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Understanding Memory Loss & Cognitive Impairment

Memory loss and changes in cognitive functioning are frightening for patients and their families. In a very real sense, we are very much the collection of our memories. How we see ourselves, how we relate to others, how we navigate through our daily lives involves memory. Receiving a general diagnosis of dementia, or being told that you or a loved one has a specific disorder like Alzheimer's disease, is typically bewildering and overwhelming. The material found in this section is written for patients and their families. It is intended to help clarify and explain dementia and its causes. While there are no cures for dementia, accurate information can help patients and their families cope with these problems, and effectively plan so that independence and life quality can be maintained for as long as possible.

At the outset, it is important to distinguish between forgetfulness, which is a common and normal occurrence, and dementia, which is not a normal part of aging. Forgetfulness can be thought of as a simple "miss" in concentration or attention. We all become forgetful from time to time. Forgetting where you placed the car keys, not remembering to pick up a grocery item, and forgetting to send an email are typically benign events. As we age, we become more forgetful.

This is a normal process. In almost all circumstances, benign forgetfulness can be prevented or remedied by improving our focus and concentration, or by being less distracted. However in the case of dementia, memory errors are not easily corrected. For persons with dementia, the actual ability to make new memories is impaired.

One way to help determine if apparent problems in memory are the result of simple forgetfulness or are instead an indicator of a serious memory disorder is through cognitive screening. Cognitive tests like the BCAT® can be quickly administered by your healthcare practitioner. They can indicate whether more thorough evaluation is necessary. Cognitive screening has many advantages, but is also associated with complex issues.

Below you will find short and basic descriptions of memory syndromes and disorders. They are presented to provide you with information to better cope with very challenging and often life-altering illnesses.

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What Do I Do Now?

Perhaps you have been told that you have Alzheimer's disease (AD), or that your mother has dementia. The question, "what do I do now?" - is one raised by millions of people after being given a dementia diagnosis. From our experience in working with patients and their families, we've learned that the following information can help one navigate the frightening world of dementia.

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What is Mild Cognitive Impairment (MCI)?

Healthcare practitioners think about cognitive functioning in terms of a continuum. In normal cognitive functioning, forgetfulness is increasingly common as we age, and by itself, does not signify dementia. There is a syndrome, however, in which persons experience a cognitive deficit that goes beyond normal cognitive functioning but does not meet criteria for dementia. The typical deficit is in memory, but generally other cognitive features, such as language, judgment, and reasoning are intact. This syndrome is called Mild Cognitive Impairment (MCI).

Generally speaking, people with MCI are able to perform everyday tasks of living and can live independently. However, many experts believe that MCI is a pre-dementia stage. It does appear that the rate at which MCI patients eventually develop dementia is much higher than persons with no evidence of MCI. Therefore, careful monitoring of MCI progression is very important. Research shows that memory medications work more effectively in MCI than they do in actual dementia. There are practical considerations associated with MCI. For those who are living independently in the community, an assessment of IADLs is often important. IADL, or instrumental activities of daily living, is a term that refers to the more complex daily tasks. Examples are shopping, laundry, transportation, medication, telephone, housekeeping, and finances.

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What is Dementia?

Permanent and progressive loss in one's ability to make new memories and learn new information is the defining feature of dementia. Dementia is a general term that refers to a cluster of mental symptoms. Dementia is not a specific disease. There are many possible causes of dementia, but the most common cause of dementia is Alzheimer's disease. Alzheimer's disease accounts for 50 to 70 percent of dementia cases. Dementia always involves mental or cognitive decline. Indications of dementia are:

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What is Alzheimer's Disease (AD)?

AD is a progressive brain disorder that gradually destroys one's ability to make new memories, learn new material, reason, make judgments, problem-solve, communicate with others, and complete activities of daily living. Person with AD become increasingly confused, misplace things, get lost in familiar places, and demonstrate changes in personality and behavior.

Some Facts about AD

Specific Information about Beta-amyloid

Stages of AD

There are a number of staging models for describing the progression of AD. One relatively simple framework is a three-stage model:

Diagnosis and Treatment of AD

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Other Dementias

There are numerous diseases other than AD that can cause dementia. Some of these are summarized below.

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