Memory loss: What’s normal, what’s not?

The holiday season has arrived. That often means hurried shopping for perfect gifts, baking the most delicious cookies, and of course, seeing extended family members at gatherings and parties–often, for the first time since last year’s holiday get-together.

You might notice subtle memory changes in your favorite loved ones that could be concerning. Some memory loss is a normal part of aging, but what’s considered atypical?

“Changes as we age are incredibly variable for physical and cognitive function. It depends a lot on genetics, environment and lifestyle,” says BCH board-certified neurologist Alan Zacharias, MD, of Associated Neurologists. “Sadly, by the age of 20, we start to lose brain cells and many of the important chemicals for our brain function.”

Many terms have been applied to normal aging-related memory loss, says Dr. Zacharias. These include:

• Late-life forgetfulness
• Benign senescent forgetfulness
• Age-associated memory impairment
• Aging associated cognitive decline

“When you are more aware of your memory issues than others are, that is often a good sign of the benign nature of your concerns,” he says.

Carrie Fearn, a nurse practitioner with BCH’s Associated Neurologists, says minor lapses in memory generally will not affect one’s ability to function independently in life.

“This may look like forgetting the day of the week or someone’s name, but generally recalling it later,” Fearn says. “You may forget to pay a bill or miss an appointment on occasion. Word finding can also be challenging, but typically you are able to find other words to get your point across.”

Mild cognitive impairment (MCI) is the stage between the normal cognitive decline of aging and the early stages of some type of dementing condition that affects memory, thinking and social abilities to a degree that interferes with daily life. There is no definitive test or single symptom that results in a diagnosis of MCI. Dr. Zacharias further explains, “It’s a judgement that we have to make to the best of our ability.”

If a senior citizen retires but becomes increasingly forgetful as demands have been reduced in retirement, “this is a reg flag,” Dr. Zacharias warns.

Fearn advises family members–usually the first to notice abnormal memory loss–to look for the following difficulties and disruptions to daily life:

• Planning or following instructions
• Navigating to familiar locations, such as the grocery store
• Getting lost
• Deteriorating decision-making
• Keeping up with daily hygiene

Changes in personality and withdrawal from favorite social activities may also occur.

MCI will progress to dementia, usually Alzheimer’s Disease, at a rate of about 10 to 15 percent per year. It’s important to note that not all of those with MCI will develop Alzheimer’s disease. A small percentage of people with MCI improve, and some remain stable for many years. Dr. Zacharias notes that while we are getting better, we are not yet at a point where we can predict how a patient will progress.

The major risk factor of Alzheimer’s is age, with about one to two percent of those ages 65 and older having the disease. By the time someone turns 85, there’s a 40% risk of having Alzheimer’s disease. It’s also more common if a sibling or parent is affected, and is more common in women.

Are there any known ways to reduce the risk of dementia?

“Staying mentally, socially and physically engaged can help reduce risk. Additional beneficial strategies include eating a predominantly Mediterranean diet and working with your primary care provider to prevent or manage cardiovascular risk factors including high blood pressure and cholesterol, along with diabetes,” says Fearn.

If you are celebrating the holidays with someone with dementia, the Alzheimer’s Association offers tips and resources for adjusting expectations and gift giving, connecting through technology, and familiarizing others with the situation.

To make an appointment with the providers at Associated Neurologists, call 303-415-8800.