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Sterlings serve up an opportunity to explore dementia

Are Donald Sterling's rants attributable to a brain disorder instead of a callous heart?
Bad news for young adults smugly thinking they don't have to worry about dementia for a while
Dr. Claudia Kawas: 'Dementia is the loss of an ability you used to have'

I 'm not entirely familiar with Shelly Sterling's background, but I don't believe she has any medical training. So when the co-owner of the Los Angeles Clippers said on national television that she thinks her husband, Donald, is suffering from "the onset of dementia" it was hard to put much stock in that.

But could she be right?

Maybe Shelly Sterling was making an honest observation. Or maybe she, or her husband, thought it was possible to generate a little sympathy for Donald Sterling if his race-related rants were attributable to a brain disorder rather than to a callous heart.

I'm no doctor, either. So I'm not going to try to diagnose Donald Sterling as anything other than a guy who's been accused of racist attitudes in the past, and who didn't have the good sense to keep his mouth shut in a rambling, sad spectacle Monday night on CNN.

But since the Sterlings have served up this opportunity, I thought I'd take a look at what dementia is and isn't, because a lot of people don't seem to know much about a disease that affects millions.

"We estimate that 50% of the people who have it don't get a diagnosis, ever," said Debra Cherry, executive vice president of the California Southland chapter of the Alzheimer's Assn.

Some people simply aren't aware of the condition or chalk it up to a normal part of the aging process, and even some primary care physicians fail to diagnose neurological diseases, Cherry said.

Alzheimer's disease is the most common form of dementia, and it's not just forgetfulness that's associated with the many forms of this disease. Mood and personality changes are also common symptoms.

"You might think things you wouldn't ordinarily think and do things you wouldn't ordinarily do," Cherry said. "We have seen people who made sexual advances on other people or walked out naked when they would never have done that before."

Dr. Claudia Kawas of the UC Irvine Institute for Memory Impairments and Neurological Disorders said it's not always clear to people that they are passing into the early stages of dementia.

"My personal belief is that even doctors aren't sure where the line is," said Kawas, who recommended that anyone who has experienced worrisome symptoms get an evaluation. Even if you're OK, she said, doctors will then have a baseline against which to measure future cognitive loss.

"Dementia is the loss of an ability you used to have," said Kawas, whose research on 90-year-old residents of Leisure World in Laguna Woods was featured in a recent "60 Minutes" segment.

"Judgment is definitely one of those things that goes wrong in dementia," she said, and that could present itself as an inability to censor your own comments.

Anybody who has dealt with a loved one suffering from cognitive loss knows how horrible it can be. My father suffered from dementia during his long, slow demise. He could be depressed one day, verbally abusive the next. And he'd swing from perfect clarity to total confusion. Once, when I visited him at a nursing home, he asked whether I had come to take him to school.

But he was in his 80s then, and his disease was pretty advanced. What's scary for many middle-aged folks is getting to where you can't quite find the word you're searching for. The "tip of the tongue" phenomenon, Cherry called it.

"Anyone you meet who's 60 will tell you their memory's not as sharp as it used to be," she said.

I can identify. I prefer attributing such problems to information overload, because it's almost gotten to where you have to remember a password to turn on the lights. But I do get a little worried when I have trouble remembering the name of someone I know or forget where I put my keys.

No need to panic, the experts tell me, until those problems begin to interfere with your daily routine.

"If you're forgetting where you leave your keys, but then you're finding them within a few minutes or a few seconds, that's age-related, but that's not disease-related," said Dr. Lon Schneider, professor of psychiatry, neurology and gerontology at the Keck School of Medicine of USC. "On the other hand, if you're putting your keys in the refrigerator and not finding them," it's time to see a doctor.

If you're a young adult smugly thinking you don't have to worry about this for a while, Schneider has some bad news.

"It really is downhill after 30, and just as certainly as one loses physical prowess and athletic skills, one shows age-related losses in intellectual ability," Schneider said.

But we develop coping mechanisms. We plan better, for instance. And Schneider said that significant neurological deterioration before age 65 is rare.

Schneider said that once the disease sets in, pharmaceutical remedies can be of limited use in some cases. Can you delay the onset of the disease or limit its severity once it settles in? There's some evidence that exercise and good nutrition can be helpful. As Cherry, of the Alzheimer's Assn., put it, "What's good for your heart seems to be good for your brain."

The 10 warning signs of Alzheimer's include memory loss that disrupts daily activity, challenges in planning or solving problems, difficulty completing familiar tasks, confusion with time or place, trouble understanding visual images and spatial relationships, problems with words, misplacing things, decreased or poor judgment, withdrawal from work or social activities, and changes in mood and personality.

You can get specific examples of each, information about support groups and a hotline at

Copyright © 2014, The Baltimore Sun
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