Normal Cognitive Losses
Posted 10/19/2012
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I have had several conversations this week about "chemo brain". Many of us are all too familiar with that foggy feeling and some of us contend with diminished mental acuity for a long time. It always, or almost always, improves with time, but the worries may persist. Through the years, I have known only a handful of women who felt that their chemo-related difficulties with memory and general sharpness really messed up their lives. Two were accountants and, years apart from one another, described the identical experience of staring at computer screens of numbers that suddenly seemed meaningless. I recall one other woman, a surgeon, who gave up her practice several years after breast cancer treatment as she never felt fully recovered. Clearly, her patients needed her to be at least 100% competent, and she worried that she could not deliver.
For most of us, however, this is a less serious problem--more of the frustrating, rather than the distressing variety. We may have trouble with word finding or remembering names. The name part has a special twist for me. Although I have the standard trouble with names (meaning that I always remember peoples' stories, but sometimes forget names), my work delivers an additional difficulty. Not infrequently I run into someone in a hospital hallway who warmly greets me by name. She looks familiar, but I have no idea who she is. The problem: I only knew her bald, either wearing a wig of hats/scarves, and the woman in front of me with medium length blond hair does not look like anyone I know. A request: please, if we see each other, especially after years, tell me your name!
These comments were stimulated by this article from MedPage Today that describes normal cognitive losses that occur with normal aging. It suggests that increasing numbers of patients present with some memory issues, and that for 99% of us, these are not warning signs of horrific dementia. Nor can they always be attributed to chemo brain.
More Patients Presenting with Memory Issues
PHILADELPHIA -- As the population ages, more patients are concerned about memory impairment, but only about 1% will have a progressive cognitive problem, a researcher said here.
The challenge for primary care doctors is how to handle this large segment of the population who are experiencing natural cognitive aging rather than dementia or Alzheimer's disease, according to Tom Rosenthal, MD, chair of department of family medicine at the University of Buffalo, in Buffalo, N.Y.
"One of the most important things to know is that the brain has plasticity. The healthy, undiseased brain with adequate blood flow will change in form, but also in its ability to function, with exercises aimed at increasing brain power," Rosenthal said at the annual meeting of the American Academy of Family Physicians.
Speaking to a standing-room-only crowd of several hundred people, with scores more watching remotely in adjacent rooms, Rosenthal detailed a few studies that demonstrated the flexibility of the brain.
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