In popular culture, we call them “senior moments” – those episodes of forgetfulness that we all experience. Where are my glasses? What’s Betty’s husband’s name? What the heck did I come upstairs for?
We usually laugh off these episodes, but in the back of our minds there’s often an ominous question lurking: “Is this something worse? Am I experiencing the beginning symptoms of serious cognitive problems?”
To answer that nagging question, and hopefully to restore our peace of mind, we turn to this recent article we discovered from The Washington Post in which author Robert Klitzman, MD, tackles the issue. If the fear plagues you that normal forgetfulness might be a sign of something worse, we hope you’ll find Dr. Klitzman’s analysis reassuring. At the same time, there can be warning signs to alert us that more serious memory lapses merit further diagnosis.
Assuming we can find our glasses, let’s read on to see what this article has to say.
Are Our Memory Lapses Serious, or Normal?
Klitzman begins his article with a handful of relatable examples of “senior moments,” such as not recalling where he put his phone, or walking into a room and forgetting why, or finding more typos than usual in his emails.
“Many people worry they are developing serious cognitive deficits when these are in fact only minor and within the bounds of normal aging,” he writes. “Most people who fear Alzheimer’s do not appear to get it. Doctors routinely reassure worried patients: ‘Forgetting where you left your keys is normal. Finding them in your refrigerator and not knowing what they are for indicates Alzheimer’s.’”
Klitzman calls cognitive impairments—like so many other symptoms of decline and age—a “wide spectrum” from mild and harmless to severe. Understanding the difference, and the murky waters in between, can be a challenge.
Three Aspects of Normal Cognitive Aging
Klitzman explains that normal age-related cognitive decline usually starts around age 40, but “it consists of several distinct mental processes that shift at very different rates.” These changes affect three areas of cognition.
The first is processing speed. This is pretty much what it sounds like. Visual processing speed is how quickly someone can process visual input, like letters and numbers. Cognitive processing speed is how long it takes you to process information generally, think about it, and respond to it.
The second is something called “crystallized” intelligence. This includes a person’s vocabulary, knowledge, and skills acquired through education and experience. Klitzman adds, in a parenthetical: “The good news is that this tends to get better over time.”
And finally, the third is memory, which is the brain’s ability to recollect from past experiences and learn new information in the present.
Ability to Process Information Slows Naturally with Age
“In normal brain aging, crystallized intelligence remains relatively intact,” Klitzman explains. “But our ability to process information slows down. Speed drops by about 20 percent when we are 40 and may naturally decline 40 to 60 percent by the time we are 80.”
Memory also diminishes as we get older, he says, though every individual exhibits this very differently, even from day to day.
“What’s important to remember is this,” Klitzman continues. “While about 40 percent of us over 65 have occasional memory impairment associated with age, most people do not go on to develop dementia. We may sometimes take a bit longer to retrieve certain words, but usually we eventually recall them. We may forget someone’s name, but we still clearly recognize them if we see them.”
A good rule: something simple like forgetting a word is pretty normal, because it doesn’t disrupt our life or our ability to function, and it doesn’t necessarily indicate impending dementia. “Importantly,” Klitzman adds, “we can still reason, solve problems and make key decisions.”
Mild Cognitive Impairment Affects Up to 1 Senior in 5
You have likely heard the phrase “mild cognitive impairment” (or MCI) before. Klitzman tells us that this phrase was established by researchers several years ago as a term to describe the tough-to-define transitional state between normal cognitive aging and dementia.
“About 16 to 20 percent of Americans over 60 have mild cognitive impairment, which represents significantly more than the normal aging process,” he writes. “About 10 to 20 percent of people with MCI develop dementia each year.”
The good news is that you can check yourself for MCI, for free. Online tests such as the Self-Administered Gerocognitive Examination (SAGE), were developed by Ohio State University for just this purpose. It only takes a few minutes and asks questions like the names of several objects and animals, the number of nickels in a certain quantity of money, and so on.
To be officially scored, you need to discuss your results with your primary care doctor. But Klitzman says that you’ll probably have a pretty good idea of how you performed.
