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Early memory lapses may be sign of dementia finds new medical study

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A woman, suffering from Alzheimer's desease, walks in a corridor on March 18, 2011 in a retirement house in Angervilliers, eastern France.   AFP PHOTO / SEBASTIEN BOZON

A woman, suffering from Alzheimer’s desease, walks in a corridor on March 18, 2011 in a retirement house in Angervilliers, eastern France. AFP PHOTO / SEBASTIEN BOZON

(CNN) — At least once a week a patient will come into Dr. Thomas Loepfe’s busy geriatric clinic in Lacrosse, Wisconsin, with a worry. She will tell him she’s been misplacing her glasses lately, or he’ll say he’s concerned about losing the car keys.

“Age is the biggest risk factor for forgetfulness, so this can be perfectly normal,” Loepfe said. As a geriatrician in the Mayo Clinic Health System, his patient population struggles with memory issues more than a pediatrician’s. “I tell them it doesn’t always mean there is something serious going on.”

But a new study in the American Academy of Neurology this week is giving Loepfe some pause.

The research suggests that people who feel they are forgetting more things may need to be concerned, even if bigger issues aren’t yet showing up on cognitive tests. Participants who reported memory problems at the beginning of the study were more likely to have dementia down the road than those who did not.

“Now we have more evidence that this is something we should watch from appointment to appointment,” Loepfe said.

There is no blood test or definitive way to diagnose Alzheimer’s, at least not when the patient is alive. An autopsy can provide a diagnosis, because the brain of someone with dementia has physical signs of the disease. But, of course, that test comes too late for any kind of prevention.

Doctors rely on a battery of memory tests to diagnose dementia. The tests are simple exercises that ask patients to name animals or verify where they live. The method is a good way to measure memory over time, but it has its limits, especially in early stages of the disease.

This new study suggests doctors should pay closer attention to self-reported memory complaints from their older patients.

Researchers watched 531 people over 10 years at the University of Kentucky. The participants were considered “cognitively intact” when they were enrolled. Each year, scientists asked them if they felt any changes in their memory since their last visit to the doctor’s office. They did autopsies on participants who died to see if their brains showed physical signs of dementia.

More than half the people enrolled in the study (55.7%) reported some memory complaints. Scientists found that those who reported struggling to remember things were more likely to have dementia down the road than those who did not report memory troubles. Mild cognitive impairment on average happened about 9.2 years after participants first noticed a problem.

People who smoked developed memory problems sooner than nonsmokers. Women who took hormone replacement therapy staved off dementia longer.

Other studies looking at self-reported memory complaints have shown similar results. What surprised the study’s lead author, Richard Kryscio, was how long someone felt they had memory problems before they were diagnosed with dementia.

“Not everyone who has memory complaints ends up with impairment,” Kryscio said. “But if we can get some hints that there is something going on here and treat people early on, there may be some hope (for prevention).”

“Right now we are catching this in the mid-stage or when people already have Alzheimer’s, and we don’t have a lot of tools in our arsenal yet to help you. We have to find a way to get out there in front of the disease.”

Dr. Susanne Steinberg, who specializes in geriatric psychiatry in the Crozer Keystone Health System and has written studies about risk factors and prevention methods for Alzheimer’s and dementia, said this study shows it can be a decade before serious memory problems start.

“There is something you can do about it, to minimize your risk factors,” Steinberg said.

Research has shown that people who exercise, eat a proper diet, people who stay mentally engaged and people who manage their diabetes or high blood pressure can keep some dementia at bay.

In her research, Steinberg has seen people who have three or more drinks a day also eventually have problems with their memory. People with depression, anxiety and stress can also struggle with memory problems; so can people with a poor quality of life or people who dwell on their past, rather than making goals for the future.

“There is a whole long list of things you can do to decrease your risk that these memory complaints can turn into something more serious,” Steinberg said. “What people should take away from this (study) is it is never too late to change your behavior to be healthier in the long run.”

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