop specific questions to ask [and] to see if this relates to
dementia," Amariglio said.
For now, simple questions don't
portend "what the future holds," she added. But answers may indicate
that follow-up is warranted.
"It's one little extra red flag
that can maybe direct decisions," Amariglio said.
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