A TGB READER STORY: The Fine Art of Dying
Our Poor Bedraggled USA

Is This the Beginning of Dementia? Plus The Alex and Ronni Show

Most old people I know ask themselves that headline question from time to time. It usually follows such instances as these:

In the middle of a sentence, you forget the name of the movie or book or author you're talking about.

Sometimes it's the name of an everyday item you forget. Not long ago, I perfectly well knew I wanted the word, “scissors,” but it wouldn't come to mind. I resorted to “that thing you cut paper with.”

Now and then I forget what I did yesterday. It happens often enough that I've begun joking that as far as I can tell nowadays, I go to bed on Sunday night and wake up Saturday morning.

These common incidents of forgetfulness are unlikely to be signs of serious disease. According to the U.S. National Institute on Aging (NIA),

”Forgetfulness can be a normal part of aging. As people get older, changes occur in all parts of the body, including the brain. As a result, some people may notice that it takes longer to learn new things, they don't remember information as well as they did, or they lose things like their glasses. These usually are signs of mild forgetfulness, not serious memory problems, like Alzheimer's disease.”

Here's a handy chart from the NIA on the differences between normal forgetfulness and Alzheimer's disease:

ForgetfulnessVAlzheimers

According to the NIA, there are both biological and psychological causes of non-dementia and non-Alzheimer's forgetfulness:

Tumors, blood clots, or infections in the brain
Some thyroid, kidney, or liver disorders
Drinking too much alcohol
Head injury, such as a concussion from a fall or accident
Medication side effects
Not eating enough healthy foods, or too few vitamins and minerals

”Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful and can be mistaken for dementia. For instance, someone who has recently retired or who is coping with the death of a spouse, relative, or friend may feel sad, lonely, worried, or bored. Trying to deal with these life changes leaves some people feeling confused or forgetful.

“The confusion and forgetfulness caused by emotions usually are temporary and go away when the feelings fade.

The Mayo Clinic website has an easy-to-use report about dementia-or-not-dementia on a page titled, Memory Loss: When to Seek Help. Here is an encouraging list of possible causes of memory loss that are reversible:

Medications
Minor head trauma or injury
Emotional disorders. Stress, anxiety or depression
Alcoholism. Chronic alcoholism can seriously impair mental abilities
Vitamin B-12 deficiency
Hypothyroidism
Brain diseases. A tumor or infection in the brain

Not to mention plain-old old age which, if not reversible, does not disrupt one's life much. The Mayo Clinic discusses a condition known as mild cognitive impairment thusly:

”This involves a notable decline in at least one area of thinking skills, such as memory, that's greater than the changes of aging and less than those of dementia. Having mild cognitive impairment doesn't prevent you from performing everyday tasks and being socially engaged.

“Researchers and physicians are still learning about mild cognitive impairment. For many people, the condition eventually progresses to dementia due to Alzheimer's disease or another disorder causing dementia.

“Other people's memory loss doesn't progress much, and they don't develop the spectrum of symptoms associated with dementia.

As the Mayo piece notes, professionals “are still learning” not only about cognitive impairment but how the brain works in general so what is thought to be true today may not be tomorrow.

And what else I found out in researching this post is that just about everyone from health and medical reporters to doctors and researchers have a bias. They interpret the same information on a scale that runs from “don't worry about, it's normal” to “oh my god, see your doctor immediately.”

Okay, I'm overstating for effect, but as far as I can find it works that way a lot of the time.

That notwithstanding, personally I am relying on the conclusion of the bevy of physicians from five disciplines (!) who worked together on the solution to my internal bleed problem last spring.

When all of them showed up together in my hospital room late one afternoon, each trailed by two or three of his or her medical students, I asked for a clarification of a point because, I told them (and it's true), I get really stupid every day after about 3PM.

Each immediately replied with some version of “Oh, please, Ronni, you're sharp as a tack, you've got nothing to worry about.” I have decided to believe that until something untoward happens.

I've carefully monitored my mind for decades. I know the kinds of mistakes I make regularly and I know the ones – mostly memory – that have increased as the years pile up. Knowing these things helps keep them at bay or allows me to compensate for them to a degree I couldn't do otherwise.

For example, I can't recall even a list of just three items I want at the grocery store so I never rely on memory. I always make a list and these days I can do it on my phone via Alexa, adding items between shopping trips as they occur to me or I notice I'm out of olive oil.

I must have been in my 20s when I started making daily to-do lists at the end of the day. I never shut my computer without having made my tomorrow list.

Obligations to others such as in-person appointments but also via internet or telephone are always in red pen. I use yellow highlighter for things that have a close deadline or that I could but should not let go to another day. Most of the rest are reminders.

