“My father asked me how my root canal went. I answered him. Then five minutes later, he asked me again,” my friend Paul, 59, said. “So on the one hand, it was a good thing that he knew I’d had a root canal recently. But on the other hand, he didn’t remember that the question had been asked and answered. What’s up with that?”
Does this kind of discussion sound familiar?
“My mom has started mixing up my and my two sisters’ names,” says Stacy, of her mother who just turned 90. “My grandmother used to do that when I was a kid, but this feels a lot scarier.”
Increasingly, I find that this line of conversation is becoming the new normal for my circle of friends, a group of 50- and 60-somethings with parents who are really getting up there. Whether we’re blabbing while waiting for a movie to start, having coffee or chatting at a party, somehow, the question remains the same: Are our parents losing it? Are the scary depths of dementia about to grip our lives, or is this just “normal” aging?
Welcome to Dementia Watch, a midlife phenomenon in which we scrutinize the older generation for clues as to their cognitive status.
Why we worry
There’s good reason for the anxiety. The heartbreak of watching a loved one fade into dementia, fail to recognize their family and lose the very essence of what made them, well, them — it’s a prospect that shakes us to our core. Famous figures who’ve suffered from forms of dementia — from Ronald Reagan to Robin Williams — have brought the topic into focus. And the knowledge that there’s no prevention and not much in the way of treatment adds to the gloomy outlook.
The statistics are staggering: Approximately one in four people between the ages of 85 and 89 has dementia, versus one in 70 among those 65 to 69. In our aging population, the numbers get overwhelming: The incidence of dementia ratcheted up 117% between 1990 and 2016, say study findings, with global cases rising from 20.2 to 43.8 million.
There’s the financial toll as well. The cost of providing care for Americans with Alzheimer’s disease has already surged past $259 billion, and headlines blare that the disease may bankrupt Medicare while robbing us of our loved ones.
The fear is real, and it’s taking root among our demographic. There’s definitely an emotional wallop that comes with seeing the people who raised us and supported us slip from their status as all-knowing and all-powerful. Plus, once we get past the worry about our older relatives comes a dark reckoning: “Will this be me in another 20 or 30 years?”
On high alert
These facts conspire to have us on high alert. My friend Kimberly, a yoga instructor in NYC, recently had an unsettling experience that plunged her into Dementia Watch territory and triggered a last-minute trip to assess the condition of a parent.
When chatting with her mom, who’s 87 and lives hundreds of miles away, Kimberly’s mother mentioned that her cat had bit her on the roof.
“On the roof?” Kimberly asked incredulously. “What were you doing on the roof? And with the cat?!”
“No, on the roof,” her mother answered. “You know, the roof. The part of your arm above your hand.”
OK, then: wrist. The cat had bit her on her wrist.
Kimberly was so unsettled by the word substitution, she rearranged her schedule and hustled to visit her mother. A medical assessment for this word-retrieval issue ensued. While the doctor wound up not being too concerned, it has sent Kimberly into surveillance mode, comparing notes with her sister about how their mother sounds on the phone and how well she shares information in person.
Similarly, Marc, of Naperville, IL, freaked out when his “usually razor-sharp” uncle Gary, 79, couldn’t remember details of a movie he’d just watched. “He said it was about ‘that famous British guy, the one from the war,’ and was played by, ‘that actor I like who was in that movie, the one about the old scary story.’”
It was so unlike Gary to be vague that Marc panicked and called his cousin Sandra to say, “I think your dad is having a stroke!” Long story short, no stroke had occurred but the cousin said yes, lately her dad was experiencing mental fogginess. (For those wondering, Gary had been watching The Darkest Hour, starring Gary Oldman, who once played Dracula.)
Now Marc and Sandra text-message anecdotes whenever Gary seems fuzzy, to better keep tabs on what’s happening. Which points to what is perhaps a hidden benefit of being on Dementia Watch: It tends to pull relatives closer together, as they check in and ask, Are you seeing what I’m seeing?
What a neurologist wants you to know
Surely, the question everyone wants answered is whether these slip-ups should concern us. For the answer to that, we consulted Dr. David Wolk, a board-certified neurologist, an Associate Professor at the University of Pennsylvania Perelman School of Medicine, and co-director of the Penn Memory Center.
“The reality is that by our 40s, 50s or 60s, all of us experience some difficulty retrieving names and memories; that’s normal aging and not necessarily going to worsen and become dementia,” says Dr. Wolk. “Often the issue is getting the information out, not losing it completely. When you tell an older person the word or name they’ve forgotten, and they say, ‘Oh yes, that’s it!’ — that’s a good sign. What’s more concerning is if, when you fill in the blank for someone, it doesn’t ring a bell or register.”
Dr. Wolk continued, “Similarly, an older person might repeat a story because they are tired, distracted, had some wine, or are in a loud restaurant. If you mention that they told you the story twice and they seem unaware of that fact, that’s more suggestive of something serious than if they say, ‘I had a feeling I was repeating myself.’” The self-awareness is critical.
If you feel you have reason to worry, Dr. Wolk’s offers this advice:
- Do check in with other people in your relative’s circle to find out what they are seeing. This allows you to get a picture of how often so-called brain glitches are happening.
- If you see recurring mild symptoms — or a single one that is unusual enough to trouble you — do encourage the older person to have a cognitive assessment; this can start with a primary doctor or a specialist (neurologist, geriatrician, or psychiatrist).
- Know that no amount of worry or annoyance will help the situation. Making a big deal out of the fact that a loved one can’t remember a name or fact won’t suddenly make them come up with it — it will just stress everyone out.
So if you’re on a keyed-up kind of Dementia Watch, take it down a notch. No one is saying to be oblivious or negligent; just summon your inner zen and forge ahead with all the calm, loving support you can muster. And likely the kind of support they provided for you back in the day.