New guidelines for diagnosing Alzheimer’s disease were released this week, for the first time in nearly 30 years. The original guidelines,which were developed in 1984, defined Alzheimer’s as having just one stage — dementia — and based diagnosis only on clinical signs that a person was having trouble with thinking, learning, and memory. It was assumed that people who had no symptoms of dementia had no disease and the only way to get a true diagnosis was after someone died and changes were found in the brain during autopsy.
Developed by the National Institute on Aging and the Alzheimer’s Association, the new guidelines acknowledge what is now known — that Alzheimer’s probably begins years, maybe even decades, before a person has any noticeable signs of memory or thinking problems. Current research has shown that 40% of people who die without any symptoms of dementia have definitive signs of Alzheimer’s in their brains. It’s mind boggling to think that any one of us could be walking around with the classic signs of early Alzheimer’s in our brains and not even know it.
Scientists say it’s possible for some people to function fairly normally early on because they have extra brain capacity, or cognitive reserve. They also say that these people share some common traits — purpose in life, stimulating activities, and active social lives.
Essentially, they outline three phases of Alzheimer’s disease progression over time:
- Preclinical Alzheimer’s Disease – Measurable changes in biomarkers (such as brain imaging and spinal fluid chemistry) that indicate the very earliest signs of disease, before outward symptoms are visible. Currently, there are no clinical diagnostic criteria for this phase, but the group provides a scientific framework to help researchers better define this stage of Alzheimer’s.
- Mild cognitive impairment (MCI) due to Alzheimer’s Disease – Mild changes in memory and thinking abilities, enough to be noticed and measured, but not impairment that compromises everyday activities and functioning.
- Dementia due to Alzheimer’s Disease – Memory, thinking and behavioral symptoms that impair a person’s ability to function in daily life.
Alzheimer’s disease is something that worries a lot of people as they age, but minor memory lapses are often simply the result of normal changes in the structure and function of the brain. In a recently released report on age-related memory loss, Dr. Kirk Daffner, Director of the Center for Brain/Mind Medicine at Brigham and Women’s Hospital in Boston, says forgetting something may be just a matter of not paying attention. At the same time, as you age you don’t retrieve information as quickly as you used to. But there are also lots of reasons why brains slow down that have nothing to do with age, such as high blood pressure, lack of sleep, certain medications, too much alcohol, thyroid disease, and depression.
If you are seriously worried about your memory, you should make an appointment with your doctor. Otherwise, I did a little research and found hundreds of tips on improving memory. Here are 10 memory tips that I can personally recommend.
- When you unplug the iron, turn off the stove, or lock your car say what you are doing out loud and include a description of what you are wearing — ” I just unplugged the iron and I am wearing my favorite red shoes.”
- Before leaving the house, stop, take a deep breath, and think about what you are doing and whether you have everything you need.
- Limit distractions — don’t try to do several things at once and listen to what someone (like your spouse) is trying to tell you.
- Try to get at least 20 to 30 minutes of aerobic exercise every day — it will increase blood flow to your brain. When I was in college, I would stand on my head after studying for an exam for the same reason — for what it’s worth, I usually passed.
- Know what memory method works best for you. I need to write things down. For years I have kept journals to record all work-related information. Each day I write down the date and highlight it, then record everything — phone calls, interviews, meeting notes — so much more efficient than all the little scraps of paper that used to clutter my desk.
- Connect information. Think about how things are related and your memory will be enhanced for each.
- Challenge your mind. Learn something new or try doing something familiar in a different way.
- Use as many senses as you can when you want to remember something.
- Use mnemonics — I love that word. When I was in an anatomy class decades ago, we had to learn the names of all the bones. I can still rattle off the bones of the wrist because of this racy little sentence; Never lower Tilly’s pants, mother might come home. The bones are navicular, lunate, triquetrum, pisiform, greater and lesser multangular, cuneiform, and hamate.
- If you are desperate, or don’t have access to a teleprompter, write crib notes on the palm of your hand. ☺
Getting back to Alzheimer’s for a moment — while it’s not inevitable that you or I will get it, the reality is that, according to the Alzheimer’s Association, an estimated 5.4 million people in this country have the disease. Although the new guidelines discuss using brain scans and spinal fluid tests to identify the disease early on, they say for the time being, the tests should only be used on patients enrolled in clinical trials. The authors of the guidelines also urge caution, because currently there are no drugs that can stop or significantly delay the onset of Alzheimer’s symptoms.
While that may seem discouraging, the new guidelines do offer hope that scientists are one step closer to finding treatments that will stop this devastating disease even before there are any symptoms.