Is it dementia, or just aging?

Sylvia Brown’s memory lapses came on rather suddenly in the early 1990s. A gregarious New York transplant with a ready laugh and a long history of retail and office jobs, Brown found that she frequently did not remember people who greeted her as if they knew her well.

But neither she nor the doctors she consulted rang alarms bells. They told her she was probably suffering from depression -- though she says she did not feel depressed -- and sent her away.

But several years later, Brown says, she had a brain MRI to investigate an unrelated medical problem, and was told her scan showed evidence of her having suffered a series of strokes. “I knew my thinking had started to go bad,” she says. But at last, she had a name for it: vascular dementia.

Brown found recently that she was forgetting to keep an eye on her oatmeal and often has to remake it several times in a morning; she has decided to pull up a chair next to the stove and sit and watch her breakfast cook. She knows she sometimes forgets to take her medicine and pay her bills. Her house, she says, looks like a hurricane, and clutter often threatens to engulf her.

“People in my community say, ‘Oh I do the same thing.’ It’s very disturbing and I know what I have is different,” Brown says. “I don’t know whether they want me to think it’s normal; they just brush it off -- ‘Oh, you look fine, you’re all right,’ they say. And I know I’m not . . . I’m going wacky!”

Brown lives alone and suffers from poor vision. But she is an adventurer who travels widely on public transportation, volunteers for every fundraising walk she can find and attends memory classes at her Alzheimer’s Assn. chapter. She will sometimes pack a picnic and take the bus to the beach at San Clemente. She has traveled all over the West with a senior adventurers’ club and elder hostel group. She goes to the movies regularly and only recently decided that, in view of her high blood pressure, she should abandon her passion for riding roller coasters at local amusement parks.

Brown says her counselor at the Alzheimer’s Assn. is urging her to consider moving into an assisted living situation, given her lack of family nearby; it’s a suggestion she resists. “I don’t like to rely on other people,” she says. But she knows that it’s an option she needs to consider. “Sometimes I feel like I’m going down faster than a roller coaster, what with my memory,” she says.

-- Melissa Healy