Is it really Alzheimer's? There are several differentials

Early diagnosis is critical, but so is heightened awareness of a range of conditions that trigger reversible dementia.

By Kathleen Phalen Tomaselli, AMNews correspondent. March 6, 2006.

They are a generation of rebels and rock 'n' rollers ready to defy the restraints of old age. Still, bodies and minds change as decades pass, and the first of the nearly 77 million postwar babies are turning 60 this year at the rate of 8,000 a day.

In other words, the Gray Wave is upon us.

And some forecasts offer the dire estimate that more than 50% of them will have Alzheimer's disease by the time they are 85. "It's hard to make predictions about what 2030 will look like," says Barry Fabius, MD, an internist and medical director of geriatrics at Holy Redeemer Health System outside Philadelphia. "For the worst-case scenario, we can prepare for a huge population of demented individuals. ... It's rare that it would be that simple to explain. The population is very diverse. Some are very robust and healthy. On the other end of the spectrum, there are those with dementia and six or seven co-morbidities."

And symptoms and circumstances often make these situations complex.

The greatest challenge for doctors may well be rooted in preparation for and an understanding of the unique characteristics of seniors. Medications are metabolized differently, depression presents without sadness, and memory loss is often passed off as a normal part of aging -- the kinds of nuances aging specialists are trained to spot. But with only 6,000 geriatricians in the United States, the burden falls to primary care physicians who are not always equipped with the time or training to sort out aging's idiosyncrasies.