Alzheimer’s disease remains the biggest fear many of us have about growing older, but for most people with dementia, the symptoms did not show up all at once. Instead they started appearing gradually, often in the form of what physicians refer to as MCI, or mild cognitive impairment. This condition, regarded as a precursor to Alzheimer’s disease in about 50 percent of cases, is usually measured by a battery of tests to gauge the patient’s cognitive function. But now a new research study out of the University of California San Diego School of Medicine has demonstrated that the process of evaluating for MCI may be flawed, and women with the condition may be frequently misdiagnosed.
Why Do Women and Men Receive the Same Tests for Mild Cognitive Impairment?
We found this article, written by journalist Eve Glicksman, here on the NextAvenue website. It paints a troubling picture about a testing protocol that may be under-diagnosing mild cognitive impairment in women and over-diagnosing it in men. The underlying cause is a basic gender-based difference: women generally outscore men at all stages of life on verbal memory tests, but when evaluating for MCI, men and women typically receive the same battery of tests. The UCSD study speculates that women’s strength in verbal recall might be masking early symptoms of cognitive decline.
According to Glicksman’s article in NextAvenue, UCSD researchers administered cognitive assessments to nearly 1,000 adults between the ages of 55 and 90, and they also reviewed the subjects’ brain scans. In the study, the results of which were recently published in the medical journal Neurology, the goal was to use the brain scan to measure the amount of plaque found in the subjects’ brain tissue – a telltale sign of Alzheimer’s disease – and compare their findings against cognitive test scores. The result was a clear difference between male and female subjects. “The researchers found that women with the same level of Alzheimer’s-related brain changes as men still scored better on memory tests,” says NextAvenue. But once the testers adjusted the verbal memory scores for gender, the overall outcome changed. Under the new testing protocol, the number of women with mild cognitive impairment increased by 10 percent, while the number of men with MCI dropped by 10 percent.
Women Can Compensate for Mild Cognitive Impairment with Better Verbal Skills
In the opinion of one of the leaders of the UCSD study leaders, “the results suggest that women are able to compensate for early dementia through their superior verbal skills,” says NextAvenue, which can result in a diagnosis that comes at a later stage in the progression of dementia. Doctors speculate that this could also explain why women, once diagnosed, tend to decline at a more rapid rate than men: if the diagnosis comes late, the deterioration appears to progress faster.
Doctors caution that it can be challenging to differentiate between what NextAvenue calls “normal age-related cognitive decline” and true mild cognitive impairment. One doctor told reporter Eve Glicksman that she is frequently contacted by otherwise healthy and high-functioning patients who become worried when they notice a decline in their mental sharpness in midlife. “They have high expectations and intolerance of the normal slowness of thinking that happens to everyone,” she said. She cites the case of one 57-year-old professional woman who started to worry about her own memory loss. After a battery of cognitive tests, this patient received her diagnosis: she was in fact suffering from nothing more than “age and overload.” She was able to slow down a bit, ease her stress, and keep on working. The article also cites other studies that show that the cognitive abilities of women in midlife are more affected than their male counterparts by stressful life experiences.
There Aren’t Many Treatment Options for Mild Cognitive Impairment
Once patients are diagnosed with mild cognitive impairment, treatment options are limited, especially if further testing shows the condition to be a precursor to Alzheimer’s disease. Aerobic exercise and better, deeper sleep appear to slow the progression of cognitive decline and can have a protective effect on memory. But as the article cautions, “there is no scientific evidence that cognitive training, diet, medications or supplements can improve memory or thinking.” Instead, patients should focus on taking care of their overall health, improving their quality of life, and getting regular testing to monitor symptoms. “For some people,” says NextAvenue, “MCI never worsens.” They simply find ways to adjust and live life successfully.
In our view here at AgingOptions, this article is one more strong piece of evidence that every senior adult should have a geriatrician as his or her primary care physician. Standard medicine tends to do a mediocre job of dealing with the unique health needs of aging adults, and if you are relying on one-size-fits-all medical care you may be putting yourself at risk. By placing yourself in the hands of a board-certified geriatric physician, you’ll have a trusted professional who will take the time to get to know you and understand all aspects of your life more fully. Then if you need testing or a prescription, your doctor will ask the right questions and know what to watch out for. We encourage you, if you haven’t already done so, to contact our office and allow us to refer you to a geriatrician in your area.
The Right Approach to Retirement Planning
It’s good to feel like we’re “on top of things” as we grow older, but unfortunately a positive mental attitude alone is not enough to protect you in retirement. Instead, what’s needed is an overarching retirement plan that is comprehensive and multi-faceted. For example, you may think your financial needs will be met over the coming ten, twenty or thirty years – but do you have adequate legal protection in place, which is much more than a simple will? Is your family fully aware of your hopes and desires as you age and will they be there for you? Have you considered your best options for medical coverage and your best housing plan, so you’re prepared for whatever the future may hold? If this seems like a lot to accomplish, we have terrific news: all these interconnected components are part of an AgingOptions LifePlan, a uniquely comprehensive, robust retirement planning strategy. Only AgingOptions offers it.
Why not make it your goal as the New Year approaches to find out more by attending a free LifePlanning Seminar with Rajiv Nagaich? Let Rajiv explain the process and answer all your questions in a lively, information-packed session – then the next steps will be up to you, with no obligation and no pressure. Visit our Live Events page for a current calendar of seminars, and then register for the date of your choice. Let’s make this the year when you really begin the journey toward the retirement you’ve always dreamed of enjoying. Talk about a positive mental attitude! And meanwhile, age on!
(originally reported at www.nextavenue.org)