If there is something I absolutely must take with me when I leave the house, I put in front of the door where I will trip over it if I don't pick it up. I've learned that a sticky note on the door doesn't work, especially if it's been there for more than a day when it becomes just part of the woodwork.

A great help is that I have come to see my memory lapses as funny – at least when they are not annoying. I wrote this to give you a little information on the dementia/not dementia question but I also wonder how this stuff affects you and what you do about it.


* * *

Here is the latest episode of The Alex and Ronni Show recorded yesterday. If you would like to see Alex's entire two-hour show with other guests following our chat, you can do that at Facebook or Gabnet on Facebook or on YouTube.


Comments

B and I joke that we don't need netflix, or a library card. We could just watch the same movie and read the same book, over and over, b/c we can never remember what happened. But seriously, thanks for the good update and checklist. I think we're doing okay, so far.

I've carried a grocery shopping list with me for several years. The majority of my weekly trips I remember the list while I unload the purchase from the shopping cart.

Olive oil! That was the illusive thing floating in my head when at the grocery today I couldn’t remember! Thank you 😊

All through my career, I relied heavily on a good work organizer/calendar and, like you, Ronni, didn't consider the workday complete until I had organized tomorrow's list. I've tried to keep that going in retirement but it hasn't transitioned seamlessly (I'm determined to get it on track). As for shopping lists, I do write them but then often lose them. It worries me a bit, but my mother, who was famous even in her 50s for things like putting the dishtowel in the freezer, never really developed dementia. After breaking her hip at nearly 99, she did drift off mentally, but I'm hopeful that the various occupational and physical therapists who worked with her were right in telling us that her problems mostly stemmed from the hip break.

I really like the Alex & Ronni Show. Thanks for the example you set of friendly conversations between 'mature adults!'

I'm a big believer in lists. If I don't write it down, it WILL get forgotten, be it something important, like a doctor's appointment, or something minor, like picking up milk. And it has to be a pen-on-paper list or calendar -- I tried a long time ago to use a calendar/agenda/list/app on a computer/cellphone, but it doesn't work for me. I also sometimes use different colored pens for different categories of items.

Interestingly, I will remember, without writing anything down, appointments and urgent to-dos for both my husband and my almost-adult child. They never suffer the consequences of having forgotten something important because, if they might, I am there to remind them. It's only my own stuff that disappears from my head. No doubt there's some significance to this, and I should spend some time in figuring it out... I'll put it on the list.

And here I thought it was Google that ruined my memory!

If it weren't for the dateline on my computer, I sometimes wouldn't know what day it is. They are all so much alike. I've learned recently that my Google Home can remind me of things, which is great, because I may not read or see the notifications that come from my calendar to my email. It will also keep a running grocery list for me, but I've not yet weaned myself from years of having a written list in hand. I do get extremely frustrated when, in mid-sentence, I can't remember the very familiar name or word I was about to say.

Yep, all that works (or doesn't) for me too.

Thank you for this one. It describes my problems to a T. Glad to hear that, at my age of 81, it's fairly common and apparently natural and not a thing for panic anytime soon! Am going to share this with a whole covey of friends having similar reactions to these problems. It's frightening, to say the least. but, as usual, your blog comes at a very good time.

Fortunately, a lifetime habit of keeping lists and calendars is still strong in me and is nowadays even more useful than ever.

I use all the tricks you have stated and they do keep me functioning adequately.

the one thing that did surprise me though and keeps me wondering what the problem is is learning a new language. When I retired 10 years ago at 62--- I decided to concentrate on learning Spanish. I have always tried to improve my Spanish over the years but I thought if I just had six months in a Spanish speaking country, I would achieve my goal.

Well, I have been in a Spanish speaking country and that goal has not been reached. Since I started my quest, I am improving inch by inch every year but at the rate I am going I will die before I can say, "yes, I speak Spanish."

I am college educated and did well in school and life -- so what gives? I am quite embarrassed when people ask me how my Spanish is going or how long have you been in the Argentina? Sigh

All I can say about my memory lapses is thank goodness for Google!

The Alzheimer's characteristics listed above can also be signs of stroke, either a TIA or larger. My father was misdiagnosed by the VA as having Alzheimer's when he had a TIA or possibly a series of TIAs. He ended up having a stroke.

I have Alzheimers on both sides of my family. I always worry about it but the reality is a stroke is going to be more probable for me. Either a stroke or heart attack.

Hallelujah! I’m normal. Your post is so timely because this week I totally forgot a lunch date with a friend. Then I made plans for this Sunday and didn’t realize I had tickets to the theater!!! My guidelines for if I’m really losing my mind now are: 1. Do I still remember how to get home from work. YES! 2. Do I still remember to pay my bills on time. YES! 3. Can I still follow a recipe. YES!

