What would happen to our Country if God forbid our President was in the early stages of memory loss Ronald Reagan is a good example.

Ron Reagan, the late president’s son has written a memoir about his father to celebrate the 100th year of his birth. In this memoir Ron states that towards the end of his first term in office, he began to notice changes in his father suggestive of memory loss.

There seemed to be a greater level of confusion than expected during the presidential debates with Walter Mondale and his ability to engage in vigorous debates with his son seemed to decline. The president had become alarmed that he could no longer remember the names of very familiar places and was on occasion at a loss for words.

Ron Reagan states that if diagnosed earlier his father may well have left office before the end of his second term.

The big question that begs to be answered is whether or not having early memory loss impaired President Reagan’s ability to function in the most important position on our planet. Here the answer is almost certainly not, or at worst only minimally. Any lapses could readily be overcome by having a strong cohort of loyal advisers around him.

Alzheimer’s is a slowly progressive disease with abnormalities occurring in the brain at least 20 years before the disease becomes clinically recognizable. Symptoms develop very gradually; the earliest recognizable problems being a decline in short term memory. Usually a memory problem is initially suspected by family members who note that the patient begins to repeat himself, ask the same question again and again and may have trouble recalling recent events. At this stage, and in a person with great intellect only detailed and extensive testing would be able to identify an early deficit.

While there is no question that much later in his life and long after he left the Presidency, Mr. Reagan had Alzheimer’s disease, the problems during his presidancy could be due to subtle declines in memory that is called “benign forgetfulness”.  Symptoms include a decreased ability to remember names and places as well and occasional lapses in train of thought. These symptoms are almost universal with advancing age (as anyone aged 70 or older would attest to) and are of no clinical significance.

Thus the Presidents occasional lapses in his early to mid 70’s may well have been of no significance or at worst reflected the earliest stages of the disease. Assuming that was the case, we as a nation and those suffering from the earliest stages of the disease should be reassured and understand that at this stage, declines in memory are nothing more than a minor disability. Long-term memory, judgment, the ability to make rational and clear decisions and the ability to manage a large enterprise can be readily managed.

But because there is an early disability those around the patient must understand the problem and protect him from lapses in short term memory. If the patient has difficulty remembering a recent event or turns to a relative for help with an answer, do not try and squeeze the answer out of him (that can be very frustrating) but rather immediately provide him with the correct answer. And if he does not remember the name of someone assure that you subtly remind him of the name to avoid embarrassment.

If a problem is suspected it is important that evaluation by a specialist in memory disorders be considered. A careful evaluation can make an accurate diagnosis, and often determine that perceived forgetfulness is of no relevance. If necessary extensive memory testing by a qualified neuropsychologist may be needed.

In the event that early Alzheimer’s is diagnosed, patient and family education, compulsive management of medical problems and therapies to slow the rate of progression of disease can provide many years of productive and high quality life.

Being diagnosed with Alzheimer’s instills as much fear as hearing that we have a terminal disease. We must understand that in its earliest phases that can last for years, this disorder should have virtually no impact on our ability to enjoy and participate in life to the fullest.


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