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Healthy Living

Are You Forgetting Something?

You walk into a room but can’t remember why. No matter how hard you try to keep them in the same place, you’re always misplacing your phone and keys. And you can see that actor’s face in your mind but can’t name him. You’re starting to wonder—you’re sure it’s nothing, but let’s just say it: You may be experiencing the onset of Alzheimer’s dementia.

“Memory loss is a common prevailing concern when people come to see me,” says Torrance Memorial Physician Network primary care physician Nicole Alexander, MD. “Of course the worst-case scenario would be dementia. But in my experience, when I see a patient who is suffering from dementia, it’s usually a family member who brings them in. If someone comes to me and tells me they’re worried because they are forgetting things, it most likely is not Alzheimer’s dementia.”

To put Alzheimer’s in perspective: According to the Alzheimer’s Association, 1 in 10 people age 65 and older—an estimated 5.6 million people—has Alzheimer’s dementia. Almost two-thirds of Americans with Alzheimer’s are women. It definitely should be a concern. One in three seniors dies with Alzheimer’s or another dementia.

So if it’s not Alzheimer’s, what does it mean when someone over 65 notices memory loss? “The truth is,” says Dr. Alexander, “we are multitasking so much that we do forget things. Alzheimer’s dementia is a progressive cognitive impairment that affects functional independence. So more than skills are compromised. For example, a senior is not able to balance their checkbook, or the bills aren’t getting paid.”

Primary care doctors are the best at catching any signs of dementia. “If a patient or their loved ones express concern, we go through an assessment to evaluate whether they have any cognitive impairment. We ask questions about whether they exercise or if they smoke, and we take a family history. And Medicare patients over 65 get an extensive annual exam during their annual wellness visits. With that MMSE we can establish a diagnosis and a baseline. We also do labs and sometimes a CT scan to check for any masses or stroke.”

Here’s the rub, though. According to the Alzheimer’s Association, only 16% of seniors receive regular cognitive assessments during their routine health checkups. But the good news: Primary care physicians are conducting brief cognitive assessments more frequently and placing more importance on them than ever before, suggesting in the future we will see improved early detection of cognitive decline.

The risks increase with age, says Dr. Alexander. “The prevalence of dementia between ages 56 and 69 is 8%. In developed countries, 40 to 100 people develop it. If you live past age 80, there’s a 25% chance you’ll develop dementia,” she says.

So are there any ways to keep your brain healthy? “Exercise, exercise, exercise,” Dr. Alexander asserts. “It increases the blood flow to your brain, and study-wise that’s it. A healthy diet with plenty of antioxidants can reduce chronic inflammation we think might contribute. Brainteasers and puzzles that can stimulate your brain might help, but research hasn’t shown that.

“There are certain risk factors, such as obesity, low education, history of stroke, and sometimes depression and anxiety, that might indicate brain dysfunction. Alcohol use puts you at risk, as does diabetes and hypertension. We are not sure why, but there also might be a genetic component.”

If you are over 65 and concerned, see your doctor. “Make sure you have good sleep habits, getting six to eight hours a day, drink plenty of water and decrease whatever risk factors you can, such as high blood pressure and diabetes. Engage your brain frequently through talking and social interaction.

“And we find structure is important,” Dr. Alexander says. “People who come in worried about memory loss are often just plain distracted.”

Nicole Alexander, MD, is a primary care physician with the Torrance Memorial Physician Network. She practices at 3333 Skypark Drive in Torrance and can be reached at 310-784-6300.