My husband's Alzheimer's started with his not remembering conversations we had just had. A friend told me -- "oh, husbands just tune out their wives sometimes." Then it turned out he couldn't compute a tip on a restaurant bill. He never knew what day of the week it was so I started marking completed days on the wall calendar -- didn't help. He was a self-employed lawyer who had done well until the 2008 recession, which is why I thought his income had dropped off.
Then I had to use his computer briefly while mine was in the shop and came across his current billings to clients. It was a very scary wake up call. He couldn't add things up, had seemingly forgot about the computer's calculator, and was re-billing clients for the same days or hours of work. I straightened out the bills and he was able to keep writing legal briefs for another few months (I read them all to be sure they seemed OK, though I am not a lawyer). Two big cases had recently ended, and he just could not make himself attend the required continuing legal education classes to remain current as a lawyer, so finally he was convinced to resign from the bar. That itself was a harrowing experience as the paper work was incredibly complicated -- I had to walk him through it barely knowing what I was doing. It's a lot of little things that just start to add up, then pile up, and then overwhelm the person's life and yours. He was only about 65 when he had to resign from the bar, had loved his work on environmental law and was not planning to quit any time soon.

Here is the one message I can give: if you can possibly afford it, get Long Term Care BEFORE any medical visits mentioning memory issues (after such a medical conversation, you will be ineligible for coverage). It is most affordable before age 55 but unless you have very few assets, and can easily move towards Medicaid, the inevitable nursing home/memory care facility will bankrupt your family, which is the path we are now on. Also, consult with an Elder Lawyer (I had never heard of that category) as there are some cases in which, for instance, you may be able to keep your house -- it all differs by state.

If there is anything we all share absolutely, it’s fear of dementia. Every time I mention my age-related memory problems in their presence, my children, who are far from old, will immediately chime in with “me too, me too” which annoys the hell out of me. I will be sending this TGB post to them to let them know the difference between age-related dementia and minor memory lapses. Like Ronni, I am constantly monitoring my own memory lapses so that I can, I hope, reassure myself that they are within normal range. So far, so good.

I don’t think it’s as much about aging as about lack of practice at conversation, but I have found that words don’t come as easily to me in retirement as they did when I was working in a professional capacity. I have found a sort-of solution for this problem. Although I am practically a Luddite—except for a love affair with my iPad Pro—Google and I have a synergistic relationship that I couldn’t live without. When I am in a face to face conversation, I am sometimes articulate, more often mumbly and stammering. But when I’m on the telephone, which is more often, I am never at a loss for words because I am the fastest Google-user I know. Before you can say uhm, er, I have the exact word or reference I need.

Lyme. Lyme. Lyme. As an SLP I often wonder what would happen on the “dementia” wards if everyone was just aggressive treated.

I congratulate all of you who do not have dementia and I understand the buffers you put, with all your intact intelligence, between the idea of yourself as you are and the nightmare of dementia. Keep your hopes intact, but try not to brag on your abilities at the expense of the inexplicably, irreparably disabled. What I hear in these comments is: thank goodness that it's only them, not me! Totally understandable, I was like you until about six years ago. They tell me we have somewhere between another six, or more likely ten or twelve years or more years to become bankrupt and leave nothing for myself (except SS) and truly nothing for our child.

I wish you all, all the best, but I dislike the downplaying of the reality of dementia on this blog. Of course, this site would not exist if its author were not sharp as a tack.

Tanti auguri a tutti, from the land of the lost.

Hi Ronni! wow, it's been a long time since we've chatted!! I recently found myself at the end of menopause and having some little memory lapses. Easy for me to forget the day of the week because my days aren't structured, but I quickly recover. Forgetting words when speaking is a new thing, and probably a result of that stuff too. I used to be so sharp with all those hormones. Now, not so much! Some days I panic, then others I remember that it's just the whole getting old thing. And suffering most of my life with depression hasn't helped it either. One thing that's been a constant is my inability to keep track of the bills. but I've always been that way. If that changes, then wow, there really is a problem ;)

I think I was near 50 (can't remember) when I replaced "exhaust fan" with "sucky-outy thing", which has since become our usual name for it.

Okay, yesterday I had to run several errands. One thing I needed to do was to replace the bottle of that sports/electrolyte drink that I took from my roommate's side of the refrigerator. I wanted to replace it before she got home from work. However, the first thing I had to do was to put gas in the car. While at the gas station I had the brilliant idea to buy that sports drink at the mini-mart there. I got over the fact that it was twice the price I would pay at the grocery store by reasoning I'm paying for the convenience of saving me an extra stop. So I spent $12 on gas and $2 on that icy cold bottle of blue whatever it is. I was so tickled with myself that I drove away completely forgetting to put gas in the tank! I am so embarrassed with myself. Fortunately, I rushed back to the pump in time to make it all better.

