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Elderly Memory Loss May Be a Matter of Perception

Author: Helen Dennis, Specialist on Aging

Question: Now that I am not working, I feel I am losing some ability to articulate and am less effective than I was.  My sentences don’t come as easily as they did when I was working and I just seem more forgetful.  I am okay with this, but just curious.  Is this typical or do I have a problem?

Answer:
Your concern is reasonable and could cause one to worry.  I recall a conversation with my mother years ago.  She announced to me over the telephone that she thought she was getting Alzheimer’s disease because she repeatedly forgot where she placed her car keys. Fortunately it was just forgetfulness.

Older adults often think their memory is worse than it is.  In fact, researchers have found there is little, if any, relationship between older adult’s view of their memory and how they perform on memory tests.

One explanation for this is that some confuse normal age-related changes in their physical abilities with mental changes.  If a person cannot hear very well and has a vision problem, it is a short leap to assume that other functions are a bit deficient.

Another reason is that older adults tend to overestimate the amount of memory problems they have on a daily basis.  They often are more aware of memory failures than younger people. How many times do students forget their books, homework assignments or lunches?  If an older person experiences that same thing, he or she may say, “I am really having a problem with my memory.”  The students have no problem at all.

Add to this, society’s expectation that as people get older, they lose it.  This belief can easily affect an older adult’s emotional reaction to simply forgetting something.   A positive belief helps.  According to the American Psychological Association, older adults who have positive beliefs about aging can actually improve their memory.

Although there are differences among individuals as they age, we know that some cognitive abilities improve into older age, some are constant and others decline.  All are part of normal aging, with the recognition that people age differently.

One type of memory that improves or stays the same is call semantic memory.  It’s the ability to recall concepts and general facts that are unrelated to experiences.  Knowing that a clock tells time is an example.  This type of memory includes vocabulary and knowing a language; both are known to improve with age.

Procedural memory, which refers to how to do things, typically does not change with age.  An example is telling time by reading the numbers on a clock.

Episodic memory can decline. This type of memory captures the “what,” “where,” and “when,” of our daily lives.  Episodic memory is involved when we go to the grocery store and forget what we needed to buy, or have trouble locating our car in the parking lot.

Other types of brain functions that may decline or slowdown are information processing, learning something new, doing more than one task at a time and shifting one’s focus between tasks. Fortunately, there are ways to compensate for these changes.  And, we know that age, per se, is a poor predictor of performance.

Memory problems also can be caused by conditions that can be reversed, such as anxiety, dehydration, depression, infections, poor nutrition, stress, substance abuse, and medications being taken.

Knowing when to ask for help is important.  The symptoms become clear.  They include being unable to remember things, asking the same question repeatedly or telling the same story over and over again.  If one is gets lost in familiar places, cannot follow directions, is disoriented about time, people and places and neglects personal safety, hygiene and nutrition, it is definitely time to ask for help.  An appointment with a geriatrician or other health provider specializing in diseases of older age is in order.

A number of brain functions are generally unaffected by aging:

  • Doing things you have always done and being able to continue doing them.
  • Wisdom and knowledge acquired from life experience.
  • Innate common sense.
  • The ability to form reasonable arguments and judgments.
  • The ability to learn new skills and make them routine (though it might take a little longer).

Additional good news is that there is much we can do to maintain and improve our memory.
The American Psychological Association and the Mayo Clinic offer these tips:

Stay mentally active: Physical activity keeps the body in shape; mental activity keeps the brain in shape. Do crossword puzzles, take alternative routes when driving someplace familiar, or learn to play a musical instrument. The late Gene Cohen, a noted geriatrician, and others have found that the mere act of learning – learning anything – creates new neural pathways in the brain.

Socialize: Socializing on a regular basis helps ward off depression and stress. Both can contribute to memory loss. Look for opportunities and be the initiator, particularly if you live alone.

Get organized: If your home is cluttered with lots of notes and “stuff,” it is easy to forget where you have placed things. Set aside a place for your keys, glasses, wallet and other essentials.

