I read yet another newspaper article on Alzheimer’s disease touting “early diagnosis.” Now that it is clear that brain changes of Alzheimer’s disease develop decades before there are symptoms, the push is to make a medical diagnosis well before there are any symptoms. Furthermore, if we pursue this strategy, many (based on current data as many as 30%) will be diagnosed who will never develop symptoms. We will instill fear and hopelessness needlessly.

“Alzheimer’s disease’ a label that has no usefulness in the real world. Everyone with Alzheimer’s disease does not become demented. The label provides a false level of understanding along with an expectation that there is nothing that can be done. There are effective treatments for memory loss but they are not medical and therefore undervalued. Furthermore, a diagnosis should direct you to actions that tell you what to do. What do you do if you are diagnosed with Alzheimer’s disease?

The question is wrong. Ask instead what is the primary functional change that marks most progressive mental decline? The answer is that there are progressive changes in short-term memory – the ability to learn new information. The better approach is to target measuring short-term memory. If I am told that I have Alzheimer’s disease, there is no direct action to take. On the other hand, if I am told that I have changes in short-term memory, it is clear what to do.

If I have short-term memory loss, I can develop strategies that engage long-term memory. Memory loss occurs well before dementia. Do this while you are still in control of your future. It allows you to be proactive. You can get ahead of progressive memory loss. You can be proactive rather than reactive about your future. This proactive plan should be a part of advanced directives.

Simply, the plan needs to include family, as they need a say in the details. In addition to legal directives, the plan should address how to monitor ability to do complex and simple finances and cooking as well as how to transfer decision-making powers before they are compromised. The plan should advise on how to monitor driving, how to initiate cessation of driving, and how to have a life if I can no longer drive.

The plan should also direct others on how to make my life good even if I can’t remember what I just did or what to do next. If I am reduced to living in the moment, I need to make those moments joyful either by doing or reminiscing about the things I love. As I always tell my audiences, don’t make me play bingo. I’ll get ornery. Instead, I love to travel. Visit museums. Watch movies. Walk in the mountains. Play with my cats. Build my life around my retained interests and skills for as long as possible. I should put this plan in writing now in case I need it in 10 years. The objective is to have a good life even if my memory fails.