You walk into a room but can’t remember why. No matter how hard you
try to keep them in the same place, you’re always misplacing your
phone and keys. And you can see that actor’s face in your mind but
can’t name him. You’re starting to wonder—you’re
sure it’s nothing, but let’s just say it: You may be experiencing
the onset of Alzheimer’s dementia.
“Memory loss is a common prevailing concern when people come to see
me,” says Torrance Memorial Physician Network primary care physician
Nicole Alexander, MD. “Of course the worst-case scenario would be
dementia. But in my experience, when I see a patient who is suffering
from dementia, it’s usually a family member who brings them in.
If someone comes to me and tells me they’re worried because they
are forgetting things, it most likely is not Alzheimer’s dementia.”
To put Alzheimer’s in perspective: According to the Alzheimer’s
Association, 1 in 10 people age 65 and older—an estimated 5.6 million
people—has Alzheimer’s dementia. Almost two-thirds of Americans
with Alzheimer’s are women. It definitely should be a concern. One
in three seniors dies with Alzheimer’s or another dementia.
So if it’s not Alzheimer’s, what does it mean when someone
over 65 notices memory loss? “The truth is,” says Dr. Alexander,
“we are multitasking so much that we do forget things. Alzheimer’s
dementia is a progressive cognitive impairment that affects functional
independence. So more than skills are compromised. For example, a senior
is not able to balance their checkbook, or the bills aren’t getting
Primary care doctors are the best at catching any signs of dementia. “If
a patient or their loved ones express concern, we go through an assessment
to evaluate whether they have any cognitive impairment. We ask questions
about whether they exercise or if they smoke, and we take a family history.
And Medicare patients over 65 get an extensive annual exam during their
annual wellness visits. With that MMSE we can establish a diagnosis and
a baseline. We also do labs and sometimes a CT scan to check for any masses
Here’s the rub, though. According to the Alzheimer’s Association,
only 16% of seniors receive regular cognitive assessments during their
routine health checkups. But the good news: Primary care physicians are
conducting brief cognitive assessments more frequently and placing more
importance on them than ever before, suggesting in the future we will
see improved early detection of cognitive decline.
The risks increase with age, says Dr. Alexander. “The prevalence
of dementia between ages 56 and 69 is 8%. In developed countries, 40 to
100 people develop it. If you live past age 80, there’s a 25% chance
you’ll develop dementia,” she says.
So are there any ways to keep your brain healthy? “Exercise, exercise,
exercise,” Dr. Alexander asserts. “It increases the blood
flow to your brain, and study-wise that’s it. A healthy diet with
plenty of antioxidants can reduce chronic inflammation we think might
contribute. Brainteasers and puzzles that can stimulate your brain might
help, but research hasn’t shown that.
“There are certain risk factors, such as obesity, low education,
history of stroke, and sometimes depression and anxiety, that might indicate
brain dysfunction. Alcohol use puts you at risk, as does diabetes and
hypertension. We are not sure why, but there also might be a genetic component.”
If you are over 65 and concerned, see your doctor. “Make sure you
have good sleep habits, getting six to eight hours a day, drink plenty
of water and decrease whatever risk factors you can, such as high blood
pressure and diabetes. Engage your brain frequently through talking and
“And we find structure is important,” Dr. Alexander says. “People
who come in worried about memory loss are often just plain distracted.”
Nicole Alexander, MD, is a primary care physician with the Torrance Memorial
Physician Network. She practices at 3333 Skypark Drive in Torrance and
can be reached at 310-784-6300.