If you're worried about your memory, maybe you shouldn't be.
If your wife or husband is worried about your memory, that's another story.
A study from Penn Medicine, which was presented last week at the American Academy of Neurology meeting in Philadelphia, found no correlation between progressive cognitive decline and people’s worries about their own memories.
But proxies — usually spouses — were much better at identifying cognitive changes that progressed to mild cognitive impairment or dementia over the two years of the study, said Dawn Mechanic-Hamilton, a neuropsychologist who is director of cognitive fitness programs and neuropsychological services at the Penn Memory Center. She worked with David Wolk, co-director of the memory center, and Leah Zuroff, a medical student, on the study, which has not yet been published.
Other recent studies that have explored whether people who think they have cognitive changes are at heightened risk for dementia have had mixed results, so the worriers among us can't relax completely just yet.
Mechanic-Hamilton said the Penn study results support the importance of including someone who knows you well when your memory is being evaluated. Penn Memory Center always asks that a proxy attend meetings with the patient. If that's not possible, Mechanic-Hamilton asks for permission to call a family member or close friend.
The study involved 540 pairs of subjects and informants whose perceptions were compared with the results of cognitive tests. The pairs agreed most closely when the subject had mild cognitive impairment, but the subjects’ reports still didn’t correlate well with their actual performance. Normal subjects were more likely to worry when their proxies thought they were fine. The reverse was true when the subjects actually had Alzheimer’s disease.
Mechanic-Hamilton said the normal worriers did have slower processing speed, a common age-related change that is not a harbinger of dementia. They may have perceived that their memory was worse when their brain was actually just working more slowly. Mechanic-Hamilton said people in this group were often still in the work force and finding it harder to keep up in fast-paced environments. Their memories actually were working, but their ability to search for information and find it was not quite as good as it used to be.
The worriers were also more likely to be depressed. Depression, she said, is itself associated with cognitive problems, particularly processing speed and executive function. Previous work has shown that worries about memory are, not surprisingly, more common in people with anxiety.
Mechanic-Hamilton said it’s “really important to be assessing for depression” in people with memory complaints. Their thinking could improve with cognitive behavioral therapy (CBT), a form of talk therapy designed to change thinking patterns, or a combination of CBT and medication. People with memory problems should steer clear of treatment with benzodiazepines.