I have believed for years that Alzheimer’s disease and related disorders are present for decades before a medical diagnosis can be made. A newly published study confirms my belief.

The study focused on healthy, independently living persons 40 years or older who were cognitively normal. Nearly 80 percent of the participants expressed concerns about decline in their memory (“Worriers”); the rest reported that they felt they had normal memory (“Nonworriers”).

The two groups were similar in education and ratio of men to women. The average age of participants was about 65. Interestingly, all participants did very well on the Mini-Mental State Exam. The exam is very commonly used in research and clinical practice to screen for dementia and memory loss and has a perfect score of 30 points. Participants average score was 29 (a score that can lead to false reassurance).

Nearly half of the participants declined cognitively by the end of the study after 7 years. A greater proportion of the worriers (54.2 percent) declined than the nonworriers (14.9 percent). Eighty percent of worriers were diagnosed with Mild Cognitive Impairment (objective decline in memory on rigorous testing). In short, cognitive decline occurs many years (as many as two decades) before there is a decline serious enough to be labeled as dementia (severe enough that independently living is not safe).

The investigators suggest that these findings raise the “possibility of preventative research.” I feel the findings tell us so much more. First, current medical screenings are not adequate. By the time that one is losing even a point on the Mini-Mental State Exam, changes may have been occurring for several years.

Second, your intuitions about your memory are good. If you think there are changes, get a rigorous evaluation to establish a baseline and make memory evaluations as common as physical exams. Be as proactive about your memory as you are with monitoring blood sugars or blood pressure.

Third, you don’t have to wait until the medical world finds a treatment. Treatment begins with the use of external memory supports and management of life style. We don’t wait until we are 80 to start saving for retirement but we wait until we have substantial changes to address our memory.

Treat changes (whether they be senior moments or more) in memory early. Use your calendar well. Get a digital watch for orientation. Put everything in its place. Make a plan to stay involved in your passions. Quit trying to remember. Plan on how you will remember. Don’t wait until you forget that you forget.