At 82, Gainesville resident Julie Gray Burns remains mentally sharp, but she can’t stop wondering occasionally whether she might be susceptible to dementia.  

Her mother had dementia, and a sister and a brother have both died of Alzheimer’s disease. A brother, who is three years younger than her, got tested to see if he had the Alzheimer’s gene, but he got an all-clear.  

Burns says she’s not going to do any testing. She says she has concerns but tries not to dwell on it.  

“It crosses my mind, but I still play mahjong and a French card game. And I used to play bridge and backgammon. I was always a game person,” she said.

During the pandemic, Burns went a step further and studied French online. She also reads incessantly. 

Burns sometimes forgets a name but says she doesn’t worry about it too much.  

“If I can’t think of a name, I know it will come to me in two or three hours,” she said. “I don’t let (worry about dementia) affect my life. I still drive. I still go out. I still see people.”

Dementia, Alzheimer’s disease, and other aging and memory disorders are front and center these days as reflections of concerns about the cognitive capabilities of aging political candidates. However, it is also getting attention because of the Food and Drug Administration’s (FDA) recent approval of pharmaceutical advances that may reverse the course of the disease.  

In July, the Food and Drug Administration (FDA) approved the use of Donanemab, an intravenous infusion therapy to be taken monthly. When taken in the early stages of Alzheimer’s, it can slow the progression of the disease, giving people more time to participate in daily life and live independently.  

“This is real progress. Today’s approval allows people more options and greater opportunity to have more time,” said Alzheimer’s Association President and CEO Joanne Pike in a prepared statement. “Having multiple treatment options is the kind of advancement we’ve all been waiting for — all of us who have been touched, even blindsided, by this difficult and devastating disease,” she said.  

Lecanemab is another intravenous infusion therapy approved by the FDA in 2023 that helps slow disease progression.  

A third drug which slows cognitive decline, Aducanumab, got FDA approval in 2021, but its manufacturer, Biogen, is discontinuing production. It will only be available to those who already have a prescription until Nov. 1. 

Other drugs, like donepezil, rivastigmine, and memantine, treat symptoms. While they do not stop the damage Alzheimer’s causes to brain cells, they may help lessen or stabilize symptoms for a limited time by affecting certain chemicals involved in carrying messages among and between the brain’s nerve cells, according to the association’s webpage.  

“Because multiple FDA-approved Alzheimer’s treatments are now available, early detection and diagnosis are even more critical to ensure individuals receive the most benefit,” said Dr. Shellie-Anne Levy, a clinical neuropsychologist and assistant professor in the Department of Clinical and Health Psychology at the University of Florida. “Access to these treatments should not be delayed at any stage or by any entity — not the Centers for Medicare & Medicaid Services (CMS) coverage with evidence development policy, private insurers, health systems or doctors.”  

Pike also said clinical trials for Alzheimer’s drugs need to improve the representation of all affected populations, given that the rate of dementia and Alzheimer’s is twice as high for African Americans and one-and-a-half times as much for Hispanics when compared to aging white individuals. Experts are still trying to figure out why. 

“These groups are severely underrepresented in treatment studies,” Pike said. “It is critical that clinical trial study populations reflect the communities these treatments intend to serve. 

However, not all memory or cognitive issues are a result of Alzheimer’s disease. 

“Sometimes people are deficient in certain vitamins, and because of that metabolic disruption, it can cause thinking and memory changes in your day-to-day activities,” Pike said. “But those things are modifiable.  And with treatment, dementia symptoms can reverse.” 

Florida is second in the nation for the number of people living with Alzheimer’s, with more than 580,000 Floridians aged 65 and older living with the disease.  Overall, in 2023, the association reported 7 million people with Alzheimer’s in the United States, with 1-in-3 seniors reported as dying of Alzheimer’s or another type of dementia. 

In Alachua County, the association reports 41,100 residents over the age of 65, with 4,800 of them, or 11.6%, estimated to be living with Alzheimer’s. 

Experts say keeping your mind active, healthy eating, physical exercise, a good night’s sleep, and social interaction are all things that can help delay dementia. In other words, whatever is good for your health is also a tool to help prevent dementia. 

“In truth, dementia prevention begins in the womb,” says Glenn Smith, principal investigator for the 1Florida Alzheimer’s Disease Research Center, a consortium of institutions working to promote prevention and treatment of Alzheimer’s and related dementias. 

“Higher educational attainment is strongly associated with reduced dementia risk because higher education builds cognitive reserve,” Smith said. “The better we do at educating people and helping them obtain advanced education, the more we reduce their risk.”  

While higher levels of education are associated with a decreased risk for dementia, other health-related conditions and behaviors can increase risks. 

“Head injury has an association with dementia. Smoking is associated with dementia. So is high blood pressure. Being socially and cognitively active protects against dementia,” he said.  

Julie Roca, host of the podcast Aging Gracefully, says something often not considered is the impact of hearing loss on dementia.  

“Hearing loss doesn’t cause dementia, but hearing loss can make dementia progress faster. People with hearing loss feel isolated. They don’t understand what is being said, so they don’t participate as much in the conversation,” Roca said.  

Now that a few drugs have become approved to treat early Alzheimer’s disease or mild cognitive impairment, there’s even more of an imperative to stay healthy longer.  

However, treatment access also depends on an individual’s willingness to see their doctor about their concerns, as no one can be put on a course of drug treatment without a prescription, said Roca, who is also a healthcare relations representative for Community Hospice & Palliative Care and a volunteer with the Alzheimer’s Association.   

“You must have a diagnosis, and that’s where a lot of people miss getting help because they are trying to avoid what they are seeing,” Roca said. “They say ‘No, it’s OK. This is just a part of aging.’ … They are not going and asking doctors to check it out and investigate it. Maybe they don’t want to know, but we need to know now that there are things out there that can help.” 

However, experts caution every forgotten name doesn’t necessarily mean dementia is lurking in your brain.  

“When you have your ‘senior moments’, that’s typical aging. Everyone, as they get older, has changes in their thinking ability,” said clinical neuropsychologist Levy. “They may slow down a little bit. They may not remember the name of the person. That’s typical.  

“You guys will have your senior moments all the time, but it doesn’t necessarily mean something wrong is happening,” she said. 

So, while not every forgotten name is a roadmap to dementia, staying aware of the signs of potential problems helps people to get an early diagnosis and, if needed, early medical help, experts say.  

Editor’s note: This is the latest story in Mainstreet’s Aging Matters series. It was independently reported by Ronnie Lovler and underwritten by Elder Options.