It’s important to discuss signs of dementia
When Tatiana Lagos’ father stopped driving, she didn’t think much of it at first.
“He’d say, ‘Hey, can you pick me up?’” Lagos recalled of her father, who was in his early 60s and had recently retired from a career in international law. “And he was leaning heavily on his wife for the smallest things,” such as scheduling a coffee date.
Lagos, who lives in Potomac, Maryland, brought up her concerns with family members, including relatives in her father’s home country of Chile. But they chalked them up to the changes in his life after retirement.
It was not until two or three years later, when her father had a stroke, that he was diagnosed with Alzheimer’s disease. By then, it was too late to involve him in discussions about treatment options or endof-life planning. He died in 2017.
Often, when a person first exhibits signs of dementia, close family members are the first to notice. A parent starts repeating the same stories. A spouse forgets how to get home from the grocery store. Daily life feels off in ways that are at first subtle, then less so.
Bringing up cognitive decline with a loved one can be so fraught with pain, embarrassment and denial that many are reluctant to broach the topic until far into dementia’s progression.
A survey released last month by the Alzheimer’s Association found that nearly 90 percent of Americans say they would want others to tell them if they were showing signs of memory loss or other symptoms of dementia. And yet, nearly three-quarters said that having that conversation would be “challenging” for them.
There is no cure for Alzheimer’s, but talking about it early in the disease’s progression is crucial, said Ruth Drew, director of information and support services at the Alzheimer’s Association.
Early discussions give people time to take care of legal and financial issues, make a long-planned trip, participate in their treatment plan or join a medical trial, Drew said.
“It gives you a voice,” she said. “If you know early on, you have a voice on how things go and who’s going to make decisions on your behalf.”
An estimated 5.8 million Americans are living with Alzheimer’s dementia, and that number is projected to more than double to 13.8 million by 2050, barring the development of medical breakthroughs to prevent, slow or cure it.
Patients cannot always rely on their doctors to notice Alzheimer’s or test for it. Only half of seniors are assessed for thinking and memory issues, and only 16 percent receive regular cognitive assessments, according to the 2019 Alzheimer’s Disease Facts and Figures report by the Alzheimer’s Association.
The organization recently launched a new ad campaign that encourages people to speak up if they suspect cognitive decline in themselves or their loved ones.
When initiating the conversation, family members should be careful not to jump to conclusions, said Ronald Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging.
“It’s not something you want to jump into and say, ‘Dad, I think you have Alzheimer’s,’” he said. “You might say, ‘Dad, have you noticed, are you more forgetful than you used to be? You seem to be repeating yourself.’”
Petersen, who gives a talk called “How Much Forgetfulness Is Too Much?” said Americans are more comfortable than they once were with conversations about cognitive impairment, and added that there is a lot more nuance in those conversations than there once was.
“Twenty years ago, we had normal, and then we had dementia,” he said.
Now, mild cognitive decline is a commonly recognized term to describe problems that might be early signs of dementia or might, in fact, be caused by reversible non-dementia-related factors, such as a reaction to medication or changes in sleep patterns.