Memory Loss: Is It Age Related, Or Is It Alzheimer’s?

By Jan Howard

You’ve lost your car keys, mislaid parts of the coffeepot, and can’t remember someone’s name.   Is it age-related memory loss, or a sign of Alzheimer’s Disease? 

Orestes Arcuni, MD, chairman of the Department of Psychiatry at Danbury Hospital, discussed “Signs and Symptoms of Memory Loss, Dementia and Alzheimer’s Disease” at the June 20 Lunch and Learn Program sponsored by Ashlar of Newtown. 

 Dr Arcuni is also a clinical professor of psychiatry at New York Medical College and chairman of the Medical Education and Research Committee at Danbury Hospital.  Board certified in psychiatry, forensic medicine and geriatric psychiatry, he has published and presented extensively on topics related to geriatric, adolescent and family psychiatry.

Dr Arcuni said there are normal changes to memory as people age. Memory is composed of three parts: sensory memory, such as sight, hearing and smell; working memory, which needs to function on a daily basis; and long-term memory, information that a person gains over a lifetime.

“As people age, they must make sure their eyesight and hearing remain as good as can be or they will have memory problems,” Dr Arcuni said. “That’s an important issue.”

The most common complaints in regard to memory loss include forgetting names or where things are. Fatigue and too many other things going on can cause these memory lapses, he said.

Normal Age-Related Changes

The need is to distinguish between what are normal, non-progressive changes to memory as a result of aging and what is disease, Dr Arcuni said.

In normal aging, the working memory is most vulnerable. “It’s use it or lose it. It’s information you need on a regular basis. To keep it, use it as much as possible.”

Participate in many activities, he suggested. “As people age, they stop doing things,” he noted. “They need to stay as active as possible.”

Taking a longer time to remember something is the result of normal aging. It is not a sign of illness.

“When we are into our 50s, we can’t do too many things at the same time, “ Dr Arcuni said. This problem, a normal change in aging, is called multi-task confusion. If doing multiple tasks is a problem, Dr Arcuni suggested doing one thing at a time. For instance, he noted,  “You should not be cooking and talking on the phone at the same time.”

He suggested keeping a notebook for daily appointments. He also urged senior citizens not to be afraid of technology. “It gives immediate feedback. If you do something wrong, it tells you. A lot of seniors are having a good time learning the new computers. It helps keep working memory alive.”

Some causes of memory loss can be remedied, he said, such as from medications, depression, injury or diet.

 “Medications sometimes can have side effects,” he said. Allergy and cardiac medications should be reviewed if a person is having dizziness and confusion.

Depression of two or three days or more, head injuries because of falls or motor vehicle accidents, and vitamin deficiencies can also lead to memory loss. “Vitamin B is very important to take, particularly B6 and B12,” he said. Leafy green vegetables, such as spinach and broccoli, are good suppliers of B6, he noted.

Certain conditions can cause memory loss. In diabetes, if blood sugar is low, dizziness or confusion can occur. “Glucose is a major fuel for cells,” he said.

 An under-active thyroid is notorious for taking away memory, Dr Arcuni said.

These conditions are easy to treat, he noted.

There is evidence from European studies that ginko can be a mild memory enhancer. He cautioned, however, that ginko is also a blood thinner. “Before you go on ginko, check with your doctor.

  “The brain is a pretty tough organ,” Dr Arcuni said. “Comprehension is one aspect of normal memory loss. You can continue to learn. You must use it and reinforce it.”

Signs and Symptoms

Dementia is a decline in mental function that interferes with daily activities and relationships, Dr Arcuni said.

He compared it to having all the parts of a coffeepot but not being able to put it together or knowing how to make the coffee. Alzheimer’s is a progressive disease that is one of the causes of a decline in mental function, he said. “You can’t put the task together.”

Four million Americans have Alzheimer’s, he said, and this number is expected to triple over the next 50 years.

“We can manage it better, but there is much to do,” he said.

 There are many types of dementia, such as from stroke or infections, but 60 to 70 percent of the cases are because of Alzheimer’s Disease. Ten percent of people over 65 have Alzheimer’s, he said.

The good news is that 50 percent of the people over 85 don’t have Alzheimer’s Disease. In the past, he noted, it was unusual to see people over 100 years of age. “Now it is not that unusual,” Dr Arcuni said, noting that most Ashlar residents over 100 are there for reasons other than Alzheimer’s.

He said the use of medication in the early to moderate stages of Alzheimer’s are somewhat effective by slowing the progress of the illness. It has kept people out of nursing homes for an additional year, he said. That extra year allows time for planning, for spending time with their families and for activities. “It’s an important year,” he noted.

One form of Alzheimer’s that begins when people are in their 40s and causes them to be quite disfunctional by their 50s is clearly an inherited disease, he said.

However, the bulk of Alzheimer’s Disease patients are older, Dr Arcuni said. “On a statistical basis, it might run in families, but it’s pretty iffy. It does not predictably run in families. Just because one family member has it does not mean another will get it.”

Dr Arcuni said there are new genetic tests that may be able to determine a person’s risk of having Alzheimer’s Disease.

People with Alzheimer’s need functional assistance, he said, such as an aide or caretaker, to be with them on a regular basis. There may be loss of memory and the ability to think and changes in personality. They may be more frightened and more depressed. “There is a lot of disorganization in the later stages,” he said.

In the mild stage of two to four years, a person can usually remain at home as long as they have some help. There may be some forgetfulness, and the issue of driving must be addressed.

In the moderate stage, which lasts from two to ten years, a lot of assistance is needed, Dr Arcuni said. Daycare may be required. A person can still feel and have joy, but personality changes are worse. There may be wandering.

In the severe stage, people need to be in a skilled facility because they are no longer able to communicate or care for themselves, he said.

“It can take eight to ten years for the course of the illness. That’s a pretty long time for the family to have an important person who needs care,” he said.

While patients can die of Alzheimer’s itself when the brain no longer drives the rest of the body and all neurological function stops, most die from other causes, such as infection or stroke, he said.

Dr Arcuni said Alzheimer’s patients can enjoy themselves in the early to moderate stages. “Behavior can be managed. Symptoms can be managed. We can preserve the quality of life by understanding the hundreds of behavior changes and help families and agencies with their care. We can make sure they have no pain and as little worry as possible.”

This program was the last in Ashlar of Newtown’s 1999-2000 series of free seminars for mature adults about living and aging well. The series will resume in September.

To learn more about upcoming programs, please contact Hilda DeLucia at (203) 364-3127.