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Aging Brain

Is forgetfulness in old age normal?

By Stef Cruz, M.D.


It is easier to forgive than to forget. That adage probably holds true in most situations, but for some, forgetting requires very little effort.


That’s not always a good thing. Forgetting becomes a problem when, instead of involving people with golden hearts, it involves people in their golden years.


Forgetfulness does not seem like a significant enough issue, but it is. Many assume it’s always a normal part of aging, but is it okay to shrug off absentmindedness and, well, forget about it?


Senior moments

“What time is it?” Lita, 50 years old, asked her daughter, Sarah. It was the nth time Lita had asked; she just didn’t know it.


“Almost a decade ago, I remember her saying she had misplaced her vintage brooch. A month after that, I found her brooch inside the sugar bowl.” Sarah shrugged. “Forgetfulness is a normal part of aging. It’s just plain old absentmindedness.”


Of course, Sarah was wrong. After all, forgetfulness is not always “just a normal part of aging.”


Absentmindedness, senility, second childhood: All these terms point to dementia, an umbrella of diseases wherein advanced age is the greatest risk factor, report Joshua Sonnen and colleagues in a 2007 study published in Annals of Neurology.


“We can’t always remember where everything is. We misplace our keys,” says Maria Ida Corazon Sibayan, M.D., a fellow of the Philippine College of Geriatrics Medicine. “But more often than not, we could recall what it was that we forgot.”


“However, with cognitive decline, memory loss soon becomes frequent and permanent,” warns Dr. Sibayan. A person suffering from dementia who forgets where she last placed her brooch might never again remember.


Who are at risk?

“Advanced age is the greatest risk factor,” Dr. Sibayan explains. That’s partly because neurodegenerative conditions are usually linked to diseases also common in the elderly, such as hypertension, high cholesterol and chronic smoking.


In a 2002 study by Lon White and colleagues published in Annals of the New York Academy of Science, people who suffered from minor strokes multiple times had a higher risk for dementia. Those who died without suffering from any brain lesions had the lowest risk.

Low educational attainment is another risk factor. In a 2008 study by Valentina Garibotto and others published in Neurology, a person with a higher educational attainment can create a “cognitive reserve” which he can tap if and when dementia sets in.


“If Alzheimer’s disease runs in the family, you are at a high risk for dementia, too,” Dr. Sibayan adds.


It’s Alzheimer’s if…

Alzheimer’s disease is just one of the many conditions that can cause dementia, but it’s indeed the most common, with almost half of all cases attributed to it.


Here are 10 early signs of Alzheimer’s disease:

• Disruptive memory loss. Absentmindedness is frequent and often permanent. Even your friends and family start to worry.

• Difficulty with familiar tasks. Even ordinary chores, such as balancing a checkbook, become impossibly difficult.

• Word wipe-out. You forget what ordinary objects are called. For instance, you might substitute the word “cat” with the phrase, “that pet that goes meow.”

• Disorientation. You lose your way back home from the church, a place you used to visit every week.

• Lack of good judgment. You forget to put on pants on your way out.

• Poor abstract thinking. You can no longer follow instructions on how to cook spaghetti despite being a chef.

• Misplacing things in the oddest places. You accidentally put your keys in the fridge or your favorite CD in the washing machine.

• Mood changes. You find yourself weeping but can’t recall why.

• Personality changes. You suspect that your family, the security guard, and even the newspaper boy are plotting against you.

• Loss of initiative. Because of the many symptoms you’ve been experiencing, you want to avoid embarrassment and often stay indoors. You no longer enjoy the things you loved doing beforehand.


Amnesia of advanced age

Although it may start as forgetfulness, dementia involves all mental spheres. “Cognitive decline involves not only memory, but also personality and later, even physical functioning,” Dr. Sibayan clarifies.


“In brain aging, the last thing you learn is the first thing you unlearn. First, you forget what you did yesterday, then the day before that,” the geriatrician explains further.


In a person with cognitive decline, life slowly unravels, starting from present to past, until memories of childhood are all he has. Eventually, even the things he learned as a little boy, such as walking and talking, are unlearned, too.

“The good news is, the progression of dementia may be delayed, especially if it is diagnosed early,” assures Dr. Sibayan. There are ways to ensure that Lita and other people suffering from frequent memory loss don’t end up forgetting how to walk at 55. Learn about them in the September issue of HealthToday magazine.

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