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Neurologists Reveal the Most Commonly Missed Warning Sign of Dementia – and What You Can Do About It

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What’s the most common warning sign of cognitive decline? Many of us might be tempted to answer, “Forgetfulness.” We bump into a familiar person at church or in the grocery store and can’t for the life of us remember her name. Or we walk into the bedroom and realize we have no idea what it was we were after. And, for heaven’s sake, what did I do with those sunglasses?

In fact, however, these minor moments of forgetfulness, the punchlines of a hundred “senior jokes,” are common to us all – and they typically have little or nothing to do with the onset of dementia. But according to this article we just discovered on the HuffPost website, neurologists now believe that there are a few specific warning signs that, should they persist, might raise some caution flags and prompt a closer examination. We’ll share that finding below.

The HuffPost article, written by reporter Leigh Weingus, goes on to suggest a few actions people can take should further diagnosis indicate that cognitive decline is present. It’s in these recommendations where we think the article misses the boat just a bit. We’ve asked Rajiv Nagaich for his comments which he shares toward the end of the piece.

Watch for Subtle Signs of Cognitive Decline

“When we think about dementia,” Weingus writes, “we often think of a person experiencing memory loss and confusion. While it’s true that these are certainly symptoms of dementia and Alzheimer’s (the most common form of dementia), missing some of the more subtle signs that aren’t as well-known can lead to a later diagnosis and delay in care.”

Noticing these signs is important for us all, says HuffPost, especially since there are an estimated 6.7 million Americans over the age of 65 living with Alzheimer’s. “Dementia is far from rare,” Weingus observes. “So, what dementia-related signs should someone look out for in themselves and others? And when should they see their doctor for a dementia screening?”

Speech, Directions, Spatial Awareness Top the List

Neurologists interviewed for the HuffPost article pointed to speech problems as one of the first issues families might notice. As the article states, while we all forget a word now and then, if this becomes a pattern, it could signal a problem.

“Difficulty with language including word-finding difficulty, incorrect sentence construction or difficulty with self-expression can present well before the loss of memory,” said Dr. Arif Dalvi, a neurologist and physician at Florida’s Delray Medical Center. While we can easily ignore the occasionally misspoken word or phrase, the article explains, “it’s important to monitor if there’s any frequency with this behavior.”

Another cautionary sign, adds HuffPost, is what the article calls “a change in your sense of direction.”  Dr. Dalvi put it this way: “Visual or spatial skills can also be affected early. A common way this presents is difficulty navigating a previously familiar route or needing GPS directions to a route that was previously known.”

Other Warning Signs Less Common but Still Worrisome

While speech and directional problems may show up in many situations of cognitive decline, there are what HuffPost calls “other less commonly recognized symptoms.”  These include difficulty completing familiar tasks, noise sensitivity and a change in taste and smell. That’s according to Dr. Stanley Appel, neurologist and director of cellular therapeutics at Houston Methodist Hospital.

“Some types of dementia, such as Lewy body dementia, can [also] cause hallucinations or delusions,” Dr. Appel explained. “It’s crucial to note that hallucinations can also result from other causes, and any unusual symptoms should be discussed with a health care provider.”

“An abrupt change in personality or mood without underlying explanation should also raise a red flag,” Dr. Dalvi added.

It’s Essential to See Your Doctor for Evaluation

While we all fear the diagnosis of cognitive decline and dementia, the HuffPost article urges readers to get tested early should warning signs arise. “Sadly,” Weingus writes, “there is no cure for dementia. But both experts emphasized that an early diagnosis can improve quality of life and stop the disease from progressing as quickly.”

Dr. Appel of Houston emphasizes medical approaches. “Traditional treatment options, such as medication to manage symptoms, recommendations for lifestyle changes and referrals to support services like occupational and speech therapy are vital in maintaining cognitive function and overall well-being,” he told HuffPost.

Appel also cites what the article calls “a significant breakthrough in the treatment of Alzheimer’s disease” in the form of two new drugs, Aduhelm (aducanumab) and Leqembi (lecanemab). These controversial drugs target the buildup of amyloid beta plaques in the brain, which is a hallmark of Alzheimer’s disease, HuffPost explains.

Dr. Appel emphasized that researchers are actively working on what the article calls “other innovative approaches to treatment.” He’s optimistic that this research will bear fruit. “These breakthroughs in medical science offer hope for individuals with dementia and their families,” he told HuffPost’s Weingus.

To Screen or Not to Screen?

The notion of widespread screening for dementia is controversial among some health experts, especially since dementia is currently untreatable. “There is no ‘official’ age to get a dementia screening, but it’s always a good idea to reach out to your doctor if you’re experiencing any symptoms,” HuffPost states.

