Memory loss can sneak up on families. Those with early and mild decline changes are adept at coping. Furthermore, others don’t notice until changes are more dramatic. You can even fool yourself. For example, you notice a “senior moment” and ask your friends and they often report the same problems. But how do you know a senior moment from beginning memory loss? The overlap between normal changes of aging and mild memory loss is substantial.

There is a push for early detection of dementia including the addition of memory screening as part of Medicare’s annual wellness program. The problem is that the recommendations don’t go far enough for two reasons. First, the screenings are too superficial to find truly early changes. Consider a screening consisting of telling someone three random words that they are to recall later. The words are followed by the task of drawing the face of a clock with all of the numbers. Then make the time set the time to be something like “ten minutes after eleven.” By the time you are forgetting words on such an easy task, you have lost your advantage to be proactive, often by years.

Second, the objective should not be to detect dementia. By the time the condition is severe enough to be called dementia, you are no longer in control. Alzheimer’s disease takes decades to unfold and in the earliest changes cannot be detected by screenings like described above. Your physician can’t tell by talking to you. You do not yet have the warning signs of Alzheimer’s disease. The problem is that a progressive decline like Alzheimer’s disease usually starts with increasing problems with short-term memory (i.e., the ability to learn something new). Habits, routines, and long term memory work just fine. You must be challenged to show the changes and three or even ten words are not enough.

The good news is that early detection of memory loss is easy. As with cancer we should not wait too long to determine if there might be a problem. The good news is that there are tests – memory tests – that work just like blood work. They measure strength of memory. They don’t hurt – no one has yet fainted on me. You cannot pass or fail. There are at least two ways to examine the brain. Take a picture of what it looks like by having an MRI or CT scan. That’s all well and good but I am more concerned about what my brain can do than what it looks like. The second way to examine a brain is to do a memory test which allows direct measurement of what the brain can do. Don’t wait for dementia to set in. Get your memory evaluated now. There is so much you can do if you act early and make memory evaluation (not screening) part of your wellness program.