The Doctor Will See You Now – When it’s more than just losing your keys

By Dr. Nishiena Gandhi – Neurologist, Optum New Mexico

Most of us have heard of — and possibly had a chuckle over — our own so-called senior moment. We ask something twice, or lose our keys, or forget an appointment. It’s generally not cause for concern. But how do you determine if it’s something more serious?

Cognition is the function of the brain that helps us learn, remember, and make judgements about things. Some cognitive decline can occur as part of the natural aging process. Severe cognitive disorders can be the result of one of many forms of dementia, the most common being Alzheimer’s disease.

Subjective cognitive decline

On a severity scale, between having an occasional memory lapse and a debilitating form of dementia, is a condition called subjective cognitive decline (SCD). It can be one of the earliest indicators of dementia. In New Mexico, subjective cognitive decline affects one in eight adults over the age of 45, or 12.8 percent of the population.

With SCD, a person experiences memory problems and confusion that become progressively frequent over the course of a year, inhibiting the ability to carry out usual activities. It has a detrimental impact on day-to-day living and well-being. Normally manageable activities like going to work or even cooking your favorite recipe can become difficult.

Examples of normal, age-related memory changes include misplacing something, forgetting a word, or missing a bill payment. What’s not normal is the inability to retrace your steps to find the misplaced object, having difficulty with regular conversation, or finding yourself unable to manage your budget. Almost half of people with SCD require help with day-to-day things like household chores and social activities, or have given them up altogether.

More than 83 percent of New Mexicans with SCD also have one or more chronic conditions such as coronary heart disease, asthma, arthritis, diabetes, cancer, or stroke. Memory problems can make these conditions more difficult to manage.

The prevalence of SCD is a growing public health concern. Dementia overall is on the rise in the United States. The number of adults with Alzheimer’s disease (6.7 million) is expected to double by 2060, impacting some racial and ethnic groups, like Native Americans and Native Alaskans, more than others.

Mitigating risks

Two-thirds of Americans have at least one potential risk factor. For people 45 and older these include diabetes, obesity, smoking, and poor sleep. Some of the most prevalent risk factors in people from New Mexico are mid-life hypertension, mid-life obesity and not getting enough physical activity.

The best defense against subjective cognitive decline (and many other health challenges) is a good offense. Living a healthful lifestyle, staying active, eating a nutritious diet, and not smoking can reduce the risks.

The New Mexico Aging and Long-Term Services Department’s website, aging.nm.gov, provides more than a dozen resources for assistance with age-related health and well-being challenges.

On occasion, we’ve all struggled to remember someone’s name or had other brief memory lapses. When they happen more often and/or start to interfere with your ability to live your life, it could be a sign of something more serious.

One of the most alarming facts about subjective cognitive decline in New Mexico is that less than half of the people with memory problems have discussed them with their health care provider. That’s the first — and most important — step to take.

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