Finding answers on memory loss, aging

Where are the keys? What did I go into the kitchen for? Should I be worrying about my memory, or is this just what happens to everyone with age?

Here are answers to common questions about memory loss, gleaned from interviews with three experts: neuroscientist James McGaugh of the University of California, Irvine; Dr. Gary Small, director of the UCLA Memory Clinic and the UCLA Center on Aging; and Dr. William H. Thies, vice president of medical and scientific relations at the Alzheimer’s Association.

Q. I think I’m losing my mind. I agree to a meeting and then completely forget about it. I’m introduced to someone and five minutes later don’t remember his name. Do I have Alzheimer’s disease?

A. Forgetting things you have learned recently is a red flag for early Alzheimer’s disease, the experts say.

“The ability to consolidate and store new memories is the first thing to go,” McGaugh says. “Established memories hang out for a long time.”

Alzheimer’s sufferers might still have a rich recall of childhood memories, beloved songs and complex activities, such as playing tennis, but not remember the name of a grandchild.

But the significance of such memory lapses depends on how forgetful you always have been and whether you were focused and paying attention when you learned someone’s name, or setting off to get something in the next room.

When a person who has always been meticulous about keeping appointments starts missing them, that is a worrisome change. A person who has always been a bit disorganized or easily distracted might have other problems, including attention deficit disorder or chronic depression.

Q. Maybe I’m just getting older. But at work, what used to take me two hours to do now takes four. I’ve always been sharp and fast on the job, but I’m not performing at my peak.

A. Struggling with familiar tasks and experiencing problems with abstract thinking can be early indications of Alzheimer’s disease.

The aging brain can compensate for its declining performance for many years: It knows more about the world and its patterns than a younger, swifter brain. But if established work routines don’t come as easily as they did, perhaps the benefits of age are being undermined by disease.

Finding numbers difficult to add up in your head, or the route to your next appointment difficult to visualize, could be signs of stress and distraction – things all of us have plenty of at work. But if things you’ve always done on the job now stump you, that is a problem warranting medical evaluation.

The speed at which those difficulties have set in is important to note. The onset of Alzheimer’s symptoms is generally gradual and insidious – making them easy to dismiss as the mental decline that comes with aging.

Q. I misplace things. And when I’m talking, I am sometimes at a loss for the word I need. What’s wrong?

A. Putting your glasses in the refrigerator or a pantry cabinet rather than on your bedside table may be a sign of a problem: Misplacing things in inappropriate places is an early sign of Alzheimer’s disease.

It is also time to consult a memory specialist when you ask your spouse if she’s seen your glasses and you have trouble thinking of the word for them, or if the word that comes out is not the right one. Sometimes, those with early Alzheimer’s disease say they will get close, but a tad off the mark, to the word they’re looking for – “that thing for my nose” instead of “glasses.” Sometimes they’ll just find themselves stumped.

The way in which problems appear can give clues to the cause. Sudden word-retrieval difficulties might be a sign that a stroke is taking place or has occurred.

The “tip-of-the-tongue” phenomenon – in which a word or a name is there one moment, and vanishes the next – is a common and normal sign of age-related memory loss. But when the words for familiar objects are elusive, and word substitutions, particularly those that seem peculiar, start happening with regularity, there may be cause for concern.

Q. My spouse/partner/close friend/family member says I’m behaving differently and is concerned about my memory lapses. I don’t think anything has changed. Should I worry?

A. Memory problems that signal the possible presence of disease are usually evident first to those around the sufferer.

Physicians rely heavily on the observations of friends and loved ones – after all, doctors are often seeing a patient for the first time, whereas a close relative is able to detect changes in behavior, mood or everyday habits.

At the same time, those in the early stages of Alzheimer’s – especially those with a lifetime of mental agility, or “cognitive reserve,” to fall back on – often are adept at hiding the fact that they can’t remember what happened yesterday. In those cases, the increasingly forgetful person might be the first to notice his failing cognitive functions but the last to admit it.

Q. My mother has always loved to go out and see friends and was never one to fritter away a day. But now she can go days without ever getting started, and she’s not eager to spend time with others. She can become suddenly angry or sad, or confused and suspicious. What’s going on?

A. Changes in motivation and personality often come with Alzheimer’s disease, even early on.

Frequently, physicians see such changes as signs of depression – and, indeed, depression is the most common psychiatric disorder in geriatric populations.

But sudden mood swings and erratic or irrational emotional reactions toward loved ones might be a sign of Alzheimer’s. And often before they have recognized a problem, those who have early Alzheimer’s report that they have become far less motivated – either because they fear the failure and disorientation of going out or … just because.

Changes in hygiene are sometimes a tip-off. If your normally perfectly turned-out mother shows up for a visit with no lipstick on, or your fastidious father takes to wearing mismatched socks, those could be changes worth discussing with a physician.