The Enid News and Eagle, Enid, OK

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December 29, 2008

At 70, where's your memory?

At Marie and Ted’s 50th wedding anniversary, Marie spoke to the guests: “Some of our friends may have missed this celebration. We’re getting old, you know, and some of us are forgetful.”

She was joking — and not joking. Most seniors are acutely aware of memory loss, although not always so willing to talk about it openly. Ronald Reagan and Margaret Thatcher, major figures in world politics during the 1980s, both developed dementia within a decade of leaving office.

And you’ve undoubtedly had your share of senior moments — misplacing your keys yet again or struggling to recall the name of an acquaintance. Are these the early signs of a disease you dread?

The reassuring news in that minor memory lapses, known as age-associated memory impairment (AAMI), are virtually universal. As early as age 20, the human brain begins to lose cells a few at a time, and, by age 60, the cumulative effect begins to be noticeable. With aging, there is also a decrease in the chemicals needed to keep brain cells working properly.

Dementia, by definition, affects at least two areas of thinking – such as memory, language, reasoning, judgment or orientation. You might forget where you placed your keys; a person with dementia might place the keys in the sugar bowl or park the car in someone else’s driveway.

Alzheimer’s disease, the most common dementia, involves profound changes in the brain – abnormal clumps of a protein called beta amyloid and tangled fibers within nerve cells. In addition to memory loss, Alzheimer’s patients undergo major changes in personality and become disoriented and unable to handle even simple daily chores.

Margaret Thatcher is affected by vascular dementia, the second most common type, usually caused by multiple small strokes or blockages in arteries of the brain.

There are many other types of dementia, and they affect more than 30 percent of Americans age 85 and older. But dementia is by no means an inevitable part of aging.

There is, however, a gray area between age-related memory loss and dementia that creates concern for many seniors. Most persons with dementia go through a period of moderately severe memory loss known as mild cognitive impairment (MCI), generally defined as memory loss greater than expected considering the person’s age but with no other effects on language, judgment, reasoning or orientation.

As many as 20 percent of Americans age 70 and older have mild cognitive impairment, and half of these go on to develop Alzheimer’s within five years.

Instead of forgetting an appointment with a friend, the person with MCI might forget ever making the appointment or keep the appointment but forget that it ever took place.

Only recently have doctors begun recognizing mild cognitive impairment as a possible precursor to dementia. As a result, there’s not much agreement about how severe memory impairment must be to qualify as MCI.

A patient with symptoms suggestive of mild cognitive impairment is usually given a thorough physical examination to rule out medical causes. Depression, infections, autoimmune disorders, thyroid disease, alcohol-ism, liver disease, anemia, drug toxicity and vitamin B12 or other nutritional or vitamin deficiencies can cause memory deficits that are usually reversible with treatment.

Fatigue and stress can make anyone less attentive. Declining vision and hearing can make it harder for a senior to stay connected and attentive.

Good memory, at any age, requires effort and attention. Information lingers in your short-term memory for approximately 15 seconds unless you encode it and file it away in long-term memory. This encoding may involve 1) visualizing it, 2) repeating it several times in your mind and 3) putting it in the context of other information.

If you have trouble remembering names of people you meet, repeat the name out loud once and then several times in your mind. Don’t be ashamed to use tools: make lists, keep an address book, a personal organizer and a calendar. Make a habit of putting your keys and glasses in the same place.

Age apparently has little or no effect on long-term memory. Particularly secure is memory that has personal significance – episodes from your childhood or the organized learned material related to your occupation or hobbies. Stay mentally as well as physically active, use your skills and knowledge, maintain your important family contacts and you’re less likely to forget what it was all about.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.

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