Forgetfulness is Not Necessarily a Warning Sign of Dementia

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One in nine North Americans over age 65 will develop dementia, a progressive brain disorder that interferes with normal daily living and is marked by memory loss, personality changes and impaired reasoning (Alz Dementia, 2015;11(3):310-320). Aging is the major risk factor for dementia, but forgetfulness among seniors does not necessarily mean the person is headed for dementia.

When people are tested after they complain about minor memory problems, they may receive a diagnosis of Mild Cognitive Impairment (MCI) and often fear that this means they are about to become demented. People diagnosed with MCI can maintain their daily activities, but may have difficulty shopping, taking their medications, and remembering names and places. Common problems for people with MCI include:
• losing their train of thought during a conversation
• being unable to stay on a thought or a task such as paying a bill
• being unable to find their way in a familiar place

A new study from Columbia University followed more than 2,900 adults in their seventies (Neurology, published online Dec 1, 2021). Over six years, 752 were diagnosed with MCI and 480 of those with MCI were tracked for an additional two years. The results after two years should encourage seniors who think their occasional memory lapses are a forecast of dementia:
• Nearly half of those 480 seniors no longer had MCI when they were retested and were “cognitively normal”
• 30 percent still suffered from MCI but had not shown any further decline
• 10 percent had suffered some further decline in mental functioning but were still in the range of MCI
• Only 13 percent had descended itnto full-blown dementia
The researchers noted that a weakness in the study was the short follow-up period, but they felt that their findings suggest that a diagnosis of MCI should be viewed only as a “higher risk classification,” and not as an early stage of dementia.

Of the 480 participants, those who had become demented were more likely to have an Alzheimer’s-associated gene called APOE4, have a history of depression, taken antidepressants, and/or had severe loss of memory, language and spatial relations in their initial testing. The participants who did not progress towards dementia were more likely to have more years of formal education, have higher income, participate in more leisure activities, visit friends regularly and/or go for walks.

Lifestyle Factors Associated with Lower Risk for Dementia
Several studies suggest that healthful lifestyle habits are associated with decreased dementia risk:
• a regular exercise program or physical activity (Front Aging Neurosci, Jan 14, 2021)
• 7-9 hours of sleep each night
• following a plant-based diet (Neurology, 2017;90:e214-e222), restricting mammal meat (Am J Clin Nutr, Jul 1, 2021;114(1):175-184) and restricting sugar-added products (Appetite, 2017;110:61-71)
• using your brain regularly with activities such as memory games, solving mental problems or learning a new language
• having lots of friends
The 2015 FINGER trial found significantly less cognitive decline over two years in older adults who ate a healthy diet, exercised regularly, and participated regularly in social events (Alzheimer’s Dement, Nov 2013;9(6):657-65).

My Recommendations
If you notice that you are becoming forgetful, lose your train of thought, or forget names and common words, you may want to ask your doctor for a medical assessment. In “Harnessing Healthy Behaviors to Prevent Dementia,” the American Heart Association reported that dementia is associated with the following modifiable risk factors: depression, all heart attack risk factors, high blood pressure, diabetes, obesity, high cholesterol, physical inactivity, an inflammatory diet, smoking, social isolation, excessive alcohol use, sleep disorders and hearing loss (Stroke, Mar 15, 2021:52(6A);52:e295-e308). Changing these lifestyle risk factors can reduce your chances of suffering from dementia. See Challenging Your Brain During Exercise May Help to Prevent Dementia