Is it age or something else?

The importance of keeping your brain strong and healthy

By BRIAN SCANLAN, M.D.
Posted 5/2/23

Forgetting the name of a familiar person or having difficulty finding the right word in a conversation can be disturbing at any age, but this form of memory impairment can make an older person wonder …

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Is it age or something else?

The importance of keeping your brain strong and healthy

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Forgetting the name of a familiar person or having difficulty finding the right word in a conversation can be disturbing at any age, but this form of memory impairment can make an older person wonder if it is an early sign of dementia. The good news is that chances are it is not. 

Memory impairment is a cardinal feature of dementia. However, the diagnosis of dementia requires some impairment in a person’s ability to conduct essential activities of daily life ranging from the ability to dress or feed oneself to using public transportation or balancing a checkbook. The loss of so-called “executive function” may be recognized first by colleagues or family members, and remain unnoticed by the one experiencing the loss. 

Age-related memory impairment is common and is a function of an otherwise healthy aging brain. Every system of the human body changes with advancing age. Muscle structure and function decline with age due to changes in muscle structure that may explain why you can no longer climb a flight of stairs as easily. The central nervous system changes in a similar manner, leading to decline in the brain’s ability to adapt its activity in response to an internal or external stimulus. As a result, while playing Scrabble you may not see that seven-letter word staring you in the face. 

Another condition, mild cognitive impairment (MCI), differs from the memory loss of aging in subtle ways. The frequency of memory loss and character of the impairment is more likely to be noticed by family or friends. The subject, who otherwise displays normal daily function, may remain unaware. 

Rather than occasional difficulty finding the right word, a person with MCI is apt to forget having told someone something immediately after telling them or asking the same question after having gotten the answer. Testing to confirm the diagnosis is crucial, since by the third year after diagnosis about 20 percent of those with MCI develop dementia. 

The most common form of dementia is named for the scientist Alois Alzheimer, who in 1906 presented the first case of “presenile dementia” in a 51-year-old woman. In the early 20th century, aging and “senility” went hand in hand; in fact, “senile” is derived from the Latin for “old man.”

The first case of Alzheimer’s disease (AD) was a young woman who developed signs of senility in her 40s. Postmortem examination of her brain displayed the changes which to this day are characteristic of the disorder and are thought to explain its various signs and symptoms. 

Currently, “Alzheimer’s” has become a catchword for any condition causing memory impairment, some dire and others remediable. AD accounts for well over half of persons diagnosed with dementia; and vascular dementia, the next most frequent form of dementia, accounts for around 20 percent. Several other forms of dementia with equally devastating outcomes occur less frequently. 

The diagnosis of dementia is a clinical diagnosis that is based on an evaluation of signs observed by caregivers and symptoms expressed by the patient. As yet, there is no reliable biomarker—such as a blood test—for Alzheimer’s disease or any other form of dementia. Postmortem examination of the brain is the current method of confirming the diagnosis. 

The cause of AD is not yet established, and identification of those most likely to develop AD is limited to a small population with a rare genetic abnormality. 

While researchers continue to search for effective treatment to lessen the burden of the disease on patients and their caregivers, the chief strategy remains management of risk factors associated with the disorder. It is the same strategy applied to other devastating conditions, such as heart disease and diabetes. In fact, many of the risk factors are shared with these conditions. 

Well, you’ve seen this before 

Treat hypertension 

Reduce elevated cholesterol 

Establish and maintain a healthy weight and a healthy diet 

Maintain a regular program of physical activity 

Use your brain 

Read 

Learn something new—a language, a game, etc 

Get enough sleep 

Don’t smoke or use tobacco 

Avoid excessive alcohol 

Maintain a social network 

Treat depression and other behavioral issues 

Protect your head—e.g. wear a helmet riding a bike 

Now, do it.

memory impairment, dementia, old age, elder,

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