“Since the incidence of dementia rises with age, particularly after 65, that’s a good time to have a simple dementia screening such as a mini cognitive assessment,” according to Florida’s Dr. Dalvi. If memory loss is present, physicians can look for other causes that might be reversible, such as a vitamin B12 deficiency or hypothyroidism. “Screening for hearing loss at this age is also important as it is estimated that 1 out of 9 dementias can be explained on the basis of age-related hearing loss,” Dr. Dalvi advises.

Is There More to the Story? Rajiv Says Yes

The HuffPost article ends on a somewhat low-key note. “While there may not be a complete cure for dementia and Alzheimer’s, there is a lot doctors can do once they reach a diagnosis,” it states. The article quotes neurologist Dr. Appel who emphasizes that screening for dementia should be free of any stigma. “An early and accurate diagnosis allows a plan to be put in place for either treating or slowing the cause of dementia,” he states.

But according to Rajiv Nagaich, that doesn’t tell the whole story. “The idea that people should simply wait until these problems show up, and then go on a horribly expensive drug that may or may not work, makes no sense,” he argues. “Where’s the emphasis on prevention? And what about those who manage to live successfully even with what later turn out to be telltale signs of Alzheimer’s? I think that’s where the focus ought to be.”

National Institute on Aging Report

While Rajiv is quick to acknowledge that much of the data concerning dementia treatment is preliminary, there is exciting research being done to show how lifestyle changes can potentially slow the onset of cognitive decline and help many live fruitful lives even after a diagnosis of dementia. One example is this report from the National Institute on Aging.

The NIA report states the problem honestly. “So far nothing has been proven to prevent or delay dementia caused by Alzheimer’s disease,” it says. “But researchers have identified promising strategies and are learning more about what might—and might not—work.” While we lack the space here to dive in too deeply, the report cites three areas in which changes in lifestyle can help “prevent or delay” various forms of age-related cognitive decline. These include increased physical activity, control of high blood pressure, and cognitive training. Other areas of research include diet and medication.

“Alzheimer’s disease is complex,” the report concludes, “and the best strategy to prevent or delay it may turn out to be a combination of measures. In the meantime, you can do many things that may keep your brain healthy and your body fit.” Makes sense to us.

“Nun Study” Shows Benefits of a Purposeful Life

Our final tool in the anti-dementia toolbox comes from an unlikely source: a longitudinal study of 680 nuns that has been going on for the past 35 years. Commonly referred to as “the Nun Study,” this decades-long research project has continued to reveal fascinating insight into (among other factors) the relationship between cognitive health and purposeful living.

As the nuns in the study group have begun to pass away, examination of their brain tissue has revealed that many had all the “plaques and tangles” which are the physical signs of Alzheimer’s disease, yet displayed little or none of the behaviors associated with dementia. While research is ongoing, some experts conclude that what sets these nuns apart and keeps them mentally sharp, even with brains that display signs of disease, is a positive attitude and a sense of purpose.

Again, we lack space for an in-depth look. If you do a web search for “the Nun Study,” you’ll find hundreds of articles, including this one which had been republished on LinkedIn. That’s where we found this quote:

“There’s one intriguing finding,” says the article. After examining diaries kept by each nun, researchers observed that, “At the age of 85, more than 90 percent of the happiest nuns were still alive, compared to only about a third of the unhappiest nuns.” The happier sisters outlived their less-happy peers by as much as a decade.

“Not only did the sisters who seemed to have a more positive outlook on life have less disease and lower mortality rates, they also seemed to have a natural immunization against Alzheimer’s disease,” the article states. “In short, a positive outlook on life may not only help you live longer and prevent you from having dementia, but if you do have the disease, you may not be as affected by it as much as your less optimistic and less cheerful counterparts.”

Can lifestyle changes and purposeful living stave off dementia? The answer for now is an honest “maybe.” But the signs are encouraging, and we’ll be watching for news of further breakthroughs. Stay tuned.

Breaking News: Rajiv’s New Book is Here!

We have big news! The long-awaited book by Rajiv Nagaich, called Your Retirement: Dream or Disaster, has been released and is now available to the public.  As a friend of AgingOptions, we know you’ll want to get your copy and spread the word.

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Through stories, examples, and personal insights, Rajiv takes us along on his journey of expanding awareness about a problem that few are willing to talk about, yet it’s one that results in millions of Americans sleepwalking their way into their worst nightmares about aging. Rajiv lays bare the shortcomings of traditional retirement planning advice, exposes the biases many professionals have about what is best for older adults, and much more.

Rajiv then offers a solution: LifePlanning, his groundbreaking approach to retirement planning. Rajiv explains the essential planning steps and, most importantly, how to develop the framework for these elements to work in concert toward your most deeply held retirement goals.

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(originally reported at www.huffpost.com)

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