Dreamstime
Transient global amnesia is an enigmatic form of memory loss that doctors still can't explain 65 years after it was first described.
Chris J. Hanson was preparing to leave his beachfront hotel on the last day of vacation when his mind started malfunctioning in a rare and mysterious way.
As he put on a shirt, he told his wife, Bobbi-Jo, that he wished they’d spent more time on the balcony. She was puzzled. He’d just been on the balcony, and they had eaten several meals there.
“I don’t want to scare you,” he told her, “but I don’t remember any of that.”
He did scare her. Afraid he was having a stroke, she rushed him to a Miami hospital. Every 15 seconds or so, he’d ask the same questions. “Where am I?” “Where’s my phone?” “Where’s my wallet?” He remembered who he was. He remembered Bobbi-Jo and their kids. But the last six months were a blank, and he wasn’t making any new memories.
He teared up when Bobbi-Jo reminded him that he had bought tickets to an Ultimate Fighting Championship event when they returned home to Colorado Springs. He didn’t remember that, either, a sign that something was very wrong.
Eight hours later, a doctor asked whether Hanson knew why he was in the hospital. For the first time, he said yes. A few minutes later, the doctor asked again. Hanson not only remembered why he was there, he remembered that the doctor had asked before. His earlier memories came back just as suddenly as they had vanished, but Hanson, now 51, still doesn’t remember what happened during those eight hours.
He had a classic case of transient global amnesia (TGA), an enigmatic form of memory loss that doctors still can’t explain 65 years after it was first described. It was unusual enough — about five to 10 of every 100,000 people are diagnosed with it each year — that Hanson’s doctor brought some younger colleagues to crowd around Hanson’s bed and ask him questions. “They were extremely fascinated,” Hanson said. Doctors will tell you that it is rarely good to be a fascinating patient.
Transient global amnesia, though, is an exception to that rule, which is one of the things that neurologists like about it.
“I don’t have bad news for these patients, and neurologists often have bad news,” said Nathan Young, a Mayo Clinic neurologist.
TGA does not seem to be a harbinger of worse things to come, and only 5% to 15% of patients have a second episode, said Young, who has studied recurrent cases. The bad news is that it’s still very distressing for patients and families.
“It’s always a frightening, disturbing event,” Young said.
Among the potential triggers are stress and strong emotions. A recent study from a German academic medical center found an increase in transient amnesia cases in the early days of the COVID-19 pandemic. The researchers thought stress might be to blame. Between Feb. 1 and May 15, 2020, the hospital saw 16 patients with the condition compared with an average of 9.7 during that time period in the previous 10 years. Ralph Werner, one of the doctors involved in the study, said the numbers returned to baseline this year, possibly because the pandemic no longer seemed so frightening.
Neurologists in the United States said they were not aware of similar research in this country.
Beyond stress, transient global amnesia is associated with a strange assortment of possible triggers: sudden immersion in cold or hot water, strenuous activity, sexual intercourse, some medical procedures, and mild head trauma. It is more common in people over 50 — the average age is about 62 — and often starts in the morning. People who, like Hanson, have a history of migraines are at higher risk.
Epileptic seizures can cause shorter memory lapses called transient epileptic amnesia. While people with strokes usually have physical symptoms, as well, some with amnesia are actually having strokes, so it’s important to see a doctor. Physicians have to rule out other neurologic problems before settling on the more reassuring TGA diagnosis.
The hallmark of TGA is repeated questions. What am I doing here? Where was I going? This may sound a lot like dementia, but dementia patients have broader problems with their thinking that develop gradually. People with TGA know their names and their addresses. They can still competently perform such skills as driving a car, hitting a golf ball, cooking or doing math problems. They just can’t remember what happened a few minutes ago.
“They just sort of lose the context of that moment,” said Diana Tzeng, a neurologist at Thomas Jefferson University Hospital.
The memory changes usually last four to six hours, Young said, but can continue for up to 24 hours. It’s variable, but memory usually returns in a “piecemeal fashion,” he said.
The condition is hard to study because it is so unusual and doesn’t last long. Patients are often seen in emergency departments and may not be seen by doctors who specialize in cognition until after the symptoms are gone. Doctors said it’s a shame they don’t know more, because TGA could help them better understand other memory disorders.
“Potentially, these cases illuminate how the mind works and how memory works,” said Barry Gordon, a Johns Hopkins University neurologist.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
shurkin_son // Shutterstock
According to The Centers for Disease Control and Prevention (CDC), “Dementia is not a specific disease, but is rather a general term for the impaired ability to remember, think, or make decisions that interfere with doing everyday activities.” The most common type of dementia is Alzheimer’s disease, though there are several types of dementia including frontotemporal dementia (FTD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) to name a few. Globally, more than 50 million people have dementia, and an estimated 10 million new cases are reported each year. Projections show that the number of affected individuals will reach 82 million in 2030 and 152 million by 2050.
