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Does the Caregiver Also Need Care?

September 7, 2022

Many people 50 and older worry that their memory is slipping and that it might be an early sign of Alzheimer’s disease. The fears are often particularly pronounced for anyone who cares for a parent or family member with Alzheimer’s disease. Seeing the daily toll that Alzheimer’s can take on a loved one, and knowing that Alzheimer’s may run in the family, can take a toll on any caregiver’s well-being.

A new study shows that for many people in middle age, worries about a failing memory may or may not be cause for special concern. It found that people over 50 with subjective cognitive decline, or SCD, a nagging sense that the memory is failing even when medical tests do not show signs or symptoms of Alzheimer’s disease, are at increased risk of developing Alzheimer’s disease or other forms of dementia years down the road. But many middle-aged people with memory problems will never develop Alzheimer’s disease, and some could live to 100 with their memory mostly intact.

Earlier studies have established that in older men and women, subjective cognitive decline may be an early sign of Alzheimer’s disease. But most of these studies were conducted in people aged 65 and over. Many seniors in their 70s and 80s who develop dementia sense something is wrong with their memory long before the diagnosis is confirmed by follow-up tests with their doctor. 

This new study looked at younger men and women, aged 50 to 75. For the study, German researchers looked at 6,190 men and women whose median age was 62. At the start of the study, they were asked two simple questions to help assess whether they had subjective memory decline:

  1. Do you have difficulty remembering things that have happened in the recent past (hours to a few days)?
  2. Do you have difficulties remembering things that have happened in the distant past (years to decades)?

A “yes” answer to the first question was an indication of short-term subjective memory difficulties, while the second question assessed long-term subjective memory problems. About one in four of the participants reported being worried about their short-term or long-term memories, or both.

The researchers then assessed study participants’ condition with periodic check-ups over the next 17 years. During this time, 492 of them were diagnosed with Alzheimer’s disease or other forms of dementia.

The researchers found that those who had earlier reported short-term subjective memory problems (a “yes” on question 1) were at increased risk of developing Alzheimer’s disease or other forms of dementia down the road. Among the 492 with a dementia diagnosis, 181 had reported having short-term memory problems. The risk of developing dementia was particularly high in those with short-term memory complaints along with a history of depression.

Long-term subjective memory complaints (a “yes” to question 2), on the other hand, were not associated with an increased risk of developing Alzheimer’s.

But having subjective memory complaints by no means guaranteed a diagnosis of dementia. While subjective memory loss may be a sign of increased risk, the majority of the people who worried that their memory was slipping did not go on to develop Alzheimer’s disease during the 17-year follow-up period.

The findings underscore earlier research showing that while people who have a close relative with Alzheimer’s may have an increased risk of developing the disease, most will never develop it themselves. Many health conditions can affect memory, including thyroid disorders, urinary tract infections, vitamin deficiencies and mood disorders like depression. Prescription medications can also impair memory in some people. The anxiety and stress of caring for a loved one with Alzheimer’s, and the problems with sleep that can accompany it, can take its toll on memory as well.

If you are worried about memory issues, your doctor can perform tests to look for treatable conditions that may be affecting your brain health. Experts also say you shouldn’t be worried about fleeting memory issues as it is also one obvious trait of normal aging. Rather, if the memory loss is sustained over months, or if friends and family are noticing it as well, it may be time for a visit to the doctor.

But remember that while fear of developing Alzheimer’s is common, especially among dementia caregivers, most cases of memory problems will not be a result of the disease. Taking steps to improve brain health, such as doing crossword puzzles and reading, eating a heart-healthy diet, getting regular physical activity, staying socially engaged, and taking time off to relax and to get a good night’s sleep can go a long way in helping to keep the mind sharp into old age.

By ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University. 

Source: Tobias Mollers, Hannah Stocker, Laura Perna, et al: “Subjective Short-term Memory Difficulties at Ages 50–75 Predict Dementia Risk in a Community-based Cohort Followed Over 17 Years.” Age and Ageing, August 1, 2022

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