Stuttering, Senior Moments, or Dementia?

Whose has more brain cells left?

Source: Illustration 201343472 © Georgii Urushadze | Dreamstime

As the presidential race heats up, everyone with strong beliefs has an opinion about the opposing candidate’s mental acuity, gleefully waiting for the Ahah! moment that bolsters their opinion that “the old man is nuts.”

Two problems with this. The first is that Mr. Trump and President Biden are both old. Some would say, really old. The second is that speculation on their thinking ability is based more on ideology than facts.

We can’t do anything to clear up misconceptions about the first in time for the election—as a society, we will still stigmatize age. But we can do something about the second by looking at three areas that can tell us if what we are hearing is stuttering, a senior moment, or dementia.

Forget their speech when following a teleprompter. Anyone who can read at a sixth-grade level can appear to be mentally adequate as the monitor’s lines scroll by. But, listen to what and how they communicate spontaneously or when answering questions. When you hear something “odd,” determine if it is a sign of stuttering, a senior moment, or a dementia warning light.

Stuttering

Stuttering is the disruption of the flow of speech characterized by hesitations, repeats of sounds, or blocks. Problems with how words are said are not related to their meaning or a person’s cognitive ability.

Speech is not the same as language. Speech is how you say words, and language is the meaning of words you use. Stutterers who are successful in controlling their disorder (it’s a neurological motor problem) have developed many strategies for fluency on their own or with the help of speech-language therapists.

If you saw the movie The King’s Speech, you’ll remember many techniques the King’s therapist taught him to control his stuttering, ranging from stretching out sounds to tapping his fingers. When these techniques stop being useful, they often remain, disrupting speech and sometimes making the conversation difficult to follow.

President Biden has been a stutterer his entire life. There is no history of Mr. Trump being diagnosed with stuttering. Therefore, stuttering behaviors can only be attributed to President Biden, none of which are related to cognition.

Senior Moments

Although senior moments are described as humorous statements or behaviors that involve lapses of memory and confined to seniors, they really are information processing errors that may or may not involve memory.

Single or infrequent senior moments rarely signal dementia. When Mr. Trump says “Obama” rather than “Biden,” does he really believe he’s running against Obama in 2024? Probably not. When President Biden can’t find a simple word to complete a sentence, does it result from a brain riddled with plaque or just a momentary lapse of short-term memory? Most likely short-term memory.

Older people, like the President, Mr. Trump, and millions of people over 50, including myself, have senior moments. All of us have said something we immediately regret, like forgetting the name of a granddaughter, misusing a common word, making a bizarre connection between events, or forgetting how to get out of a favorite shopping mall.

Disconcerting or embarrassing, senior moments—with the exception of “disorientation”—do not, by themselves, signal dementia. However, other factors may suggest the beginning of dementia, such as the frequency, severity, or context when the behavior occurs.

Dementia

The National Institute of Health defines dementia as the loss of cognitive functioning — thinking, remembering, and reasoning — to such an extent that it interferes with a person's daily life and activities.

One-third of us according to the NIH will have some signs or forms of dementia by the time we reach 85. They cite six signs:

1. memory loss

2. difficulty concentrating

3. finding it hard to carry out familiar daily tasks

4. struggling to follow a conversation or find the right word

5. being confused about time and place

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6. mood changes

These six indicators have many similarities to what we identify as senior moments. However, just like senior moments, look at the context in which they occur, the number of times they appear, and how bizarre the mistake is.

Often, within the structure and content of sentences, there may be indications of early dementia. If you start with the assumption that the language we use is a window into our brain’s functioning, you may become alarmed when a person can’t finish a sentence, repeatedly brutalizes grammar, or combines multiple thoughts into a single disjointed sentence. If it occurs once or a few times, there may be a non-cognitive explanation, such as preparing for multiple trials or solving a world crisis. However, when this type of confusion occurs repeatedly, it may be an indication of early dementia, regardless of the candidate’s age.

The Takeaway

It’s easy to label someone we disagree with as “demented.” Anyone with an adult child has unfortunately had that experience. But, disagreement becomes more rationally grounded when we acknowledge that it may be ideologically based and not gremlins scurrying around in someone’s brain. Call ideological disagreements what they are: differences of opinions, and not signs of impaired cognitive ability. However, when signs of dementia are incontrovertible, don’t be afraid to call them what they are: markers for governing disqualification.