I have had a number of clients over the years that have come to me with concerns about their memory that seemed just fine.  For example, there was the 82-year-old woman who was a Smith College graduate in physics.  I evaluated her four times over the course of ten years.   On the first evaluation, she tested among the highest I have ever seen – including short-term memory.  However, on each of four subsequent evaluations, her short-term memory scores declined even though the word list was the same.  She obviously was aware of changes before testing could detect decline.

Clients such as this are referred to as the “worried well.”  Professionals dismiss them as if they are not aware of their own bodies.  I find this particularly disturbing as progressive neurological conditions such as Multiple Sclerosis, Parkinson’s disease, and Alzheimer’s disease are often misdiagnosed as psychiatric conditions early on and self-perceived symptoms are dismissed.  As well reviewed by Pam Belluck in the New York Times (Dementia’s signs may come early, July 18) new data have begun to alter thinking about such complaints.  Apparently people with concerns about memory and organizing skills are more likely to have abnormal amyloids – a correlate of Alzheimer’s disease – than those without such complaints.

Those who sense that their memory skills are declining are now identified by a new category called “subjective cognitive decline.”   Finally professionals are saying “Hey, maybe there is something to this, and maybe we should pay attention to these people” (Dr. Ron Peterson as quoted by Pam Belluck).

Unfortunately, “experts” are not recommending evaluating for subjective cognitive decline because of the mistaken belief that there is no effective treatment – “there is nothing you can do.”  But subjective changes mark opportunity.  Clearly, not everyone with such complaints will decline or become demented.   The best treatment for possible progressive memory loss is to intervene early.  Treatment involves building memory skills and strategic planning to insure a better future just as you have already done by creating a financial plan before you needed the money.  Subjective worries should be assessed  routinely and thoroughly as part of monitoring wellness.

The goal of successful aging is to have as good a life as possible.  This is true whether your memory holds or declines.  The best way to assure that you will do the best you can is to be proactive.  Strategic planning for the future is essential.  There is lots of time as memory loss progresses very slowly.  Don’t write off feelings that your memory is declining.  Get a thorough memory evaluation.  Put together an advisory team that includes at least an attorney, a physician, a financial advisor, and a memory expert.  Include family members in the assessment and planning.   Treat memory loss by staying ahead of it.