Does forgetting a name or word mean that I have dementia?
The number of people with dementia is expected to triple by 2060.
Dementia, which is not technically a disease but a term for impaired ability to think, remember or make decisions, is one of the most feared impairments of old age.
Incidence increases dramatically as people move into their 90s. About 5% of those age 71 to 79 have dementia, and about 37% of those about 90 years old live with it.
Older people may worry about their own loss of function as well as the cost and toll of caregiving for someone with dementia. A 2018 study estimated that the lifetime cost of care for a person with Alzheimer's, the most common form of dementia, to be US$329,360. That figure, too, will no doubt rise, putting even more burdens on family, Medicare and Medicaid.
There's also been a good deal of talk and reporting about dementia in recent months because of the U.S. presidential election. Some voters have asked whether one or both candidates might have dementia. But, is this even a fair question to ask? When these types of questions are posed – adding further stigma to people with dementia – it can unfairly further isolate them and those caring for them. We need to understand dementia and the impact it has on more than 5 million people in the U.S. who now live with dementia and their caregivers. That number is expected to triple by 2060.
First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor's exam for a diagnosis. Sometimes, brain imaging is required. And, forgetting an occasional word – or even where you put your keys – does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.
Older people wonder and worry about so-called senior moments and the memory loss they perceive in themselves and others. I see patients like this every week in my geriatric clinic, where they tell me their stories. They forget a word, get lost in a story, lose keys or can't remember a name. Details vary, but the underlying concern is the same: Is this dementia?
Normal memory loss
As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is normal. Ever have trouble fetching a fact from the deep back part of your "mind's Rolodex"? Suppose you spot someone at the grocery store you haven't seen in years. Maybe you recognize the face, but don't remember their name until later that night. This is normal, part of the expected changes with aging.
What's more of a potential problem is forgetting the name of someone you see every day; forgetting how to get to a place you visit frequently; or having problems with your activities of daily living, like eating, dressing and hygiene.
When you have troubles with memory – but they don't interfere with your daily activities – this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.
You want to note the timing of any impairment. Was there a gradual decline? Or did it happen all of a sudden? This too you should discuss with your doctor, who might recommend the MoCA, or Montreal Cognitive Assessment test, which screens for memory problems and helps determine if more evaluation is needed.
Also, the Centers for Disease Control and Prevention lists problems in these areas as possible signs of dementia:
- Reasoning, judgment and problem solving
- Visual perception beyond typical age-related changes in vision
More severe issues
When memory loss interferes with daily activities, see your doctor about what to do and how to make sure you're safe at home.
There are numerous types of severe memory loss. Dementia tends to be a slow-moving progression that occurs over months or years. Delirium is more sudden and can occur over hours or days, usually when you have an acute illness. Depression can also cause memory changes, particularly as we get older.
Dementia and other brain issues
Alzheimer's dementia is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or an inability to do calculations like balance the checkbook. Certain medical conditions – thyroid disorders, syphilis – can lead to dementia symptoms, and less common types of dementia can have different kinds of symptoms. Alzheimer's has a distinct set of symptoms often associated with certain changes in the brain.
Focusing on safety and appropriate supervision, particularly in the home, is critical for all people with dementia. Your doctor or a social worker can help you find support.
It's also important to be aware of two other things that can lead to decreased mental functioning – delirium and depression.
Delirium, a rapid change in cognition or mental functioning, can occur in people with an acute medical illness, like pneumonia or even COVID-19 infection. Delirium can occur in patients in the hospital or at home. Risk for delirium increases with age or previous brain injuries; symptoms include decreased attention span and memory issues.
Depression can happen at any time, but it's more common with aging. How can you tell if you're depressed? Here's one simple definition: when your mood remains low and you've lost interest or joy in activities you once loved.
Sometimes people have recurring episodes of depression; sometimes, it's prolonged grieving that becomes depression. Symptoms include anxiety, hopelessness, low energy and problems with memory. If you notice signs of depression in yourself or a loved one, see your doctor. If you have any thoughts of harming yourself, call 911 to get help instantly.
Any of these conditions can be frightening. But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It's the first step toward figuring out what is happening and making sure your health is the best it can be.
And, as with any disease or disease group, dementia is not a "character flaw," and the term should not be used to criticize a person. Dementia is a serious medical diagnosis – ask those who have it, the loved ones who care for them or any of us who treat them. Having dementia is challenging. Learn what you can do to support those with dementia in your own community.
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Northwell Health CEO Michael Dowling has an important favor to ask of the American people.
- Michael Dowling is president and CEO of Northwell Health, the largest health care system in New York state. In this PSA, speaking as someone whose company has seen more COVID-19 patients than any other in the country, Dowling implores Americans to wear masks—not only for their own health, but for the health of those around them.
