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Memory decline may be earliest sign of dementia

Published: Thursday, July 18, 2013 10:55 a.m. CDT

BOSTON (AP) — Noticing you have had a decline beyond the occasional misplaced car keys or forgotten name could be the very earliest sign of Alzheimer’s, several research teams are reporting.

Doctors often regard people who complain that their memory is slipping as “the worried well,” but the new studies show they may well have reason to worry, said Maria Carrillo, a senior scientist at the Alzheimer’s Association.

“Maybe these people know something about themselves” that their doctors don’t, “and maybe we should pay attention to them,” said Dorene Rentz, a Massachusetts General Hospital psychologist. She helped run one of the studies, which were discussed Wednesday at the Alzheimer’s Association International Conference in Boston.

About 35 million people worldwide have dementia, and Alzheimer’s disease is the most common type. It causes a slow decline in thinking and reasoning ability.

Don’t panic, though: The researchers are not talking about “senior moments,” those small, temporary lapses most everyone has, said Creighton Phelps, a neuroscientist with the U.S. National Institute on Aging.

A true decline is a change in your normal pattern. “You’re starting to forget things now that you normally didn’t — doctor appointments, luncheon engagements, the kids are coming over ... things that a year or two ago you wouldn’t,” said Dr. Ronald Petersen, director of the Mayo Clinic’s Alzheimer’s Disease Research Center.

Pati Hoffman, of Carol Stream, Ill., near Chicago, used to design menus and organize events for restaurants but began forgetting where she filed things in her computer.

“I really just kind of started struggling. Something wasn’t right. I would have to bring my work home, spread it all over the floor, sort it and then try to get it done so that nobody at work would know I was having this difficulty,” she said. Driving to familiar places, “I would think, ‘I know where I am, but I don’t know how to get out of here.’”

Two neurologists said it was just stress and anxiety, one prescribed an antidepressant, and a third diagnosed her with early-onset Alzheimer’s disease. She was 56.

The new studies were on “subjective cognitive decline” — when people first notice they are having trouble, even if they test normal on mental ability tests:

— Richard Kryscio at the University of Kentucky led a study of 531 people, average age 73. Those who reported a change in memory or thinking abilities since their last doctor visit were nearly twice as likely to be diagnosed with dementia or mild cognitive impairment about six to nine years later.

— Researchers from the French government’s health agency and Brigham and Women’s Hospital in Boston studied 3,861 nurses at least 70 years old who were asked about memory symptoms and periodically tested for them later. About 900 of them carried a gene that raises their risk for dementia. Among the gene carriers, worry about a single memory symptom predicted verbal memory decline on tests over the next six years. In the others without the gene, worry about three or more memory symptoms was linked to memory decline on tests.

The Alzheimer’s Association lists 10 warning signs of the disease:

• Memory changes that disrupt daily life.

• Challenges in planning or solving problems.

• Difficulty completing familiar tasks at home, at work or at leisure.

• Confusion with time or place.

• Trouble understanding visual images and spatial relationships.

• New problems with words in speaking or writing.

• Misplacing things and losing the ability to retrace steps.

• Decreased or poor judgment.

• Withdrawal from work or social activities.

• Changes in mood and personality.

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