Yesterday I was at Costco with a friend and about an hour in my brain turned to mush. I couldn't make decisions, I couldn't even carry on conversation with my friend. We paid for our purchases and left. Since I was the driver and we had an hour's drive ahead of us, we sat in the car and waited until I felt up to the challenge (my friend can't drive). I recovered, and blame the episode on exhaustion and the heat wave we are having here, but it gives me an idea of what it feels like to lose one's mind. Not pretty.

Did I miss something? What the heck is "Lyme, lyme, lyme," and what is an SLP?

Haven't heard of a treatment for Dementia, let alone an "aggressive" treatment. Guess that is what my husband is doing with all his exercise. That's what studies have shown to be most effective to avoid dementia, to help those brain cells, as well as varying routines, taking different routes to one's usual haunts, learning new things, and I would imagine eating lots of fresh fruit and vegetables.

This is for Cassandra. I am so sorry for your plight. I can imagine the blade in your heart when you read comments about memory loss. I have lost a friend to Alzheimer's, and when I look back at the days before diagnosis, I remember all the ways being with her drove me crazy--in her case paranoia, forgetting past conversations, general ditziness. This was a colleague. A bright and funny woman. The last time I saw her, it was for lunch with her son and another friend. She didn't know exactly what to do with the faucet in the restroom. My heart goes out to you.

I did try to comment yesterday, but ran into that old problem of not being able to post due to taking too long and it was timed out. I have hunted in Settings and other sites to find out how to correct this problem to no avail. I am so slow with everything now and I guess writing a comment comes under that category.

I didn't have any insight to add to the comments anyhow except to say that short term memory loss is progressive/ First to fail - names of books, plays, etc. Followed by words that just won't come to mind as you speak or type. Then comes forgetting the day of the week and what you entered a room for.

So far I still remember to pay my bills, but only because I pay most on line and when I get a statement I immediately pay it whether it's due or not. I still remember to take my medicine (one lapse) and appointments. But that is only because I have morning and evening pill boxes that are right in front of me as I prepare breakfast or dinner. The appointments are on my calendar and I try to check it often.

Without prompts I wonder if I could function. Sigh.

No week goes by without someone being absent from the ILR where I volunteer.

Ambulance comes and takes someone to the hospital. Sometimes they don't come back. Their space at the table is empty. Family comes in and their apartment is cleaned out.

I look around the room and name my favourite residents.

I can still see them at their tables.

The ones that are gone.

For my fellow volunteers and I it's like staring full force at our possible future.

We are younger and stronger than the senior seniors who live there, but we are damn straight aware, every time we walk in the door, that the missing person could be us.

Nobody jokes about it. Someone has left the building. What happened? They were losing it to the point they needed to move to assisted living.

I just finished the book "The Sun Does Shine," about an African American man who was wrongly convicted of a crime, and spent 31 years on death row before
being set free. I got up in the middle of the night to finish the book.

Every now and then during those 31 years, another convict was led down the hall to the electric chair.

The innocent man could hear every single sound as this happened.

I couldn't stop thinking about this today as I left the ILR.

Two residents are missing, Both because dementia.

I thought to myself is this like being on death row in a pretty setting?

Who will be next? Why that person?

Seniors move in, make friends then boom, their friend is gone.

So far my best friend is still there.

She's 94 now.

So far so good.

Take care.

----

Ronni, I love those Alex and Ronni shows.

Thanks Ronni for this blog. I am 83 and been diagnosed with mild cognitive impairment over 5 years ago. What you describe and the comments are so familiar and accurate for what I have been experiencing in the last years.
Like you I am just ?absent? in the early afternoons. A siesta goes on for too long and interferes with my night sleep. So I let go, carry on slowly or go for a walk.
What I find stressful and sometimes worrying is my inability to multitask. I am training myself to take one thought, one plan at a time and hope for the best.

For a simple grocery list I sometimes use the mneumonic: Memorize 10 words--one, run; two shoe, three tree, etc. and attach an item to each word , e.g. One--run on the EGGS all over the road, etc. Usually works.

Just had a CT scan done to ensure my migraine auras were not a sign of anything dastardly--only thing it showed was "mild cortical atrophy", age related. Not unexpected, but for me a narcissistic injury!

Came back to this post to catch up on comments and read the one by “doctafill.” It reads like a very, very short story, but nonetheless a story, and a good one. Thank you for that, doctafill.

Thank you so much for pulling dementia facts from here, there and everywhere. Like almost everyone I wonder : is this it? So far, my memory loss is confined to names and titles; sadly they don’t always come back until it is way too late to slot them into the conversation.

Apart from that and the usual lists and aide memoir I am still ok, well able to live on my own and take care of myself. My husband had dementia problems for a very short time before he died; I am glad he didn’t live long enough for these problems to do more than cause inconvenience.

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