With Senior Moments, Mild Cognitive Impairment and Alzheimer’s Disease.

By Jonathan L. Liss, M.D., D.ABPN, D.ABSM
Copywrite 2015-2021, All rights reserved

Understanding Memory Loss

What is Cognitive Reserve?

Cognitive reserve refers to the amount of memory and intellect each mind possesses before illness is recognized. Enhancing cognitive reserve is a way in which additional abilities can be created to compensate for declining memory and thinking. In other words, the more you know, the longer it will take for you and others to see a deficit.

What are Senior Moments?

A senior moment refers to an occasional missed thought, lapse of attention, or difficulty finding a word or name. A senior moment is a normal part of aging that happens to everyone fortunate enough to live a long life. In truth, even young people have senior moments. These moments happen occasionally and do not worsen quickly over time.

Common Examples of Senior Moments Include:

What is Mild Cognitive Impairment (MCI)?

MCI is diagnosed when changes in mental abilities become detectable, but are not severe enough to affect the ability to care for oneself. Sometimes MCI affects short-term memory as its major finding and sometimes it affects other areas of thinking, such as the ability to complete complex tasks or bring together multiple sources of information. MCI can be difficult to separate from senior moments and, therefore, difficult to diagnose without specialized testing. The major difference between MCI and senior moments is that MCI is not a normal part of aging, it represents early disease. Many, but not all people with MCI will eventually develop Alzheimer’s disease. Numerous clinical research trials are targeting this group of people, as they are the most likely to maintain full independence with a successful medication. This is one of many reasons to face changes in cognition head-on. It is the earliest opportunity for a person with a memory illness to build cognitive reserve, practice healthier lifestyle habits and seek medication and research options. In other words, being diagnosed with MCI offers a patient the opportunity to take charge of his or her healthcare and maintain vibrancy.

What is the Difference Between Dementia and Alzheimer’s Disease?

Nearly every patient and family member concerned about memory loss seems to be confused about the distinction between dementia and Alzheimer’s disease. Fortunately, the answer is quite simple: Dementia (also referred to as Major Neurocognitive Disorder) is a category, the same way that sports is a category. Alzheimer’s disease is a specific type of dementia, the same way that soccer is a specific type of sport. To carry this analogy further, Alzheimer’s disease is the most common form of dementia just as soccer is the world’s most common sport. When doctors refer to this disease, they call it “Dementia of the Alzheimer’s type” (DAT). DAT accounts for about two-thirds of all dementia cases. Thus, a person with Alzheimer’s disease suffers from dementia. However, a person with dementia does not have to suffer from Alzheimer’s disease. They could have dementia caused by stroke, Parkinson’s disease, severe head injury, etc.

What is Alzheimer’s Disease?

Originally described by Dr. Alois Alzheimer in 1906, Alzheimer’s disease is a gradual loss of brain cells that most notably affects the areas of the brain where memory is stored. Alzheimer’s disease is estimated to affect about 10% of the population above the age of 65, and more than 30% of the population above the age of 85. Alzheimer’s patients often have symptoms for 3-5 years before being formally diagnosed. During this time, simple slip-ups are dismissed by reasonable excuses, humorous anecdotes, and common denial mechanisms.

The hallmark of this disease is a gradual and progressive loss of short-term memory. Early in this disease, sufferers have no trouble remembering their childhood, marriage, or professional endeavors. However, they may forget that they just told a particular story, or that they had a doctor’s appointment today, or that they were supposed to take a dose of medicine this morning.

Once Dementia of the Alzheimer’s Type (DAT) has been diagnosed, it is typically described as mild, moderate, or severe.

What is Mild Alzheimer’s Disease?

Mild disease often starts with the loss of short-term memory and mild word finding difficulties. This sounds similar to senior moments. However, as a disease, these are not temporary problems that pop-up every once in a while; rather, they worsen noticeably over time. Most people with mild disease live their lives with minimal oversight.
However, with mild disease, patients tend to:

• Lose interest in hobbies
• Undergo subtle changes in personality
• Have increasing difficulty with complex tasks, like cooking and bill paying
• Repeat questions and stories
• Get lost more easily

With counseling and planning, people can learn to live well with early stage Alzheimer’s disease. That said, there is a subset of patients who lack insight into their problem and, therefore, cannot be convinced that a need for oversight exists. The awareness machinery of the brain is damaged. The medical term for this is “anosognosia”( an-o″so-no´zhah) and it is caused by the illness itself. This can be a very troublesome problem because patients will avoid and refuse help. Care partners will sometimes believe their loved one is lying or experiencing intense denial to maintain independence. This can lead to tremendous frustration on the part of the caregiver and a severe strain on an otherwise loving relationship.

It is important to realize that the patient is neither lying nor in denial. It is the disease itself that is speaking. It cannot be helped by the patient.