Establish a routine: For example, if you take medications at the same time each day, you are more likely to remember to take them.

Eat a healthy diet: A diet that’s good for your heart is good for your brain. You know the drill: fruits, vegetables, whole grains, low-fat protein such as lean meat, skinless poultry and fish. What you drink also counts. Insufficient water and too much alcohol can lead to confusion and memory loss.

Include physical activity in your routine: Physical activity increases blood flow to your entire body, including your brain. A few 10-minute walks a day can provide the needed physical activity.

Make sure you can hear and see: That means wearing your glasses and using hearing aids if you have them. Also be sure to get vision and hearing checked regularly.

Stay focused: Try to avoid distractions that divert your attention. Distractions can range from trying to do several things at once (multitasking) to loud background noises. Thoughts also can be distracting. Yoga can help one focus on the present as a way to avoid interfering thoughts.

Don’t buy into age stereotypes: Having a negative attitude can lead to a self-fulfilling prophecy. Studies have shown that having a positive belief about aging can improve the memory of older adults.

Train your brain: Brain exercise and training is a growing area for research and business. In fact, today it is an industry that deserves its own column.

The good news is that we have an opportunity to keep our brain fit.

In his book, “The Memory Bible” (Hyperion, 2002), Dr. Gary Small, a highly regarded neuroscientist and director of the UCLA Center on Aging, wrote about action steps that one can take to keep memory at peak performance.

Age-related memory loss usually relates to short-term memory, those events or experiences that are recent.  We might forget what we ate for dinner two nights ago and at the same time remember the name of our ninth-grade English teacher and what she looked like.

Small describes three basic memory-training skills:

LOOK:
He suggests that we actively observe what we want to learn.  We need to pay attention.  This applies to remembering someone’s name after an initial introduction.  It also means we actually want to remember that person’s name.  Meaningful information is more likely to be remembered than information that seems irrelevant.

Eighteenth-century English writer Samuel Johnson stated, “The true art of memory is the art of attention.”

SNAP: Small suggests that we create a mental snapshot of what we want to remember.  For example,  to remember a name, take a visual picture of the person’s face.  Bright colorful snapshots are remembered best.  A snapshot that has movement and detail is even better.

Small also suggests creating a literal image.  For example, if you are parking on level 3B, envision the number and letter.  (Probably writing it on your parking ticket also would help.)

CONNECT: Here we need two mental snapshots that we will link.  One image can be placed on top of the other; two images can merge; or the images can just be next to one another.

We can imagine a bizarre situation to connect the images.  For example, we may want to remember a politician whose district is Palm Springs.  How about a visual picture of the person, and the Connect image of a palm tree growing out of his head?   Strange, but memorable!

Mental aerobics is another recommendation from Small.  He calls it brain training.  This consists of engaging in mentally challenging activities such as crossword puzzles, Scrabble, Sudoku, bridge or working a Rubik’s Cube.

There are many computer-based training games and software options on the market.   Here are just a few: PositScience, NeoCORTA, CognitFit, Dakim BrainFitness, BrainAge by Nintendo and Lumosity.

The question is how to choose the right brain fitness program for you.  Consider the following questions suggested by SharpBrains:

  • Have the scientists involved written for peer-reviewed journals?
  • Is there research that provides evidence the program works?
  • Are the benefits and specific cognitive skills that the program is designed to improve identified?
  • Doe the program have structure with guidance on the number of hours a week you should use it?
  • Is there an assessment to measure progress?
  • Do the exercises vary and teach something new?
  • Does the program challenge and motivate me or will it become easy once it is learned?
  • Does the program meet my personal goals?
  • Does it fit into my lifestyle?
  • Am I ready to participate in the program or will it be too stressful?

Note that memory enhancement does not come down to brain exercises alone.  Good nutrition, physical exercise and stress management are part of the brain health formula.

A final quote from the Encyclopedia of Aging:  “Imperfections of memory occur at all ages.”  Now we can all breathe a little easier.

Copyright 2011 Helen Dennis. All rights reserved.

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