Alzheimer’s or Normal Forgetfulness: How to Tell the Difference

*The following is the output of transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors.

The following podcast is provided by a Thera Farma and answers for elders radio and welcome everyone to answers for alders radio network. And we are here working again with a theory of Farma and we are so proud to be working with this organization because they are basically a clinical resource research organization that works with the top doctors based on memory care, memory issues like Alzheimer’s, dementia, you know, Parkinson’s disease, anything that has to do with brain functionality, I guess, is a probably a better term. And you know, I’m kind of like the most lucky person in the world in our industry because I get to interview some of these amazing doctors that they work with. And guess what, you’re going to all get to meet one of them today and he is missed. His Dr Michael Mega, and you’re with the Senator Center for Cognitive Research. Is that correct, Dr Mega High Suozing? Yes, Center for cognitive health in Portland. Cognitive hit hell. I’m a cognitive neurologist and I specialize in disorders of thinking. So it could be from head trauma, it could be from stroke, could be from degenerative brain diseases. Yeah, so, yeah, in general, thinking issues are my cup of tea. Well, you know what, I think we all need a lot better intellectual I. thinking wellness, and there’s obviously there’s a lot of things that we think about as we’re starting to age. Of you know, what’s the difference between natural aging, obviously, and how Alzheimer’s and dementia kind of creeps into our world, and you’re kind of the expert in that. So, Dr Mega, I’m so glad you’re with us on the show today because I love going back to basics and a lot of times we talk about, you know, all these different functions like, you know, Parkinson’s and Alzheimer’s and all these different things. But really I love that you’re willing to kind of break it down from the beginning and tell us a little bit about, you know, how do thinking issues happen and how do you tell the difference? Yeah, that’s a good question. Many people who come to my clinic worry is what I’m experiencing now part of normal aging, or is it righting of something worse? And so what we do is try and help them understand the difference between normal age related memory problems that we write yet and the beginnings of Alzheimer’s disease. And here’s a simple example. So Alzheimer’s disease, for example, has a distinct memory issue that is called a failure to learn new information. And how do we see that on fold in our lives compared to normal age related forgetfulness? Okay, so when we go to the store, if we have the list of the items in mind and we simply can’t recall the last few things because we forgot our our list of of shopping items at home, that’s me. That is normal a related memory problems to simply be forgetful. However, if we ask the same question to our spouse over and over again and they are giving us the answer, but yet we cannot learn what that answer is, that is abnormal. So the failure to learn new information is what we call Amnesia, the inability to encode new information, which is always abnormal and completely different from the simple forgetfulness that happens with normal age related changes. Yeah, so you can do this on your family and friends at home by simply giving a list of unrelated words to them for them to encode. And so it can be words that are just simple category items nouns like apple, baseball, Chevrolet, rows belt blue and have them at least risk. Repeat those were words after you over three trials. A normal person will first come up with two or three of them on the first trial, then after the second trial, four or five of them, and then after the third trial, pretty much all of them, and then after a delay, you can fill in some other fun things to do that we like to do, like, for example, some mental math. Or a quick test that’s very sensitive is naming as many animals that you can think of in one minute. And now most people with a high school education at the age of seventy five or older can come up with at least eighteen animals in one minute. They have to be different animals. This is a very good test of language function and the speed of processing in terms of searching the lexicon of where words live in our brain. Yeah, and then after you’ve done that, that’s called interference for the learning test, ask them what those list of words that you gave them were, and the normal eighty five year old will come up with seven of those words. If it’s under three, that’s abnormal. But you haven’t answered the question of whether forgetfulness is the cause of not recalling those words versus the failure to learn new information. Yes, so you figure that out by giving them category clues or multiple choice clues for the words that they did not spontaneously recall. So, for example, the words I gave Apple, baseball, Chevrolet, rose belt blue. If those, let’s say, they didn’t come up with any of them, you give them a category clue. One of the words was a sport. Oh, a sport. MMM, it was either baseball, basketball or football. Pick one, oh, it was baseball. That’s it. Yeah, so that means that the information got in, but they just needed help pulling it out, which is what’s called a retrieval