Dr. Gonzalo Ogando: "A healthy person should maintain reasonable memory throughout their life"

Dr. Gonzalo Ogando Durán is a neurologist at Juaneda Hospitals, with a practice at Clínica Juaneda. Spain is one of the countries with the highest proportion of dementia patients among its population over 60 years old, and in many cases, this condition is underdiagnosed. In this interview, Dr. Ogando provides simple insights to help understand and detect Alzheimer's disease, emphasizing that not all memory loss is Alzheimer's, nor do all people lose their memory as they age. Recognizing the symptoms and signs described here, an early visit to a neurologist can, in the worst case, significantly delay the progression of the disease. In the best case, it can provide reassurance that not all memory loss is indicative of a terrible illness.

—Will we all lose our memory?

—First, it’s important to clarify that the common belief that aging leads to memory loss is not true. That’s simply not the case. While it’s true that we may lose some cognitive abilities, a healthy person should maintain reasonable memory throughout their life.

—So, what is dementia?

—The term "dementia" refers to a condition or process that causes us to lose our abilities and independence. It’s not just about memory loss but also about being unable to manage oneself. For example, needing supervision because one gets lost or is no longer capable of running their household.

—What characterizes Alzheimer's?

—Alzheimer’s is what we call a multidomain dementia because it affects all aspects of cognition, predominantly memory. Unlike other types of dementia, such as frontotemporal dementia, Alzheimer’s does not significantly affect personality or cause major behavioral changes.

—What are its first signs?

—The first noticeable signs of Alzheimer’s are small lapses or forgetfulness. People often say things like, "My mom forgets things," or "My dad seems distracted." These lapses may involve losing objects, asking the same question repeatedly, or forgetting names. Initially, these issues are mild and often go unnoticed or are dismissed as unimportant.

—Is the patient the last to notice?

—Generally, patients are aware of the changes, but many tend to downplay or even hide them. It’s often their loved ones who point out, "You’re repeating yourself," or "You’re struggling to remember certain things." It’s a mutual perception—both the patient and their surroundings may notice the changes.

—Why does this happen?

—Advances in medicine have shown that certain proteins accumulate, causing neurodegeneration. Affected neurons begin to malfunction and progressively die. In recent years, it has also been observed that chronic inflammation in the brain can trigger the death of neurons.

—What is the degenerative process like?

—Neurons communicate through synapses, which are the connections between them. Over time, these synapses break down, leading to neuron death. This process manifests as forgetfulness, attention deficits, behavioral changes, and other symptoms that may indicate the onset of the disease.

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