Tuesday, June 25, 2013

Middle Age, Menopause and Alzheimer's

Several of us in the office are in menopause and we sometimes joke about the toll the change of life is taking on our bodies and on our brains. There are the ill-timed hot flashes during meetings. The more frequent trips to the restroom. And then there's that fuzzyheadedness we term "menopause mind."

menopauseKaren Cozakas of Placerville was in her mid-50s when a co-worker started to sense something was amiss and attributed Karen's repeated questions to menopause. But then she started to bounce checks because she could no longer track her finances and that put the memory lapses into an entirely different category.

"It seemed everything was going fine, and all of a sudden, everything seemed to shift," Karen told a reporter for a Sacramento Bee article. "It came on me so fast. Well, to me, it seemed fast. It seemed funny. I forgot little things here and there, but the little things got bigger and bigger. And all of a sudden, we were in a bigger place."

Karen was 56 when she was diagnosed with MCI, the second of three stages of Alzheimer's Disease. Only 4 percent of people diagnosed with Alzheimer's Disease are believed to be under age 65, and as such people like Karen and another profiled Alzheimer's patient, David Schooley of Sacramento, are misdiagnosed by their primary care providers.

In David's case, because he'd lost his job twice, his doctor thought he was depressed when he began to act withdrawn and confused.

Rather than immediately think of a dementia-related disease to account for the symptoms, physicians instead turn to depression or menopause or pain medications, vitamin B12 deficiency, thyroid conditions or an infection. All of these can also cause memory loss, as can cardiovascular diseases like diabetes.

"Many providers find it hard to believe that someone so young could have dementia or Alzheimer's," said Elizabeth Edgerly, the Alzheimer's Association of Northern California's chief program officer, in that newspaper article. "It's really difficult. People in their 50s are misdiagnosed with bipolar disorder or depression or even midlife crisis. Or they're told, 'Of course, you have memory problems. Who doesn't?' "

And, of course, the person and family may wish that something else is the cause because those ailments are more easily treatable and not terminal. But delayed diagnosis for Alzheimer's also may have its own consequences. For instance, we're learning that medications are most effective in the earlier stages of the disease. Once full-blown dementia sets in, drugs may not work well.

This is not to suggest that friends and family who seem to behave strangely may have dementia, but do not discount the symptoms - "He's just having a midlife crisis." - if they persist. Even if it turns out to be depression or diabetes or even menopause, it's good to know and to take proactive measures to stay well.

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