Certain 'Senior Moments' May Signal Mental Decline

Getting lost in familiar places, trouble following a group conversation are red flags, study finds

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THURSDAY, Sept. 15 (HealthDay News) -- Those "senior moments" that plague so many aging Baby Boomers may or may not be a sign of more serious problems down the line.
New research finds that losing your train of thought or forgetting where you placed your keys may be a fairly benign -- albeit annoying -- sign of age. But having trouble remembering what happened a few minutes ago, or getting lost in familiar places, may be more serious.
The information, published in the September issue of the Journal of the American Geriatrics Society, should help primary care physicians sort out the mundane from the more troublesome when they see elderly patients.
"They should be asking their patients if they have any complaints [about memory or thinking skills]," said study lead author Rebecca Amariglio, a neuropsychologist with Brigham and Women's Hospital and Harvard Medical School in Boston. "When you're getting old, it's common to ignore these complaints."
President Obama's Affordable Care Act includes a provision for screening for these types of problems, called cognitive problems, at a person's annual physical exam.
So researchers are trying to find simple ways to sort out which patients can go home (relatively) reassured, and which might need further testing for Alzheimer's disease or another form of dementia.
For this study, researchers quizzed almost 17,000 women, average age about 74, over the telephone about their own recollections of memory lapses. The investigators then correlated this data with how the women scored on standard cognitive tests, including delayed recall of sets of words and numbers, also administered over the telephone.
The researchers used a set of questions -- seven in all -- which asked the participants if they had recently experienced a change in their ability to remember things, whether they had trouble remembering a short list of items (such as a shopping list), whether they had trouble remembering recent events, and whether they had trouble remembering things from one second to the next.
The women were also asked whether they had difficulty following spoken or written instructions, whether they had more trouble than usual following a group conversation or TV program due to memory problems, or whether they had trouble finding their way around familiar streets.
"Getting lost," in particular, was highly associated with cognitive impairment. Women who reported they had gotten lost in familiar neighborhoods tended to score significantly lower on cognitive tests similar to those used to detect signs of Alzheimer's. Having trouble keeping up with a group conversation and difficulty following instructions were also strongly associated -- though not as highly -- with cognitive impairment.
On the other hand, forgetting things from one moment to the next was not associated with any decline in measure of cognitive function.
But the more complaints a woman had, the more likely she was to score poorly on the test administered by investigators. Each additional complaint was associated with a 20 percent increase in cognitive impairment. (The complaint of forgetting one moment to the next had a score of zero since it was not associated with impairment.)
The authors noted that the participants were all women and mostly white, however, which means that the findings may not be generalizable to other populations.
Another expert pointed out other limitations of the study.
The "senior moments" reported by the study participants were only related to how well they did on the telephone tests, not to whether or not the person had actual dementia, according to Mary Sano, professor of psychiatry and director of the Alzheimer's Disease Research Center at Mount Sinai School of Medicine in New York City.
"This may overstate the problem, which also is not a good thing," she said, adding that the study does not trace the source of any problems it uncovered.
"The next step going forward would be to develop specific questions to ask [and] to see if this relates to dementia," Amariglio said.
For now, simple questions don't portend "what the future holds," she added. But answers may indicate that follow-up is warranted.
"It's one little extra red flag that can maybe direct decisions," Amariglio said.

SOURCES: Rebecca Amariglio, Ph.D., neuropsychologist, Brigham and Women's Hospital and Harvard Medical School, Boston; Mary Sano, Ph.D., professor, psychiatry, and director, Alzheimer's Disease Research Center, Mount Sinai School of Medicine, New York City; September 2011 Journal of the American Geriatrics Society

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