- The CDC reports that there have been close to 7.9 million cases of coronavirus reported in the United States since January. Around 216,000 people have died from the virus so far with hundreds more added to the tally every day. Several labs around the world are working on solutions, but there is currently no vaccine for COVID-19.
- The most basic thing that everyone can do to help slow the spread is to practice social distancing, wash your hands, and to wear a mask. The CDC recommends that everyone ages two and up wear a mask that is two or more layers of material and that covers the nose, mouth, and chin. Gaiters and face shields have been shown to be less effective at blocking droplets. Homemade face coverings are acceptable, but wearers should make sure they are constructed out of the proper materials and that they are washed between uses. Wearing a mask is the most important thing you can do to save lives in your community.
Two massive clouds of dust in orbit around the Earth have been discussed for years and finally proven to exist.
- Hungarian astronomers have proven the existence of two "pseudo-satellites" in orbit around the earth.
- These dust clouds were first discovered in the sixties, but are so difficult to spot that scientists have debated their existence since then.
- The findings may be used to decide where to put satellites in the future and will have to be considered when interplanetary space missions are undertaken.
What are they?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODgyMDA0NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYzNTM1ODc0Mn0.NH33LuauIo__sUBi4tvhwxDcsvhflDFD-Nhx9FjlSNk/img.jpg?width=1245&coordinates=148%2C0%2C149%2C0&height=700" id="cec96" class="rm-shortcode" data-rm-shortcode-id="acb78abe2ab46a17e419ad30906751d6" data-rm-shortcode-name="rebelmouse-image" />
Artist's impression of the Kordylewski cloud in the night sky (with its brightness greatly enhanced) at the time of the observations.
G. Horváth<p>The<a href="https://en.wikipedia.org/wiki/Kordylewski_cloud" target="_blank"> Kordylewski clouds</a> are two dust clouds first observed by Polish astronomer Kazimierz Kordylewski in 1961. They are situated at two of the <a href="https://www.space.com/30302-lagrange-points.html" target="_blank">Lagrange points</a> in Earth's orbit. These points are locations where the gravity of two objects, such as the Earth and the Moon or a planet and the Sun, equals the centripetal required to orbit the objects while staying in the same relative position. There are five of these spots between the Earth and Moon. The clouds rest at what are called points four and five, forming a triangle with the clouds and the Earth at the three corners.</p><p>The clouds are enormous, taking up the same space in the night sky as twenty lunar discs; covering an area of 45,000 miles. They are roughly 250,000 miles away, about the same distance from us as the Moon. They are entirely comprised of specks of dust which reflect the light of the sun so faintly most astronomers that looked for them were unable to see them at all. </p><p>The clouds themselves are probably ancient, but the model that the scientists created to learn about them suggests that the individual dust particles that comprise them can be blown away by solar wind and replaced by the dust from other cosmic sources like comet tails. This means that the clouds hardly move but are <a href="https://www.nationalgeographic.com/science/2018/11/news-earth-moon-dust-clouds-satellites-planets-space/" target="_blank">eternally changing</a>. </p>
How did they discover this?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODgyMDAzNi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY1Nzc4MjQ4MX0.7uU9OqmQcWw5Ll1UXAav0PCu4nTg-GdJdAWADHanC7c/img.jpg?width=1245&coordinates=0%2C180%2C0%2C181&height=700" id="952fb" class="rm-shortcode" data-rm-shortcode-id="a778280a20f1c54cd2c14c8313224be2" data-rm-shortcode-name="rebelmouse-image" />
"In this picture the central region of the Kordylewski dust cloud is visible (bright red pixels). The straight tilted lines are traces of satellites."
J. Slíz-Balogh<p>In their study published in the <a href="https://academic.oup.com/mnras" target="_blank">Monthly Notices of the Royal Astronomical Society</a>, Hungarian astronomers Judit Slíz-Balogh, András Barta, and Gábor Horváth described how they were able to find the dust clouds using polarized lenses.</p><p>Since the clouds were expected to polarize the light that bounces off of them, by configuring the telescopes to look for this kind of light the clouds were much easier to spot. What the scientists observed, polarized light in patterns that extended outside the view of the telescope lens, was in line with the predictions of their mathematical model and ruled out other possible sources. </p>
Why are we just learning this now?<img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8xODgyMDAzOS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTY2MjUyNDMyMH0.Zl8GmQ_rJHiL4b7hN0r_YBmgb6_ZqIRvqOVuko2ubpw/img.jpg?width=1245&coordinates=0%2C141%2C0%2C185&height=700" id="87afe" class="rm-shortcode" data-rm-shortcode-id="dd4c0b5088e601d7279cc5eb226f8b7b" data-rm-shortcode-name="rebelmouse-image" />
"Mosaic pattern of the angle of polarization around the L5 point (white dot) of the Earth-Moon system. The five rectangular windows correspond to the imaging telescope with which the patterns of the Kordylewski cloud were measured."
