Forgetful? Don't Assume It's Alzheimer's Disease

From the WebMD Archives

July 10, 2000 (Washington) -- Persons who consistently misplace car keys or are "putting money in the sugar bowl" have mild memory deficit, but probably less than half of people with these symptoms actually have early Alzheimer's disease, says a team of researchers from Denmark. Gunhild Waldemar, MD, PhD, says, "Twenty percent of these people have memory problems that are caused by other conditions which can be treated and thus reverse the memory deficit."

Waldemar says that among persons with reversible memory problems, the most frequent cause is depression. She tells WebMD that when people are depressed, they have difficulty concentrating and that lack of concentration leads to forgetfulness, which is often alarming to the person experiencing it. She adds that many people are reluctant to seek help because they fear they are developing dementia. This fear, she says, leads to unnecessary delays in diagnosis.

Waldemar, reporting her findings at the World Alzheimer Congress 2000 in Washington, says, "Some conditions mimic Alzheimer's disease, and that is why it is important that patients with memory deficits be referred for a full evaluation by specialists." Waldemar is director of the Memory Disorders Research Unit of the Neuroscience Center at Copenhagen University Hospital in Denmark. She says that patients referred to the unit are given a systematic examination including medical history, physical examination, blood tests, and brain imaging.

Waldemar and colleagues reported on almost 800 patients who were referred over a 40-month period. The average age of the patients was 64, but the range was "from the 20s through the 90s."

She says that a typical group of 10 patients would break down this way: About one and a half would be "healthy, worried adults," two would have a treatable condition like depression or thyroid disease, and two would have memory disorders or disorders of their ability to function that would be considered stable but might progress to Alzheimer's disease. And "four and a half have progressive dementia," she says.

Additionally, about 35% of the Alzheimer's patients also have depression or another disorder that can make the symptoms of Alzheimer's more severe. She says that among Alzheimer's patients, treating these secondary conditions will improve the ability to function.

Waldemar says that the "20%-reversible dementia rate is very applicable worldwide."

Bill Thies, PhD, vice president for medical and scientific affairs at the Alzheimer's Association, tells WebMD that Waldemar is probably correct. He says that this is the group they want to target for identification and early treatment if the condition is indeed early Alzheimer's, but that they also need to find those people who have other conditions so they can be treated. The problem, says Thies, is that many people are reluctant to seek medical help for these symptoms.

Ronald C. Peterson, MD, PhD, also feels that Waldemar's numbers are probably on target. He says that the study is important in terms of reminding American physicians that there are treatable causes of memory loss. Peterson is professor of neurology at the Mayo Medical School in Rochester, Minn.

In addition to depression as a reversible cause, Waldemar says, "Thyroid disease and nutritional problems were also identified as a cause of mild memory disorders." Another cause was a problem with brain-fluid circulation, which is corrected by surgery. A small number of patients also had alcohol dependence as a cause, she adds.

Waldemar says the current study was "just an identification study. We have no data on the effect of treatment." She says, however, that she and her colleagues are now conducting a treatment study.

Vital Information:

  • Researchers from Denmark report that in their test group of patients showing minor memory problems, Alzheimer's disease was to blame in fewer than half the cases. About 20% of the patients had problems that could be reversed with treatment.
  • Experts note the 20%-reversible rule is probably true the world over. Depression is the most common reversible culprit, but thyroid disease, stress, and a brain-fluid circulation problem also can mimic Alzheimer's disease.
  • People often fear telling their doctors about the symptoms they may be experiencing, but experts say it's important to seek help because, many times, treatment can be successful.