Spot The Signs (Because None Of Us Are Immune)

Dementia affects increasingly many people, and unlike a lot of diseases, it disproportionately affects people in wealthy industrialized nations.

There are two main reasons for this:

• Longevity (in poorer countries, more people die of other things sooner; can’t get age-related cognitive decline if you don’t age)
• Lifestyle (in the age of convenience, it has never been easier to live an unhealthy lifestyle)

The former is obviously no bad thing for those of us lucky enough to be in wealthier countries (though even in such places, good healthcare access is of course sadly not a given for all).

The latter, however, is less systemic and more epidemic. But it does cut both ways:

• An unhealthy lifestyle is much easier here, yes
• A healthier lifestyle is much easier here, too!

This then comes down to two factors in turn:

• Information: knowing about dementia, what things lead to it, what to look out for, what to do
• Motivation: priorities, and how much attention we choose to give this matter

So, let’s get some information, and then give it our attention!

More than just memory

It’s easy to focus on memory loss, but the four key disabilities directly caused by dementia (each person may not get all four), can be remembered by the mnemonic: “AAAA!”

No, somebody didn’t just murder your writer. It’s:

• Amnesia: memory loss, in one or more of its many forms
  • e.g. short term memory loss, and/or inability to make new memories
• Aphasia: loss of ability to express oneself, and/or understand what is expressed
  • e.g. “More people have been to Berlin than I have”
  • Or even less communication-friendly, Broca’s (Expressive) Aphasia and Wernicke’s (Receptive) Aphasia
• Apraxia: loss of ability to do things, through no obvious physical disability
  • e.g. staring at the bathroom mirror wondering how to brush one’s teeth
• Agnosia: loss of ability to recognize things
  • e.g. prosopagnosia, also called face-blindness.

If any of those seem worryingly familiar, be aware that while yes, it could be a red flag, what’s most important is patterns of these things.

Another difference between having a momentary brainlapse and having dementia might be, for example, the difference between forgetting your keys, and forgetting what keys do or how to use one.

That said, some are neurological deficits that may show up quite unrelated to dementia, including most of those given as examples above. So if you have just one, then that’s probably worthy of note, but probably not dementia.

Writer’s anecdote: I have had prosopagnosia all my life. To give an example of what that is like and how it’s rather more than just “bad with faces”…

Recently I saw my neighbor, and I could tell something was wrong with her face, but I couldn’t put my finger on what it was. Then some moments later, I realized I had mistaken her hat for her face. It was a large beanie with a panda design on it, and that was facelike enough for me to find myself looking at the wrong face.

Subjective memory matters as much as objective

Objective memory tests are great indicators of potential cognitive decline (or improvement!), but even a subjective idea of having memory problems, that one’s memory is “not as good as it used to be”, can be an important indicator too:

Subjective memory may be marker for cognitive decline

And more recently:

If your memory feels like it’s not what it once was, it could point to a future dementia risk

If you’d like an objective test of memory and other cognitive impairments, here’s the industry’s gold standard test (it’s free):

SAGE: A Test to Detect Signs of Alzheimer’s and Dementia

(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)

There are things that can look like dementia that aren’t

A person with dementia may be unable to recognize their partner, but hey, this writer knows that feeling very well too. So what sets things apart?

More than we have room for today, but here’s a good overview:

What are the early signs of dementia, and how does it differ from normal aging?

Want to read more?

You might like our previous article more specifically about reducing Alzheimer’s risk:

Reducing Alzheimer’s Risk Early!

Take care!

Dementia is, statistically speaking, the most feared disease in the US. Notwithstanding…

• heart disease killing more
• COVID being more of a lottery
• cancer being the “yes you can modify risk factors but it can come for anyone” life-changing (and often life-ending) disease,

…it’s still dementia that Americans report fearing the most.

And yet… Early dementia screening is seriously underused

It may be a case of a head-in-sand approach to avoid unwanted news, or it could be a case of not knowing what’s available.

So, with that in mind…

How to watch out: first line warning signs

You walk into a room of your house, and suddenly stop: “what did I come in here for?”, you wonder.

A moment later, you’re worrying whether this is a sign of age-related cognitive decline.

The good news: it usually isn’t. In fact, you did that when you were younger, too, you just didn’t pay enough attention at the time to remember it now.

Dementia-related memory loss is less “where did I put my car keys?”, and more “what is this thing for?” (it’s your car keys). Or at a less advanced stage: “whose are these car keys?” (they are yours).

You can read about some of the nuances here:

Is It Dementia? Spot The Signs (Because None Of Us Are Immune) ← If you’d like an objective test of memory and other cognitive impairments, this article also has a link to the industry’s gold standard test (it’s free)

(The Self-Administered Gerocognitive Exam (SAGE) is designed to detect early signs of cognitive, memory or thinking impairments)

Tests you can’t do at home

We wrote a little while back about how one kind of blood testing for Alzheimer’s disease works:

The Brain Alarm Signs That Warn Of Dementia

Why “Brain Alarm Signs” if it’s a blood test? Because the blood gets (in very lay terms) bits of broken brain in it. Or more specifically, they tested the blood for density of cerebrovascular endothelial extracellular vesicles (CEEVs), which are bits of the cells from the lining of blood vessels in the brain. These cerebrovascular endothelial extracellular vesicles should not, ideally, be falling off and riding around your bloodstream, and the greater the density of them, the greater likelihood of mild cognitive impairment now, and by extension, dementia later.

It’s not the only blood test available though, see:

Highly accurate blood test for Alzheimer’s disease is similar or superior to clinical cerebrospinal fluid (CSF) tests ← this one checks the ratio of phosporylated-tau217 to non-phosphorylated tau (which is a protein antibody), which equalled or outperformed FDA-approved CSF tests in classifying amyloid-β positron emission topography (PET, as in a PET scan) status, with a confidence interval as high as, or better than, industry standards.

If you don’t like having your blood taken, trust us that you’d find having your cerebrospinal fluid taken even less enjoyable, so this is a very welcome improvement!

In case you’re curious about how the CSF test works, here you go: NPTX2 in Cerebrospinal Fluid Predicts the Progression From Normal Cognition to Mild Cognitive Impairment ← NPTX2 is a protein biomarker of Alzheimer’s risk

…but again, we really think the blood test is preferable.

Tests beyond the physiological

There are, of course, psychological tests that can be done, including a linguistic analysis of your conversation, compared with a vast database of other people’s conversations, with and without various degrees of cognitive impairment

As Dr. Ioannis Paschalidis explains:

❝We wanted to predict what would happen in the next six years—and we found we can reasonably make that prediction with relatively good confidence and accuracy.

Rather than using acoustic features of speech, like enunciation or speed, the model is just pulling from the content of the interview—the words spoken, how they’re structured.

You can think of the score as the likelihood, the probability, that someone will remain stable or transition to dementia. It had significant predictive ability.

Digital is the new blood. You can collect it, analyze it for what is known today, store it, and reanalyze it for whatever new emerges tomorrow.❞

You can read the full paper here: Prediction of Alzheimer’s disease progression within 6 years using speech: A novel approach leveraging language models

See also: AI: The Doctor That Never Tires?

What if the news isn’t good?

While bad news is never welcome per se, it is preferable to not knowing, insofar as we can then take steps to manage the situation.

You may be wondering: what can be done that I wouldn’t already be doing to minimize my dementia risk in the first place?

And the answer is: yes, do continue those things of course, but there is more to do:

See: Beyond Guarding Against Dementia: When Age’s Brain-Changes Come Knocking

Take care!