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Aging and Memory: Am I Normal or Should I Check it Out?

Most of us begin to notice mild changes in our cognition, our ability to think, by our 50s and 60s. Memory, speed of processing information, multi-tasking, attention and concentration may seem less acute than before. We feel less sharp. This can feel unnerving: forgetting people’s names, finding more checkbook errors, missing appointments, grasping for the right word. The question we ask ourselves: Is this normal? Or is this the beginning of the big D word? Dementia.

What is Dementia?

Dementia is the general term that is used for a decline in cognition, such as in memory, thinking, and communication, that is caused by brain pathology due to a disease process. There are many types of dementia, not just the Alzheimer’s type, that may be treated and/or controlled through medical treatment, especially if caught early.

One cause of dementia is cerebrovascular disease in which the blood vessels become partially blocked causing insufficient amounts of oxygen to be transported to the brain. High blood pressure, high cholesterol, and diabetes may be underlying conditions of cerebrovascular disease that can be reined in by medical interventions and a healthy lifestyle.

Don’t Be Afraid of Normal Decline

Most importantly, you can expect to experience normal decline in cognition as you age. For example, your legs may work fine, but at the age of 60, you may not be able to sprint as quickly or as efficiently as a 16 year old. This does not mean your legs have a disease. It just means you have the legs of a 60 year old. Of course, depending on how well you have taken care of yourself over the years, barring any injuries or diseases, your ability to run at the age of 60 will vary. Likewise, how you care for yourself over the span of your lifetime also impacts your brain health. So your mild brain blips in thinking may just be the normal, benign forgetting of aging.

On the continuum, between normal aging and dementia is another category called Mild Cognitive Impairment or MCI. An individual falls into the MCI zone when he or she is still functioning close to the norm for his or her age group in most areas of functioning but is showing some decline and is lower than expected in some areas of functioning.

Ask Yourself

To help determine if your lapses in memory or forgetfulness are real problems, ask yourself the following questions:

  1. Do I have difficulty with being disoriented to time or place or day?

  2. Do I frequently forget important names or dates, and once reminded, still have a hard time remembering?

  3. Am I having a harder time managing my finances and would I rather avoid them?

  4. Is making change for a purchase difficult?

  5. Do people tell me that I keep asking the same question?

  6. Do I get lost in familiar places and have a harder than usual time with directions?

  7. Do I have more episodes of forgetting to turn off the oven, stove, or water faucet?

  8. Do I avoid social activities and meeting people?

  9. Am I confused and more uncomfortable in new or strange places?

  10. Do I have a harder time making decisions, making plans or solving problems?

  11. Am I more dependent on others than I used to be in my activities of daily living because of confusion or impaired thinking, and not because of physical limitations?

  12. Are my family members, loved ones, or friends commenting about changes in my functioning or behavior?

These are just signs and should not be used alone to diagnose dementia. Importantly, if there is a SIGNIFICANT CHANGE in functioning you should contact your doctor. Many of these signs can also be found in other disorders such as depression, post-traumatic stress, Lyme disease, multiple sclerosis, lupus, chronic fatigue syndrome, or fibromyalgia.

Brain Hygiene

Although research is still preliminary as to the effectiveness of protective factors for brain health, there are a number of activities and practices that are being identified as important for keeping brains healthy. Below are 10 Brain Hygiene tips. Check with your doctor to be sure all of these tips are right for you:

  1. Maintain a healthy, balanced diet to fuel the brain including vitamins and nutrients, rich in Omega 3 fatty acids and Magnesium, which have been shown to support healthy neurons. Don’t skip meals!

  2. Keep yourself hydrated! The brain needs fluids and balanced electrolytes to function.

  3. Avoid overuse of alcohol which can impair and damage brain cells.

  4. Get plenty of sleep and be sure to address any sleep apnea issues to avoid chronic lack of oxygen to the brain.

  5. Treat medical conditions that affect blood vessels and blood flow to the brain, such as diabetes, high blood pressure, and high cholesterol. Consult your physician to reduce your stroke risk.

  6. Engage in a reasonable, regular physical exercise routine that keeps muscles strong and oxygenated.

  7. Exercise your brain by learning new tasks, skills, games, and hobbies. Cross-training the brain helps keep it sharp, can improve your planning skills, and allow you to learn strategies to compensate for any memory difficulties.

  8. Stay socially active and engaged. Spend time with family and friends. Emotional health, social support, and reducing stress helps the immune system fight disease and keep cognitive abilities sharp.

  9. Accept yourself. None of us are ever perfect and carrying around old anxieties, feelings of guilt, or fear of disappointing others is only self-destructive. If you are having a hard time feeling at peace with yourself, you may benefit from seeking the services of a psychologist to help you find tools to remove the barriers to your emotional wellness. Meditation, mindfulness training, cognitive-behavioral therapy, and biofeedback may be helpful treatments in achieving self-acceptance and promoting brain health.

  10. Undergo Neuropsychological Baseline Testing.

What is Baseline Neuropsychological Testing for Adults?
  • A “baseline” is an abbreviated compilation of computerized and/or paper-pencil tests that measure cognitive skills BEFORE there is a change or concern about mental functioning. It can provide reassurance of normal aging.

  • Test results are kept for future comparison if there has been a change in mental functioning, to help devise an appropriate treatment plan, and to help monitor recovery.

  • Having a baseline in your medical record is helpful if in the future you sustain a brain injury, perhaps from a motor vehicle accident or fall, or experience a stroke or other brain disease or disorder.

  • Sometimes a baseline may show signs that provide a heads up for further evaluation and early treatment.

  • A baseline should be administered when the individual feels well-rested so that the optimal test results are achieved.

  • Baseline neuropsychological testing should be conducted by, or under the supervision of, a licensed doctoral-level neuropsychologist who is a brain-behavior specialist and can best interpret the results.

 

Author: Rosemarie Scolaro Moser, PhD is a board certified neuropsychologist and the director of the RSM Psychology Center in Princeton, New Jersey where she has been providing testing and psychotherapy services to older adults for over 30 years. She is a subject matter expert for the US Centers for Disease Control and Prevention, past president of the New Jersey Neuropsychology Society and the New Jersey Psychological Association, past board member and Fellow of the National Academy of Neuropsychology.

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