A dementia diagnosis comes after a series of tests of memory, problem-solving, and other cognitive abilities performed by a health care provider. Blood tests, brain scans, and physicals are carried out to help doctors figure out the underlying cause. Dementia is broken down into early, mid, and late stages, with a worsening of symptoms as the condition progresses.
The long-term effects of dementia can be difficult for both those affected and their caregivers, family, and friends, and can include a lack of family recognition, difficulty walking, and significant memory impairment. The afflicted person becomes completely dependent on others for care. Early diagnosis is especially important and can help with planning both at home, with preventive care and other measures such as reminders, and at work. It also enables dementia patients to access clinical trials and available therapies that may improve cognitive functioning and overall quality of life.
Neural Effects consulted the CDC’s list of warning signs for dementia and Alzheimer’s disease to review what adults should look for before seeking an official medical diagnosis. This list may also prove helpful for those who’ve noticed loved ones who are experiencing one or more early signs of dementia.
shurkin_son // Shutterstock
According to The Centers for Disease Control and Prevention (CDC), “Dementia is not a specific disease, but is rather a general term for the impaired ability to remember, think, or make decisions that interfere with doing everyday activities.” The most common type of dementia is Alzheimer’s disease, though there are several types of dementia including frontotemporal dementia (FTD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) to name a few. Globally, more than 50 million people have dementia, and an estimated 10 million new cases are reported each year. Projections show that the number of affected individuals will reach 82 million in 2030 and 152 million by 2050.
A dementia diagnosis comes after a series of tests of memory, problem-solving, and other cognitive abilities performed by a health care provider. Blood tests, brain scans, and physicals are carried out to help doctors figure out the underlying cause. Dementia is broken down into early, mid, and late stages, with a worsening of symptoms as the condition progresses.
The long-term effects of dementia can be difficult for both those affected and their caregivers, family, and friends, and can include a lack of family recognition, difficulty walking, and significant memory impairment. The afflicted person becomes completely dependent on others for care. Early diagnosis is especially important and can help with planning both at home, with preventive care and other measures such as reminders, and at work. It also enables dementia patients to access clinical trials and available therapies that may improve cognitive functioning and overall quality of life.
Neural Effects consulted the CDC’s list of warning signs for dementia and Alzheimer’s disease to review what adults should look for before seeking an official medical diagnosis. This list may also prove helpful for those who’ve noticed loved ones who are experiencing one or more early signs of dementia.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
LightField Studios // Shutterstock
Forgetting recently learned information is one of the earliest signs of dementia. Name recall, as well as remembering important dates and events, becomes difficult for people in the early stages of dementia. Often they need to rely on memory aids, like wall calendars, sticky notes, digital reminders, or help from family members for things like taking medications at the correct time and arriving on the right date to appointments. Asking the same question several times or repeating stories is very common. While this sign is seen often in dementia, it is also a typical sign of aging as well as mild cognitive impairment, which can be, but is not always, an early warning indicator of Alzheimer’s disease. Memory loss may also be a sign of depression; B12 deficiency; kidney, brain, thyroid, or liver disorders; or a side effect of certain medications.
LightField Studios // Shutterstock
Forgetting recently learned information is one of the earliest signs of dementia. Name recall, as well as remembering important dates and events, becomes difficult for people in the early stages of dementia. Often they need to rely on memory aids, like wall calendars, sticky notes, digital reminders, or help from family members for things like taking medications at the correct time and arriving on the right date to appointments. Asking the same question several times or repeating stories is very common. While this sign is seen often in dementia, it is also a typical sign of aging as well as mild cognitive impairment, which can be, but is not always, an early warning indicator of Alzheimer’s disease. Memory loss may also be a sign of depression; B12 deficiency; kidney, brain, thyroid, or liver disorders; or a side effect of certain medications.
-
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Phase4Studios // Shutterstock
An occasional mix-up while balancing a checkbook can be a common sign of aging. Losing track of monthly bills can be a more serious sign. An inability to concentrate or difficulty following a familiar recipe may warrant a doctor’s visit. Planning may become almost impossible for those in the earliest stages of dementia and indicates a deficit in executive functioning. Difficulties with problem-solving can also signal other health issues ranging from serious conditions like a brain tumor to less insidious conditions such as stress.