“If you are now reading and fully understanding these sentences, the odds are very good that you will ‘ace’ the brief exam and see that you have answered all the questions correctly,” he writes. “No test is perfect, but this one reassures many people that momentarily forgetting someone’s name does not indicate mild cognitive impairment.”
Steps You Can Take to Guard Against Cognitive Decline
On the Blog, we’ve discussed plenty of ways that you can boost your brain health and protect yourself against cognitive decline. But Klitzman underlines the most vital ones for us, again:
Exercise and physical activity: Especially aerobic exercise, which increases your heart rate. Klitzman recommends jogging, cycling, or speed walking. He also recommends strength training through lifting weights.
Medical prevention: Klitzman urges all of us to have regular checkups to make sure we’re staying healthy, and to take care of issues like high blood pressure, high cholesterol, and other risky medical problems as soon as they become obvious.
Brain games and stimulation: Just like our bodies, our brains need exercise, too. They like to be stretched with new skills, or by communicating and interacting with others. New board games, computerized training games, crossword puzzles, and even video games or virtual reality programs can all be beneficial in their own way, too.
Education: Learning new things is always protective against cognitive decline, and continuing education programs of various types make this easier than ever.
A sense of purpose: We all want to feel wanted, to feel like we matter, and this is good for our brains, too. Klitzman says that this can come from various sources, such a religion, spirituality, or beliefs in nature or a “higher power”.
Social time: Interaction and communication with others is a naturally brain-stretching activity. Book groups, church/religious events, or other organizations can be great conduits for this.
Mental health: Certain mental illnesses, like depression, can worsen cognition. It’s important to get treatment for any mental health conditions that may arise, as soon as possible.
Avoid substance use and abuse: Alcohol and recreational drugs have a proven deleterious effect on our thinking, especially over the long term. Best to avoid them.
When to Overcome Worries and See Your Doctor
So, after all this…when is anxiety about cognitive impairment enough to ask your doctor about?
Klitzman says that when the impairments are “significant”, you should see a doctor. These symptoms could very well result from treatable medical conditions, like certain infections and cancers, but you want to be sure. (We recently heard of one older woman whose cognitive problems were traced to a urinary tract infection and sodium deficiency, easily treated.)
“In addition,” he writes, “several doctors and professors I know tell close colleagues, ‘Let me know if you see me slipping too much cognitively,’ since we ourselves may not always be aware of these alterations.”
Klitzman ends on a personal note: “I admit that when I forget where I put my phone, it troubles me. But,” he writes, “I found the SAGE test easy, and I remind myself that at 66, I’m not as young as I was and some memory slips are perfectly normal. In addition, I try to appreciate all that I do know, exercise, take my blood pressure medication, stay healthy and keep my mind active. Activities such as these will benefit not only your thinking, but your mood, heart and body as well.”
Rajiv Nagaich – Your Retirement Planning Coach and Guide
The long-awaited book by Rajiv Nagaich, called Your Retirement: Dream or Disaster, has been released and is now available to the public. Retirement: Dream or Disaster joins Rajiv’s ground-breaking DVD series and workbook, Master Your Future, as a powerful planning tool in your retirement toolbox. As a friend of AgingOptions, we know you’ll want to get your copy and spread the word.
You’ve heard Rajiv say it repeatedly: 70 percent of retirement plans will fail. If you know someone whose retirement turned into a nightmare when they were forced into a nursing home, went broke paying for care, or became a burden to their families – and you want to make sure it doesn’t happen to you – then this book is must-read.
Through stories, examples, and personal insights, Rajiv takes us along on his journey of expanding awareness about a problem that few are willing to talk about, yet it’s one that results in millions of Americans sleepwalking their way into their worst nightmares about aging. Rajiv lays bare the shortcomings of traditional retirement planning advice, exposes the biases many professionals have about what is best for older adults, and much more.
Rajiv then offers a solution: LifePlanning, his groundbreaking approach to retirement planning. Rajiv explains the essential planning steps and, most importantly, how to develop the framework for these elements to work in concert toward your most deeply held retirement goals.
Your retirement can be the exciting and fulfilling life you’ve always wanted it to be. Start by reading and sharing Rajiv’s important message. And remember, Age On, everyone!
(originally reported at www.washingtonpost.com)