J. Slíz-Balogh<p>The objects, being dust clouds, are very faint and hard to see. While Kordylewski observed them in 1961, other astronomers have looked there and given mixed reports over the following decades. This discouraged many astronomers from joining the search, as study co-author Judit Slíz-Balogh <a href="https://ras.ac.uk/news-and-press/research-highlights/earths-dust-cloud-satellites-confirmed" target="_blank">explained</a>, <em>"The Kordylewski clouds are two of the toughest objects to find, and though they are as close to Earth as the Moon are largely overlooked by researchers in astronomy. It is intriguing to confirm that our planet has dusty pseudo-satellites in orbit alongside our lunar neighbor."</em></p>
Will this have any impact on space travel?<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="c3d797fff5430c64afcb5a49bddc3616"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/Ou8N3v9SFPE?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Lagrange points have been put forward as excellent locations for a space station or satellites like the <a href="https://jwst.nasa.gov/about.html" target="_blank">James Webb Telescope</a> to be put into orbit, as they would require little fuel to stay in place. Knowing about a massive dust cloud that could damage sensitive equipment already being there could save money and lives in the future. While we only know about the clouds at Lagrange points four and five right now, the study's authors suggest there could be more at the other points.</p><p>While the discovery of a couple of dust clouds might not seem all that impressive, it is the result of a half-century of astronomical and mathematical work and reminds us that wonders are still hidden in our cosmic backyard. While you might never need to worry about these clouds again, there is nothing wrong with looking at the sky with wonder at the strange and fantastic things we can discover. </p>
New cancer-scanning technology reveals a previously unknown detail of human anatomy.
- Scientists using new scanning technology and hunting for prostate tumors get a surprise.
- Behind the nasopharynx is a set of salivary glands that no one knew about.
- Finding the glands may allow for more complication-free radiation therapies.
PSMA PET/CT technology<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="676e611b970c9b516cace0870447b325"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/RHAyoQF09X4?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>PSMA PET/CT is a new combination of <a href="https://www.mayoclinic.org/tests-procedures/pet-scan/about/pac-20385078" target="_blank">PET scans</a> and <a href="https://www.mayoclinic.org/tests-procedures/ct-scan/about/pac-20393675" target="_blank">CT scans</a> that is believed to offer a more reliable means of locating prostate cancer metastasis. A <a href="https://www.cancer.gov/news-events/cancer-currents-blog/2020/prostate-cancer-psma-pet-ct-metastasis" target="_blank" rel="noopener noreferrer">study</a> published last spring suggests it may be the most accurate way to diagnose prostate cancer metastasis than any method previously available.</p><p>Prior to PSMA PET/CT, the primary way to look for metastatic prostate cancer was to image the body using x-ray-based CT scans and to perform bone scans, since bone is where prostate cancer often spreads. CT scans, however, often miss small tumors, and bone scans can generate false positives as a result of other damage or abnormalities that have nothing to do with prostate cancer.</p><p>PSMA PET/CT scans track the travels of an intravenously administered radioactive glucose tracer throughout the body. For hunting down prostate cancer, this tracer contains a molecule that binds to the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472940/" target="_blank">PSMA</a> protein that's present in large amounts in prostate tumors. The molecule is linked to a radioisotope, <a href="https://netrf.org/2018/11/13/gallium-68-scan-for-neuroendocrine-tumors/" target="_blank" rel="noopener noreferrer">gallium-68</a> (Ga-68).</p><p>In last spring's research, PSAM PET/CT was shown to be 27 percent more accurate than previous methods at finding metastases (92 percent accuracy as opposed to 65 percent). In addition, it was found to be much less likely to produce false positives, and it was particularly good at detecting tumors far removed from the prostate.</p>
A good kind of avoidance behavior<p>"Radiation therapy can damage the salivary glands," says Vogel, "which may lead to complications. Patients may have trouble eating, swallowing, or speaking, which can be a real burden."</p><p>The researchers looked back through the cases of 723 patients who had undergone radiation treatment, interested in seeing if inadvertent radiation of the tubarial glands was associated with the complications experienced by the patients. It turned out that this <em>was</em> the case: In cases where more radiation had been delivered to this area, patients did indeed report more in the way of complications of the type one would expect when salivary glands are radiated.</p><p>Now that we know the tubarial salivary glands exist, therapists can stay out of their way. Vogel says, "For most patients, it should technically be possible to avoid delivering radiation to this newly discovered location of the salivary gland system in the same way we try to spare known glands."</p><p>He's hopeful that that things may be about to get at least a bit better for cancer patients: "Our next step is to find out how we can best spare these new glands and in which patients. If we can do this, patients may experience less side effects which will benefit their overall quality of life after treatment."</p>
A new survey found that 27 percent of millennials are saving more money due to the pandemic, but most can't stay within their budgets.