Phase4Studios // Shutterstock
An occasional mix-up while balancing a checkbook can be a common sign of aging. Losing track of monthly bills can be a more serious sign. An inability to concentrate or difficulty following a familiar recipe may warrant a doctor’s visit. Planning may become almost impossible for those in the earliest stages of dementia and indicates a deficit in executive functioning. Difficulties with problem-solving can also signal other health issues ranging from serious conditions like a brain tumor to less insidious conditions such as stress.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Monkey Business Images // Shutterstock
Often in early dementia, the simplest tasks become increasingly difficult. While older people may have trouble with operating a computer or the settings on a television remote—and this can be a normal symptom of aging—those with dementia can’t perform daily tasks that were once a part of their routine. Getting dressed can become a major undertaking. The real difficulty actually comes with the sequence or order of doing things. Writing out the steps to tasks such as preparing a meal and leaving them in easily accessible places can be helpful.
Monkey Business Images // Shutterstock
Often in early dementia, the simplest tasks become increasingly difficult. While older people may have trouble with operating a computer or the settings on a television remote—and this can be a normal symptom of aging—those with dementia can’t perform daily tasks that were once a part of their routine. Getting dressed can become a major undertaking. The real difficulty actually comes with the sequence or order of doing things. Writing out the steps to tasks such as preparing a meal and leaving them in easily accessible places can be helpful.
-
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Jacob L. // Shutterstock
Often people in the early stages of dementia forget the time and even lose track of months and seasons. While many retired people may forget what day it is because they no longer go to work and live by a calendar, the sort of confusion surrounding time is much more severe in those with dementia. Losing track of where they are or how they got to certain places is common and should be investigated by a doctor. This type of confusion may be acute and occur suddenly or may happen over time. Those afflicted will often experience periods of confusion surrounding time and place and then revert to their old selves. Perception of time and time distortion are also issues for those struggling with dementia. They may believe they haven’t seen a loved one for months or years, when in fact it was only days ago.
Jacob L. // Shutterstock
Often people in the early stages of dementia forget the time and even lose track of months and seasons. While many retired people may forget what day it is because they no longer go to work and live by a calendar, the sort of confusion surrounding time is much more severe in those with dementia. Losing track of where they are or how they got to certain places is common and should be investigated by a doctor. This type of confusion may be acute and occur suddenly or may happen over time. Those afflicted will often experience periods of confusion surrounding time and place and then revert to their old selves. Perception of time and time distortion are also issues for those struggling with dementia. They may believe they haven’t seen a loved one for months or years, when in fact it was only days ago.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
photo8313 // Shutterstock
Difficulty understanding visual images and spatial relations can impact depth perception, which can cause an increased risk of falling and can make feeding and bathing more challenging. Driving difficulty due to problems with spatial relations is quite common, and navigating turns and changing lanes can become dangerous. Often people with dementia are forced to give up driving. Reading also becomes a problem, not only because of the visuospatial issues, but also due to an inability to understand words. A 2016 study of visuospatial skills in dementia patients found that those with certain types of dementia, including Alzheimer’s disease, dementia of Lewy bodies, and vascular dementia, performed poorly in comparison to controls when examining space and object perception. The study found that significant impairment of visuospatial functions occurs in the early stages of dementia and worsens as the disease progresses.
photo8313 // Shutterstock
Difficulty understanding visual images and spatial relations can impact depth perception, which can cause an increased risk of falling and can make feeding and bathing more challenging. Driving difficulty due to problems with spatial relations is quite common, and navigating turns and changing lanes can become dangerous. Often people with dementia are forced to give up driving. Reading also becomes a problem, not only because of the visuospatial issues, but also due to an inability to understand words. A 2016 study of visuospatial skills in dementia patients found that those with certain types of dementia, including Alzheimer’s disease, dementia of Lewy bodies, and vascular dementia, performed poorly in comparison to controls when examining space and object perception. The study found that significant impairment of visuospatial functions occurs in the early stages of dementia and worsens as the disease progresses.