deficit or forgetfulness, and that’s normal for aging. Another of the words was a make of automobile. Oh, Chevrolet. Oh, see, you prove that the information is pay but it just wasn’t able to be pulled out. So that is the difference between normal age related forgetfulness versus the failure to encode or learn new information. And even in your s or your S, you should always be able to learn new information, even though you can forget or have problems retrieving it. That’s so, that’s that’s basically the difference between age related memory impairment versus the failure to learn or encode new information. Wow, and so that’s how we just determine the type of memory problem that people might be experiencing in the clinic. Yeah, furthermore, for dementia to be present, we had asked a family member whether or not the person’s function is so impaired that they are no longer safe living by themselves. The failure to be able to live safely independently is the definition of dementia. Dementia is not a disease. Dementia interest is a functional state of being able to independently exist, pay the bills, knew the shopping, not burn down the house and keep the shysters at bay. And so if a person cannot safely exist independently, that then is the definition of having dementia. And dementia caused from vitamin deficiencies, stroke, tumors, head trauma, Alzheimer’s disease or Parkinson’s disease. So, so many people, when they come to the clinic, they say, oh my gosh, dementia is Alzheimer’s disease, isn’t it? Dr Mega, and I say no, no, dementia can be caused by a reversible thyroid problem or a reversible nutritional deficiency. So you can see that dementia is a legal term of incompetence versus the various causes for it. Interesting, interesting and obviously with different farms in the way you test people, you can kind of determine probably in an initial evaluation, okay, this person, this is normal aging or this is specifically Alzheimer’s disease. And obviously then there’s a whole other side of it with this Parkinson’s disease, and then there’s a different form of dementia that can be common with that and that’s called Louis Body dimension. Am I correct on that one? Yes, very good, Susan. You’ve been doing your homework, I see. Well, I would hope so, but I’ve certainly I know enough to be dangerous, as they say. So as you’re treating someone and going through that, you know obviously an initial diagnosis is important, but you know the treatments are very different. But I’m sure that there’s also some commonalities. Where you’re talking about cognitive decline, you know different things. Could you give an example of how those manifest in each one? I’ll like if they do have a progression of it is very good. So in people who have Alzheimer’s disease, the characteristic of the cognitive profile is quite different compared to people who have Parkinson’s disease, whereas Louis Body disease is sort of in between shelzheimer and Parkinson’s spectrum. Right that a patient will have kind of a blending of the cognitive issues that are seen in Alzheimer’s and in Parkinson’s. But let’s just separate Alzheimer’s from Parkinson’s very clearly. In people with Alzheimer’s disease we see prominent problems with the failure to encode new information. As we said, that’s the definition of Amnesia, whereas in people with Parkinson’s disease it’s a an exaggeration of the normal age related failure to retrieve information. They will encode it. In fact, sometimes I have in the word list that I give my Parkinson’s patients them calling me up the next day and saying, Oh, oh, one of the words I forgot was baseball and show yeah, and belt and I go yeah, that’s good, because what they have is is an exaggeration over the retrieval deficit they encode the information, but they have problems even worse than normal aging retrieving that information. Right. Think that distinguishes them. The and this was a classical distinction that was done decades ago, is that Alzheimer’s disease is considered a cortical dementia because it also affects our visual spatial function and our language function, whereas Parkinson’s disease is considered a subcortical or deep in the brain what’s called the Basil Ganglia, a subcortical dementia because it has a failure to retrieve information and also a slowness in processing thoughts as well as a slowness in problem solving. Just like Parkinson’s patients can be slow motorically, they also are slow cognitively, and so, consequently, a subcortical dementia, Parkinson’s disease distinct from a cortical dementia that has prominent visual spatial problems and prominent language problems in Alzheimer’s. So those who are distinctly different. Yeah, that’s good, and we’re going to talk a little bit about the treatment for the disease and also about a special trial that we are running, or are a theory. Farma and Dr Mega are is a part of and for those of you that are interested, please go to, and I’m going to give some websites out, www dot lift ad trialcom. That stands for lift ad, like Alsheim Alzheimer’s Disease Trial, Tria Lcom, or you can go to https colon double slash, and then it’s shape trialcom and Dr Mega and I will be right back right after this. The preceding podcast was provided by a Thera farmer and answers for elders radio. For more information about the Alzheimer’s clinical trial, go to a thera clinical trialscom were