Alzheimer's, Dementia & Mental Health
Drowsiness, Staring, Other Mental Lapses by Senior
Citizens May Signal Alzheimer's Disease
Seniors with mental lapses were 4.6 times more
likely to have dementia than those without mental lapses
Jan. 18, 2010 - Older people who have "mental
lapses," or times when their thinking seems disorganized or illogical or
when they stare into space, may be more likely to have Alzheimer's
disease than people who do not have these lapses, according to a study
published in the January 19, 2010, print issue of Neurology, the
medical journal of the American Academy of Neurology.
These mental lapses, also called cognitive
fluctuations, are common in a type of dementia called dementia with Lewy
bodies, but researchers previously did not know how frequently they
occurred in people with Alzheimer's disease and, equally important, what
effect fluctuations might have on their thinking abilities or assessment
scores.
The study involved 511 people with an average age
of 78. Researchers interviewed the participant and a family member,
evaluated the participants for dementia and tested their memory and
thinking skills.
Cognitive fluctuations include excessive daytime
sleepiness, staring into space and disorganized or illogical thinking.
"If you have these lapses, they don't by themselves
mean that you have Alzheimer's," says senior author James Galvin, M.D.,
a Washington University neurologist at Barnes-Jewish Hospital.
"Such lapses do occur in healthy older adults. But
our results suggest that they are something your doctor needs to
consider if he or she is evaluating you for problems with thinking and
memory."
People with three or four of the following
symptoms met the criteria for having mental lapses:
● Feeling drowsy or lethargic all the time or
several times per day despite getting enough sleep the night before
● Sleeping two or more hours before 7 p.m.
● Having times when the person's flow of ideas
seems disorganized, unclear, or not logical
● Staring into space for long periods
A total of 12 percent of the people with dementia
in the study had mental lapses. Of 216 people with very mild or mild
dementia, 25 had mental lapses. Of the 295 people with no dementia, only
two had mental lapses.
Those with mental lapses were 4.6 times more likely
to have dementia than those without mental lapses. People with mental
lapses also tended to have more severe Alzheimer's symptoms and perform
worse on tests of memory and thinking skills than people who did not
have lapses.
"When older people are evaluated for problems with
their thinking and memory, doctors should consider also assessing them
for these mental lapses," said Galvin, a member of the American Academy
of Neurology.
Lewy body dementia, which causes clumps of proteins
known as Lewy bodies to form in neurons, is thought to be the second
most common form of dementia after Alzheimer's. Clinically, it can
overlap with Parkinson's disease and Alzheimer's disease. Pronounced
cognitive fluctuations are a hallmark of Lewy body dementia, as are
visual hallucinations and rapid eye movement behavior sleep disorder.
Galvin suggests that further study is needed to
determine the best way to include mental lapses in diagnostic procedures
for Alzheimer's.
The study was supported by the National Institute
on Aging.
Sources:
The American Academy of Neurology, an association
of more than 22,000 neurologists and neuroscience professionals, is
dedicated to promoting the highest quality patient-centered neurologic
care. A neurologist is a doctor with specialized training in diagnosing,
treating and managing disorders of the brain and nervous system such as
Parkinson's disease, ALS (Lou Gehrig's disease), dementia, West Nile
virus, and ataxia. For more information, visit
http://www.aan.com.
University School of Medicine's 2,100 employed and
volunteer faculty physicians also are the medical staff of Barnes-Jewish
and St. Louis Children's hospitals. The School of Medicine is one of the
leading medical research, teaching and patient care institutions in the
nation, currently ranked third in the nation by U.S. News & World
Report. Through its affiliations with Barnes-Jewish and St. Louis
Children's hospitals, the School of Medicine is linked to BJC
HealthCare.
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