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Stop Blaming 'Senior Moments'

By William R. Shankle, M.S., M.D., F.A.C.P.

October 26, 2018

“He’s having a senior moment.” That dismissive phrase seems harmless, but, in reality, it leads to devastating, debilitating disease.

I firmly believe that a generation from now, people will not know the pain of watching a loved one slip into oblivion. But the only way we will get there is we stop dismissing memory loss and other behaviors as “normal aging.”

The recent news that former Supreme Court Justice Sandra Day O’Connor is retiring from public life as a result of dementia hit the Alzheimer’s community hard. Reading stories about her decision is like reading the obituary of someone who is still alive. Dementia is robbing this great mind of her capacities and this great spirit of her passions.

It won’t always be this way. This summer an Alzheimer’s Association workgroup released 20 recommendations to help primary care physicians evaluate Alzheimer disease and other dementias.

The multidisciplinary workgroup, which included medical, neuropsychology, and nursing specialties, developed evidence-based guidelines that include specific evaluations for primary care physicians to give all patients who are middle-aged or older. Just as doctors routinely administer blood pressure checks and cholesterol screenings, simple memory tests can help “catch” problems before they get out of hand.

By identifying candidates for treatment before cognitive function is impaired, primary care physicians can play a key role in curing the disease. For example, doctors can lead patients to treatment options currently in clinical trials that appear to remove the “gunk” that leads to Alzheimer’s. They can also direct patients to the “use it or lose it” cognitive treatment model of preventing or delaying dementia.

But they can only do these things if they identify a problem that is just starting to develop. For too long, the “senior moment” excuse has masked problems that could have been cured or curbed if they had been taken more seriously.

As saddened as I was about O’Connor’s announcement, I was grateful that she took such a public approach to her disease. Because dementia is so terrifying to patients, many don’t talk about it. And because nobody talks about it, too few screen for it. We all know about colorectal screening, mammography and prostate exams. Annual memory screenings are far less prevalent – despite being considerably more pleasant.

If every person over the age of 45 underwent an annual memory screen, we would have a chance at preventing dementia entirely or greatly delaying it from claiming more brilliant minds.

Thankfully, the Orange County Vital Brain Aging Program (OCVBAP) at the Pickup Family Neurosciences Institute at Hoag has seen an increase in the number of people in their 50s getting their annual memory checkup, along with a steady increase of participants over 65 years old. Physicians are also referring their patients to the OCVBAP who have no symptoms of cognitive impairment, but who want to establish a baseline for their memory.

This is good news for the future of brain health in Orange County and in the nation. Hoag’s Orange County Vital Brain Aging Program, as well as doctors who have gone through its training, can provide an annual memory screen, depression screen and risk assessment to help manage risks and identify signs of dementia early. Sophisticated technology can also help detect harmful proteins in the brain associated with dementia.

For those who are at risk, several experimental treatment options now exist including intravenous immunoglobulin, or antibodies that remove the molecules that cause Alzheimer’s disease.

In addition, we now know that stimulating the brain builds new synapses, or connections, that help counteract the disease process. So, “use it or lose it” applies to brains as much as to biceps.

We will cure Alzheimer’s disease someday – but first, we have to identify it. So please stop blaming “senior moments,” and start getting screened.

To learn more, please visit the Orange County Vital Brain Aging Program at http://www.ocbrain.org/.

William R. Shankle, M.S., M.D., F.A.C.P., the Judy & Richard Voltmer Endowed Chair and the director of the Memory and Cognitive Disorders Program at Pickup Family Neurosciences Institute at Hoag.