Sage: Woman wants to know if husband's absent-mindedness is normal – or could it be dementia?

Dear Sage:


This has got to be a new one, even on you! My 69-year-old Dear Husband got up one Sunday morning, started his usual half-hour routine in the bathroom (Lord know what he does in there!) and was cleaning his ears out when his cellphone beeped and he took a call from our daughter. It was just a how-ya-doin’ conversation, and they talked for fifteen minutes. Afterwards, he went out for his morning constitutional – and boy did he make a spectacle of himself! He went down our street, turned at the end, and walked through a crowd of a few hundred churchgoers leaving a service, many of them friends and acquaintances, with a Q-Tip sticking out of his ear and a big hole where his front upper dental bridge was supposed to go! This was the first time I’ve seen such absent-mindedness. Could this be this a sign of dementia?                                                                                                                                                                                                                                            – Upset in Upsala, MN

 Dear Upset:


   You are correct about one thing – the Q-Tip incident is a new one on the Sage! We shall stay away from idiotic puns (‘She told you to stick it in your ear, huh, Joe?’ for example). Not to be insensitive, but there can be quite a bit of humor in forgetfulness, so long as it’s part of the NORMAL aging process. People have sat in the driver’s seat of their car, rifling through their pockets for the key, when it’s already in the ignition … driven off with a coffee cup, a lunch bag and a briefcase on top of the car … wondered where the hell their glasses were – when they were sitting right on their forehead … put the TV remote in the freezer next to the ice cream … left the house while talking on the cellphone with someone and then freaking out because he or she couldn’t find the phone anywhere … and paid for gas and then driven off without pumping it. We could go on and on and on, but we shall stop there.

   Now, the Sage is not a doctor and won’t make any attempt to assess your hubbie’s situation. If you are concerned about strange episodes or a pattern of odd behavior, you should contact your doctor for a diagnosis. But it’s worthwhile to provide information here from various experts to differentiate between dementia / Alzheimer’s versus normal forgetfulness. With the latter, we can all create strategies to live with early memory problems. But that’s often not possible with dementia.

  According to the Mayo Clinic, “Forgetfulness can be a normal part of aging. As people get older, changes occur in all parts of the body, including the brain. As a result, some people may notice that it takes longer to learn new things, they don't remember information as well as they did, or they lose things like their glasses. These usually are signs of mild forgetfulness, not serious memory problems, like Alzheimer's.”

   Beyond these signs, the National Institute on Aging says that certain medical conditions – which are treatable and for which patients should be assessed and tested -- can cause significant memory issues. These include tumors, blood clots, or infections in the brain … some thyroid, kidney and liver disorders … overindulgence in alcohol … a head injury, as from a concussion … medication side effects (this is fairly common with lots of meds) … or lack of healthy foods or vitamins, such as B12. Other medical experts point to emotional disorders (such as depression), stress, diabetes and hypertension as possible causes of memory problems as well.

   Before we explore the research on dementia, let’s focus on strategies for dealing with normal forgetfulness. The Sage himself has learned to put everything he needs in the same place at all times – wallet, car keys, phone, Chap Stick, and, most important, Starbucks card – on the kitchen counter near the garage. Or perhaps you might use a table near the front door if that’s how you exit your home. Similarly, you can put out your pills for a day, or even a week, in the same spot – maybe on a dresser – so that you never forget them. And try listing all appointments, social events and other responsibilities on a calendar. The Sage does this as well, and has made it a routine to actually LOOK at the calendar each evening and morning so that, for instance, the foot doctor doesn’t call and shout, ‘Where the hell are you – you are late for your appointment. Are you trying to grow enough fungus to start a penicillin factory???” He also hates to be late for golf tournaments, which he usually wins because his handicap, while down a couple of hundred points, is still in the mid-500s.

      For other strategies, the Alzheimer’s Association of Canada suggests – in addition to the above – repeating people’s names when you meet so you don’t forget them… keeping your body and mind active (experts generally recommend eating healthy foods, getting plenty of sleep, exercising, socializing, reading the news, thinking positive and doing puzzles, for instance) … and maintaining a routine (such as looking in the mirror before leaving the house to make sure you’ve combed your hair, and you don’t have two feet of dental floss hanging out of your teeth). The Sage, in addition, looks in a body-length mirror to ensure that he is not wearing clothing plastered with half of the previous evening’s Spaghetti alla Bolognese or the half-pint of no-sugar-added triple-chocolate gelato with almonds, cherries and sugar-free hot fudge sauce. But enough about him.

   Now for Alzheimer’s, which is one of the cruelest diseases known to man. The Alzheimer’s Association in the U.S. lists these ten early signs and symptoms of the disease – as differentiated from the typical, non-dementia changes that usually accompany normal aging:

   • Memory loss that disrupts daily life, such as forgetting important dates or events or asking for the same information over and over. Typical non-dementia age-related change: Sometimes forgetting names or appointments but remembering them later.

   • Challenges in planning or solving problems: You can’t work with numbers, follow a familiar recipe or keep track of monthly bills. Typical: occasional errors in balancing a checkbook.

   • Difficulty completing familiar tasks at home, at work or at leisure – perhaps trouble driving to a familiar location, managing a budget at work or remembering rules of a favorite game. Typical change: occasionally needing help to use settings of a microwave or to record a TV program.

   • Confusion with time or place, such as losing track of dates, seasons and the passage of time. Sometimes people forget where they are or how they got there. Typical change: Confusion about the day of the week but figuring it out later.

   • Trouble understanding visual images and spatial relationships, such as difficulty reading, judging distance or determining color or contrast, which may cause driving problems. Typical: visual changes from cataracts.

   • New problems with words in speaking or writing, such as trouble following a conversation. They may stop in the middle of a chat, may have no idea how to continue, or may repeat themselves. Also: vocabulary problems and calling things by the wrong name, such as referring to a bed as a table. Typical: trouble finding the right word.

   • Misplacing things and losing the ability to retrace steps to find them. They may accuse others of stealing. Typical: misplacing things from time to time but retracing steps and finding them.

   • Decreased or poor judgment, as in dealing with money – giving lots of money to telemarketers, for instance. Grooming may suffer. Typical: Occasional bad decision.

   • Withdrawal from work or social activities, such as hobbies, work projects or sports. They may forget how to do a hobby or have trouble keeping up with sports teams. Typical: sometimes getting tired of work, family and social obligations.

   • Changes in mood or personality. They may become confused, suspicious, depressed, fearful or anxious, easily getting upset wherever they may be. Typical: Developing ways of doing things and getting irritable when a routine is disrupted.


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   As for Upset in Upsala, assuming that your husband’s routine was rocked by your daughter’s phone call and he was in the middle of getting ready for the day, it is entirely possible that he simply did not follow a strategy that would have helped him leave the house without forgetting anything – like looking in the mirror. Hopefully he’s fine and will lead a full and happy life. As the Mayo Clinic puts it, “having mild cognitive impairment doesn’t prevent you from performing everyday tasks and being socially engaged” – if he even has that.

   The Sage certainly hopes that this is the case and wishes you both many years of happiness and good health. If either of you has any memory lapses, may they be harmless, normal, and only occasional. Meanwhile, he will schedule an email to himself so that his phone beeps ten minutes after he arrives tonight at the Busted Chuckwagon Barbecue Joint in Dust Ball, Arizona, to remind himself to tuck a massive napkin into his shirt – so that he doesn’t go home wearing a quart of Daddy Sam’s Just Slop It On Bar-B-Cue Sawce.

   Assuming he can find that damn phone …

   Humbly Yours,

   The Sage