-
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
wavebreakmedia // Shutterstock
While aging can cause an occasional problem with finding the right word, communication issues are much more significant in the early stages of dementia. Following conversations and finding the correct words for objects is difficult for those with dementia, and this early warning sign should be brought to a doctor’s attention. Aphasia, a type of language disorder, impacts communication including speech, writing, and language comprehension. According to the Mayo Clinic, “Primary progressive aphasia is a type of frontotemporal dementia.” Of course, there are other medical conditions that can cause language and communication issues including strokes, brain tumors, and brain injuries.
wavebreakmedia // Shutterstock
While aging can cause an occasional problem with finding the right word, communication issues are much more significant in the early stages of dementia. Following conversations and finding the correct words for objects is difficult for those with dementia, and this early warning sign should be brought to a doctor’s attention. Aphasia, a type of language disorder, impacts communication including speech, writing, and language comprehension. According to the Mayo Clinic, “Primary progressive aphasia is a type of frontotemporal dementia.” Of course, there are other medical conditions that can cause language and communication issues including strokes, brain tumors, and brain injuries.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
CGN089 // Shutterstock
Misplacing things could mean putting objects in strange places, like placing car keys in the microwave, and it is a common sign of dementia. Those struggling may also have difficulty in retracing their steps to find the things they’ve lost. This lack of ability to retrace steps differentiates this as a sign of dementia versus a normal sign of aging. It can be both dangerous and frustrating. As the disease progresses, the afflicted person may accuse others of stealing things that have been misplaced.
CGN089 // Shutterstock
Misplacing things could mean putting objects in strange places, like placing car keys in the microwave, and it is a common sign of dementia. Those struggling may also have difficulty in retracing their steps to find the things they’ve lost. This lack of ability to retrace steps differentiates this as a sign of dementia versus a normal sign of aging. It can be both dangerous and frustrating. As the disease progresses, the afflicted person may accuse others of stealing things that have been misplaced.
-
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Monkey Business Images // Shutterstock
During the early stages of dementia, decision-making is impacted and can cause poor judgment. People may spend money foolishly or have a hard time remembering to feed and walk a pet. They may also pay less attention to grooming and personal hygiene. Those struggling with dementia are especially susceptible to scams involving money. One poor decision should not be considered an indicator of dementia though. Instead, look for a pattern which might include things like constantly wearing summer dresses even though it’s winter, or walking in a busy area and not paying attention to traffic lights.
Monkey Business Images // Shutterstock
During the early stages of dementia, decision-making is impacted and can cause poor judgment. People may spend money foolishly or have a hard time remembering to feed and walk a pet. They may also pay less attention to grooming and personal hygiene. Those struggling with dementia are especially susceptible to scams involving money. One poor decision should not be considered an indicator of dementia though. Instead, look for a pattern which might include things like constantly wearing summer dresses even though it’s winter, or walking in a busy area and not paying attention to traffic lights.
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Nikodash // Shutterstock
Not wanting to participate in social activities once enjoyed, like golf or going to church, may be a sign of dementia. Because of an inability to follow conversations or participate in hobbies and comprehend them in a familiar way, things like watching a favorite sport or going to family dinners might become less enjoyable. This may cause people with dementia to withdraw. They may sleep more frequently or spend more time sitting in front of the television. Social withdrawal could also be a symptom of depression, anxiety, or post-traumatic stress disorder.
Nikodash // Shutterstock
Not wanting to participate in social activities once enjoyed, like golf or going to church, may be a sign of dementia. Because of an inability to follow conversations or participate in hobbies and comprehend them in a familiar way, things like watching a favorite sport or going to family dinners might become less enjoyable. This may cause people with dementia to withdraw. They may sleep more frequently or spend more time sitting in front of the television. Social withdrawal could also be a symptom of depression, anxiety, or post-traumatic stress disorder.
-
-
Nasal vaccine for Alzheimer’s disease tested in first human trial
Monkey Business Images // Shutterstock
While being sad or experiencing a shift in mood can happen to almost anyone occasionally, mood and personality changes may be early indicators of serious health issues. These can include mental health conditions, hormonal changes, or substance abuse problems. When those with dementia experience these symptoms, they can manifest as fear, suspicion, and getting easily upset or becoming irritable over minor things. Things that never would have bothered them before often will now. They may also lose patience more quickly. The National Institute on Aging recommends doing several things to help navigate these changes in mood and personality, including having a daily routine and using humor when appropriate.
This story originally appeared on Neural Effects and was produced and distributed in partnership with Stacker Studio.
Monkey Business Images // Shutterstock
While being sad or experiencing a shift in mood can happen to almost anyone occasionally, mood and personality changes may be early indicators of serious health issues. These can include mental health conditions, hormonal changes, or substance abuse problems. When those with dementia experience these symptoms, they can manifest as fear, suspicion, and getting easily upset or becoming irritable over minor things. Things that never would have bothered them before often will now. They may also lose patience more quickly. The National Institute on Aging recommends doing several things to help navigate these changes in mood and personality, including having a daily routine and using humor when appropriate.
This story originally appeared on Neural Effects and was produced and distributed in partnership with Stacker Studio.
