Memory lapses may indicate cognitive problems

Older individuals' complaints about memory lapses such as having trouble remembering recent events may indicate that they are experiencing cognitive problems that are greater than typical age-related changes. These findings, which are published today in the Journal of the American Geriatrics Society, indicate that primary care clinicians, who are often the first to see patients who are worried about their memory, should be aware that such complaints might be indicative of something serious and warrant a further cognitive assessment.

Because the number of U.S. adults aged 65 years and older is projected to nearly double over the next two decades, the incidence of Alzheimer's disease and other dementias is also expected to rise. In response, clinicians are incorporating cognitive screening tests as part of annual wellness visits for older people, and researchers are looking for simple ways to identify older individuals who may benefit from additional cognitive evaluations.

To see if certain memory complaints might be linked with potentially serious problems related to memory and thinking, investigators telephoned 16,964 older women (average age of 74 years) and asked them seven questions related to memory complaints, followed by various questions that assessed cognitive function.

Investigators found that, in general, the more memory complaints older individuals have, the worse off their cognitive functioning is. However, not all complaints are related to cognitive decline. For example, a "yes" answer to the question "Do you have much more trouble remembering things from one second to the next?" did not relate to cognitive impairment but was associated with normal aging. By contrast, a "yes" to the question "Do you have trouble finding your way around familiar streets?" was highly associated with cognitive impairment.

"These findings suggest that clinicians may need to differentiate between the types of memory complaints their patients have, as some are likely due to normal aging whereas others are worrisome for possible cognitive decline," said Dr. Rebecca Amariglio of Brigham and Women's Hospital and Harvard Medical School, one of the study authors.

This will be particularly important as the incidence of Alzheimer's disease increases and therapies for the disease become available.