Ever wonder why most contestants on quiz shows such as Jeopardy tend to be younger, while heads of state and United Nations representatives tend to be older? It has to do with memory and how it changes with aging. This blog will address some of the normal changes in memory as we age and what things affect our ability to remember, and then contrast normal aging with the serious condition that many people fear, Alzheimer’s disease.
Younger brains are better at instant-fact recall; put another way, the younger brain has a faster “hard drive” that enables 20- and 30-year-olds to access specific memory items much more quickly than older folks. In contrast, the older brain can be much better at assimilating disparate facts and figures and drawing relevant, meaningful conclusions. Hence the typical descriptions of the young as “smart” and the old as “wise.”
At any age, certain factors can significantly impact our ability to remember, including inattention and distraction, lack of sleep, and stress. We simply will not long remember things to which we do not pay attention. Memory is not a constant recording that we can access but rather something on which we must focus. When you can’t find your keys or your glasses or your phone, this is a symptom of distraction. Multi-tasking is not a good way to facilitate memory.
Without adequate sleep, we are unable to consolidate events into lasting memories, since much of this activity occurs while we sleep. And if we are tired the day after a poor night’s sleep, we will not be able to pay attention. Sleeping in a cool room and avoiding caffeine, especially later in the day, are good ways to help to fall and stay asleep, and our memory will prosper from it.
Stress will inhibit our ability to remember, and chronic stress, even moreso. Stress can affect how memories are formed. When stressed, people have a more difficult time creating short-term memories and turning those short-term memories into long-term memories, meaning that it is more difficult to learn when stressed. Exercise, yoga, meditation and deep breathing are helpful ways that you can help reduce your stress.
Brain games and crossword puzzles will not help improve your memory. You’ll get better at the games and solving crosswords, but memory will be unchanged.
Alzheimer disease (AD) is the most common cause of dementia-- a chronic or persistent disorder of the mental processes caused by brain disease or injury and marked by memory disorders, personality changes, and impaired reasoning--and is one of the leading sources of disability and death in the aging population. In the United States in 2011, there were an estimated 4.5 million individuals over the age of 65 years living with AD; this included 0.7 million people age 65 to 74 years, 2.3 million age 75 to 84, and 1.8 million 85 years and older. This figure is projected to rise to 13.8 million by 2050.
In 1906, Dr. Alois Alzheimer described changes in the brain tissue of a woman who, prior to her death, had symptoms including memory loss, language problems and unpredictable behavior. When examining her brain tissue, Dr. Alzheimer noted the abnormal clumps (now called amyloid plaques) and tangled bundles of fibers (now called neurofibrillary, or tau, tangles) that are the microscopic hallmarks of Alzheimer’s Disease.
Toxic changes of Alzheimer’s can begin to develop up to a decade before symptoms appear. These include abnormal buildups of proteins and the loss of functioning of previously healthy neurons, which leads to loss of neuron connections with each other and, ultimately, to neuron death. The first areas affected are the parts of the brain that are essential in forming memories. As the disease progresses, more and more areas of the brain are involved and the damage from AD can be widespread.
Common signs of AD include:
Memory loss that affects day-to-day activities.
Difficulty performing familiar tasks.
Problems with language.
Disorientation in time and space.
Impaired judgement.
Problems with abstract thinking.
Misplacing things.
Changes in mood and behavior.
Changes in personality.
Loss of initiative.
As AD worsens, patients experience increasing memory loss and confusion, and they may begin to have difficulty recognizing family and friends. They may be unable to learn new things or perform once -easy multi-step tasks such as getting dressed. Some patients may experience hallucinations, delusions and paranoia.
In its final stages, patients with AD cannot communicate and are totally dependent on others for their care, and they may remain in bed most or all of the time.
As of now, scientists do not fully understand what causes these changes or why the disease largely affects older adults. Factors that may influence the development of AD include genetic makeup, vascular conditions such as heart disease, stroke and high blood pressure, diabetes, and obesity. Nutritious diet, physical activity and social engagement have been associated with helping people stay healthy as they age and may help reduce the risk of cognitive decline.
To diagnose AD, doctors may:
Review past medical history and discuss changes in daily activities and behavior and personality with the patient, friends and family.
Conduct tests of memory, problem solving, attention, counting and language.
Carry out standard medical tests of blood and urine.
Perform brain scans to look for evidence of AD or other possible causes of symptoms.
Current approaches to treating AD focus on helping people maintain mental function, treating the underlying disease process, and managing behavioral symptoms. Several medications are available to reduce symptoms and to help with some behavioral conditions. Aduhelm, or aducanumab, is a new drug available for patients with mild AD that reduces amyloid plaques in the brain and may help slow the progression of AD. New drug and nondrug treatments are helping to reduce many AD symptoms, including sleeplessness, wandering, agitation, anxiety and aggression.
Caring for those with AD can have significant physical, emotional and financial costs. Croups such as the Alzheimer’s Society and the National Institute on Aging offer education, access to support groups, and information about clinical trials that can lead to new and effective treatments for AD.