One of the most dreaded conditions of aging is Alzheimer’s disease. Many middle-aged individuals joke about their memory and function failures as a way to alleviate their anxiety about these changes. They may also do so for reassurance that their experiences are within the normal range of aging and not the start of a mental decline. How couples deal with these frightening changes can be hurtful or helpful to each of them and their union.
Most people notice some changes in their mental acuity as they age. That is normal and akin to physiological losses such as muscle tone, speed of reflexes, or pace of walking. However, the doubt about whether the mental changes are manifestations of the normal aging process or the start of a more serious deteriorating condition is anxiety producing.
This assessment is not only difficult for laymen, but is often hard for medical professionals as well. According to the Harvard Mental Health Letter “One analysis of participants in a cardiovascular study estimated that 19% of those ages 65to 74, and 29% of those older than 85 had mild cognitive impairment: an intermediate state between normal forgetfulness that occurs with age and the more pronounced thinking deficits that characterize dementia. About 10% to 15% of people with mild cognitive impairment develop dementia each year and at least half develop dementia within five years, most of whom will develop Alzheimer’s disease. Yet, 20-25% of people with mild cognitive impairment regain normal functioning in time and others remain stable.”
Since there is no standard neuropsychological or physiological diagnostic tool to determine who will deteriorate further, stay stable or regain function, the assessment is left to the physician’s judgment based on family members descriptions of the individual’s daily and cognitive functioning. Worrisome signs include significant impairment in job performance, hobby engagement, social or practical skills changes as well as attention, logic, verbal abilities, recall, comprehension or planning deficits.
As a partner, you are in the best position to notice the changes in your mate’s level of functioning. However, it is unwise to highlight these observations to him/her. Since mild cognitive impairment may also cause anxiety, contribute to depression, apathy or irritability, create balance and coordination difficulties, pointing out these symptoms may cause fear that can exacerbate these symptoms.
The most helpful role you can play is to notice, observe and monitor the areas in which you identify changes, so you can later describe them clearly to the treating physician. The Academy of Neurology recommends that once a physician diagnoses a patient with mild cognitive impairment, a follow up visit including available cognitive tests should occur every six to 12 months followed by neuropsychological tests done every one to two years. There are no medications yet specifically approved for mild cognitive impairment, but some are used for Alzheimer’s disease.
Emotionally, observing a partner’s level of functioning deteriorate is disheartening. Yet, it may be no more than a normal aging process or a reversible condition about which you should not become alarmed.
• Treat the changes you observe in your mate with the same optimism you would react to your own changes in functioning.
• Abstain from diagnosing your partner – it is a challenging task even for professionals.
• Be helpful as a monitor and recorder of data to be shared with a physician.
• Do not point out to your mate his/her memory failures or behavioral faux pas.
• Encourage regular exercise and initiate activities that help with language and mental development such as crossword puzzles, scrabble, and other games.
• Take a class together, learn a new language, listen or take music lessons, paint, or undertake new creative hobbies.
• Read the same book, articles, listen to lectures or educational programs and discuss them with each other.
• Remember to treat your mate with the same love and kindness you would want to receive.