As we age, preventative health is imperative to our overall health. Dr. Susan Behnawa, our geriatrician who practices out of our Sun City office, states that one major concern individuals have as they age is not wanting to lose who they are, which is ultimately housed in one’s cognitive abilities. Dementia, or Major Neurocognitive Disorder, is a category of illness that affects many adults as they get older, whether it be through vascular trauma or just through general aging. It is imperative to educate yourself on the different kinds of dementia and cognitive disabilities so that you can be prepared for the future or be able to identify these symptoms in a loved one.

What is Dementia?

Dementia is a demonstrable cognitive impairment that affects an individual’s ability to function and live independently. Dr. Behnawa believes that Dementia as most know it, is a bit of a loaded term surrounded by stigma, a more fitting term for this category of cognitive impairment would be Major Neurocognitive Disorder. Major Neurocognitive Disorder can be described in differentiating ways, from vascular dementia like a stroke or brain bleed, to Alzheimer’s and frontal-temporal dementia. Alzheimer’s and vascular dementia are the most common types of neurocognitive disorders. Alzheimer’s and dementia can be categorized by a slow and gradual memory change. The most textbook cases of Alzheimer’s would be in an individual in their 70s and 80s who is beginning to experience short term memory loss. Whether that means forgetting what one ate for breakfast or the inability to recall recent conversations with a loved one, this short-term memory loss happens more frequently as the Alzheimer’s progresses. One of the most distinguishing factors of Alzheimer’s specifically is that the individual is unaware that the memory loss is occurring. The diagnosis of this type of memory loss usually comes from family members who notice a gradual change in their loved ones. Another way a physician would be able to ascertain whether a person is suffering with Alzheimer’s is when a patient comes into the hospital for a completely separate condition, like a heart attack or surgery, but their cognitive abilities are seen as being less than optimal. One sign that is always hopeful for physicians in regards to memory loss is if a patient is self-aware of the gaps in their own memory. If a patient is having insight into their own memory loss, it is a surefire sign that the dementia is not at severe, but if a patient is not aware of these gaps, it’s typically more concerning for physicians.

When we talk about the gradual onset of Alzheimer’s dementia, there can be differing opinions on what “gradual” means to each individual. Physicians will do a memory test on patients who are exhibiting symptoms of Alzheimer’s. Individuals with a higher level of education (graduate or doctorate degree) that have been living at a high level of brain capacity, whether in their life or vocation (doctor or lawyer), there is a lot less margin for that patient to do poorly on the memory test. Conversely, if a patient is illiterate or did not attend school past grade school, the expectations of a memory test may not be as high. Higher levels of education and cognitive ability tend to be able to compensate or even hide memory loss. Depending on how the patient performed on the memory test will determine how far along their major neurocognitive disorder has progressed.

Vascular dementia is another type of cognitive impairment however it differs from Alzheimer’s in a few main ways. The first is that it usually has an immediate onset brought about by trauma, like a brain bleed or a stroke. The second way that it differs from Alzheimer’s dementia is that this type of dementia can often be cured with aggressive rehabilitative therapies, medication and time.


Exercise can also have a beneficial impact on one’s cognitive health. Studies show seniors that commit to at least thirty minutes of aerobic activity daily prove to show preservation in their brain volume and mass in the temporal lobe and hippocampus.
            Rancho offers a wide variety of fitness and health classes to our patients 55+ in our senior centers. There are currently centers in Hemet, Sun City, and we partner with a local gym in Murrieta. We offer Zumba, yoga, line dancing, strength and balance, cooking classes, and CrossFit classes to our patients, all completely FREE of charge. 

            If you have any questions or concerns about major neurocognitive disorders, please consult your primary care physician. If you are 55+ and are looking for a doctor to entrust your care, or would like more information on our classes, please call us at (951) 225-6807

Who We Are

We are family physicians serving south Riverside county with the highest quality of care. Rancho’s goal is to approach medicine differently by offering more cohesive care and education that extends beyond the four walls of the exam room. We do not just make suggestions and write prescriptions, we have taken steps to improve the health of our patients. Our family physicians have developed educational content that empowers their community to make healthy lifestyle changes.  We also have free senior centers for our patients 65 and older that are full of exercise and nutrition classes as well as full online courses teaching a wide variety of health topics. We pride ourselves on going beyond the exam room to make our community healthier and happier.

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