我的老年期是癡呆的開始嗎?

我的老年期是癡呆的開始嗎?

The number of cases of dementia in the US is rising as baby boomers age, raising questions for boomers themselves and also for their families, caregivers and society. Dementia, which is not technically a disease but a term for impaired ability to think, remember or make decisions, is one of the most feared impairments of old age.

隨著嬰兒潮一代年齡的增長，美國的癡呆癥病例數(shù)量正在上升，這給他們自己、也給他們的家庭、照顧者和社會帶來了問題。從技術(shù)上講，癡呆癥并不是一種疾病，而是一種思維、記憶或決策能力受損的術(shù)語，它是最令人擔憂的老年障礙之一。

Incidence increases dramatically as people move into their 90s. About 5% of those ages 71 to 79 have dementia, and about 37% of those about 90 years old live with it.

隨著人們步入90多歲，發(fā)病率急劇上升。71至79歲的人中約有5%患有癡呆癥，90歲左右的人中約有37%患有癡呆癥。

Older people may worry about their own loss of function as well as the cost and toll of caregiving for someone with dementia. A 2018 study estimated the lifetime cost of care for a person with Alzheimer's, the most common form of dementia, to be US$329,360. That figure, too, will no doubt rise, putting even more burdens on family, Medicare and Medicaid.

老年人可能會擔心自己功能的喪失，以及照顧癡呆癥患者的成本和費用。2018年的一項研究估計，阿爾茨海默氏癥(最常見的癡呆癥)患者的終生護理費用為329,360美元。毫無疑問，這個數(shù)字還會上升，給家庭、醫(yī)療保險和醫(yī)療補助增加更多負擔。

There has also been a good deal of talk and reporting about dementia in recent months because of the US presidential election. Some voters have asked whether one or both candidates might have dementia.

由于美國總統(tǒng)大選，近幾個月來也有很多關(guān)于癡呆癥的討論和報道。一些選民問是否有一個或兩個候選人可能患有癡呆癥。

But, is this even a fair question to ask? When these types of questions are posed -- adding further stigma to people with dementia -- it can unfairly further isolate them and those caring for them. We need to understand dementia and the impact it has on more than 5 million people in the US who now live with dementia and their caregivers. That number is expected to triple by 2060.

但是，這是一個公平的問題嗎?當這類問題被提出時，會給癡呆癥患者帶來更多的恥辱，這會不公平地進一步孤立他們和照顧他們的人。我們需要了解癡呆癥及其對美國500多萬癡呆癥患者及其照顧者的影響。預計到2060年，這一數(shù)字將增長兩倍。

First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor's exam for a diagnosis. Sometimes, brain imaging is required. And, forgetting an occasional word -- or even where you put your keys -- does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.

首先，重要的是要知道，癡呆不能從遠處診斷，也不能由非醫(yī)生診斷。一個人需要詳細的醫(yī)生檢查才能作出診斷。有時，大腦成像是必要的。而且，偶爾忘記一個單詞——甚至忘記把鑰匙放在哪里——并不意味著這個人患有癡呆癥。記憶喪失有不同的類型，它們可能有不同的原因，比如其他的醫(yī)療條件，跌倒，甚至藥物治療，包括草藥，補品和任何非處方的東西。

Older people wonder and worry about so-called senior moments and the memory loss they perceive in themselves and others. I see patients like this every week in my geriatric clinic, where they tell me their stories. They forget a word, lose keys or can't remember a name. Details vary, but the underlying concern is the same: Is this dementia?

老年人對所謂的老年期以及他們在自己和他人身上察覺到的記憶喪失感到好奇和擔憂。我每周都在我的老年診所看到這樣的病人，他們告訴我他們的故事。他們忘記了一個單詞，丟了鑰匙，或者忘記了一個名字。細節(jié)各不相同，但潛在的擔憂是相同的:這是癡呆嗎?

Normal memory loss

正常的記憶喪失

As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is normal. Ever have trouble fetching a fact from the deep back part of your "mind's Rolodex"? Suppose you spot someone at the grocery store you haven't seen in years. Maybe you recognize the face, but don't remember their name until later that night. This is normal, part of the expected changes with aging.

隨著年齡的增長，我們會經(jīng)歷許多身體和認知上的變化。老年人往往記憶力減退。這是正常的。從你的“大腦名片簿”深處獲取事實有困難嗎?假設你在雜貨店里發(fā)現(xiàn)了一個多年未見的人。也許你認識這張臉，但直到深夜才記起他們的名字。這是正常的，部分預期變化隨年齡增長。

What's more of a potential problem is forgetting the name of someone you see every day; forgetting how to get to a place you visit frequently; or having problems with your activities of daily living, like eating, dressing and hygiene.

更有可能出現(xiàn)的問題是忘記你每天見到的人的名字;忘記如何前往經(jīng)常到訪的地方;或者在飲食、穿衣和衛(wèi)生等日常生活活動上有問題。

When you have troubles with memory -- but they don't interfere with your daily activities -- this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.

當你的記憶出現(xiàn)問題時——但這些問題并不影響你的日常活動——這被稱為輕度認知障礙。你的初級保健醫(yī)生可以診斷。但有時情況會變得更糟，所以如果你有輕度認知障礙，你的醫(yī)生應該密切關(guān)注你。