我的老年期是痴呆的开始吗?

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.

随着婴儿潮一代年龄的增长，美国的痴呆症病例数量正在上升，这给他们自己、也给他们的家庭、照顾者和社会带来了问题。从技术上讲，痴呆症并不是一种疾病，而是一种思维、记忆或决策能力受损的术语，它是最令人担忧的老年障碍之一。

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.

随着人们步入90多岁，发病率急剧上升。71至79岁的人中约有5%患有痴呆症，90岁左右的人中约有37%患有痴呆症。

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.

老年人可能会担心自己功能的丧失，以及照顾痴呆症患者的成本和费用。2018年的一项研究估计，阿尔茨海默氏症(最常见的痴呆症)患者的终生护理费用为329,360美元。毫无疑问，这个数字还会上升，给家庭、医疗保险和医疗补助增加更多负担。

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.

由于美国总统大选，近几个月来也有很多关于痴呆症的讨论和报道。一些选民问是否有一个或两个候选人可能患有痴呆症。

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，这是一个公平的问题吗?当这类问题被提出时，会给痴呆症患者带来更多的耻辱，这会不公平地进一步孤立他们和照顾他们的人。我们需要了解痴呆症及其对美国500多万痴呆症患者及其照顾者的影响。预计到2060年，这一数字将增长两倍。

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，痴呆不能从远处诊断，也不能由非医生诊断。一个人需要详细的医生检查才能作出诊断。有时，大脑成像是必要的。而且，偶尔忘记一个单词——甚至忘记把钥匙放在哪里——并不意味着这个人患有痴呆症。记忆丧失有不同的类型，它们可能有不同的原因，比如其他的医疗条件，跌倒，甚至药物治疗，包括草药，补品和任何非处方的东西。

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?

老年人对所谓的老年期以及他们在自己和他人身上察觉到的记忆丧失感到好奇和担忧。我每周都在我的老年诊所看到这样的病人，他们告诉我他们的故事。他们忘记了一个单词，丢了钥匙，或者忘记了一个名字。细节各不相同，但潜在的担忧是相同的:这是痴呆吗?

Normal memory loss

正常的记忆丧失

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.

随着年龄的增长，我们会经历许多身体和认知上的变化。老年人往往记忆力减退。这是正常的。从你的“大脑名片簿”深处获取事实有困难吗?假设你在杂货店里发现了一个多年未见的人。也许你认识这张脸，但直到深夜才记起他们的名字。这是正常的，部分预期变化随年龄增长。

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.

更有可能出现的问题是忘记你每天见到的人的名字;忘记如何前往经常到访的地方;或者在饮食、穿衣和卫生等日常生活活动上有问题。

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.

当你的记忆出现问题时——但这些问题并不影响你的日常活动——这被称为轻度认知障碍。你的初级保健医生可以诊断。但有时情况会变得更糟，所以如果你有轻度认知障碍，你的医生应该密切关注你。