When Memory is Normal and When it is Not-So-Normal for Older Adults

Memory and aging

As we age, subtle changes in memory occur, sometimes unnoticed, but at other times disturbing to ourselves or others.

Most normal changes in memory and cognition are of little importance, as they do not interfere with our daily activities or our quality of life.

But when memory loss prevents us from performing daily tasks and our accustomed roles in life it becomes a health concern that needs further evaluation by healthcare professionals.

What is normal aging and memory?

As we age, slight changes occur in our cognition that affect memory. Simple forgetfulness (the “missing keys”) and delay or slowing in recalling names, dates, and events can be part of the normal process of aging. Memory has various forms, though, that might be affected differently by aging.

Preserved memory functions

  • Remote memory (ability to remember events from years ago)
  • Procedural memory (performing tasks)
  • Semantic recall (general knowledge)

Declining memory functions

  • Learning new information
  • Recalling new information (takes longer to learn something new and to recall it)

What other changes occur with normal aging and cognition?

  • Language (“words, their pronunciation, and the ways we combine them to be used and understood”) is modestly affected by aging.
  • Language comprehension (understanding the rules of language) is preserved, as are vocabulary (semantic memory) and syntax (the way in which words are put together).
  • Some modest decline is seen with spontaneous word finding (“tip of the tongue”) and verbal fluency (takes longer to “get the words out”).
  • While verbal intelligence (vocabulary) remains unchanged with aging, the speed of information processing gradually slows (such as problem-solving skills).
  • Executive functions (planning, abstracting) remain normal for everyday tasks, but are slowed when faced with novel tasks or divided attention (“multi-tasking”).
  • A slowing of the speed of cognitive processing and reaction time (“hitting the buzzer”) occur with aging.

When is memory not so normal?

Amnesia (“memory loss”) is not a part of the normal aging process. While it may take longer to learn new information (for example, names of people) or to recall learned information (for example, names of friends in photos), with a little time and extra effort memory occurs. Some people are more forgetful, but this might be because of health conditions (for example, depression, heart disease, thyroid disease and vitamin deficiencies) or medication effects.

Memory loss is abnormal in people with mild cognitive impairment or dementia (a loss of intellectual functions severe enough to interfere with everyday social or occupational functioning).

Mild cognitive impairment

  • Important memory impairments occur without loss of independent functioning.
  • Forgetfulness and struggling to perform self-care tasks (for example, taking medications, paying bills) but still able to do so without the direct help of another person.

Dementia

Memory, language, and cognition are so impaired that self-care tasks can no longer be performed without assistance from another person.

Can normal memory be preserved in aging?

Research has shown the following:

  • More education helps preserve “cognitive reserve” and delays the onset of dementia.
  • A healthy diet–one high in antioxidants and olive oil–lowers the risk of dementia.
  • Cognitive training (memory training, reasoning training, speed-of-process training) improves cognition.
  • Playing board games (chess, checkers, cards, learning a second language) and musical instrument delays the onset of dementia.
  • Engaging in social activities slows cognitive decline.
  • Reducing cardiovascular risks (for example, treating hypertension) delays the onset of dementia.

Source: Cleveland Clinic


Charting the Course from Healthy Aging to Alzheimer’s Disease (AD)

This chart shows current thinking about the evolution from healthy aging to Amnestic MCI (Mild Cognitive Impairment) and then to AD. Researchers view it as a series of events that occur in the brain over many years. This gradual process, which results from the combination of biological, genetic, environmental, and lifestyle factors, eventually sets some people on a course to MCI and possibly AD. Other people, whose genetic makeup may be the same or different and who experience a different combination of factors over a lifetime, continue on a course of healthy cognitive aging.

Source: National Institute on Aging


Types of Memory

Read more:

Memory and Aging . . . . .

Aging and Memory in Humans . . . . .

Differences between mild forgetfulness and more serious memory problems . . . . .


Watch video:

I have Trouble Remembering Things Does that Mean I am Getting Dementia? . . . . .

For Women, Healthy Diets May Help with Mobility when Aging

In a large study conducted by at Brigham and Women’s Hospital (BWH), researchers found an association between women who maintain a healthy diet and a reduction in the risk of developing impaired physical function as they age.

The findings are published online and will appear in the July issue of the Journal of Nutrition.

“Little research has been done on how diet impacts physical function later in life. We study the connection between diet and many other aspects of health, but we don’t know much about diet and mobility, ” says Francine Grodstein, ScD, senior author of the study and a researcher in the Channing Division of Network Medicine at BWH. “We wanted to look at diet patterns and try to learn how our overall diet impacts our physical function as we get older. ”

Researchers examined the association between the Alternative Healthy Eating Index, a measure of diet quality, with reports of impairment in physical function among 54,762 women involved in the Nurses’ Health Study. Physical function was measured by a commonly used standard instrument every four years from 1992 to 2008 and diet was measured by food frequency questionnaires, which were administered approximately every four years beginning in 1980

The data indicate that women who maintained a healthier diet were less likely to develop physical impairments compared to women whose diets were not as healthy. They also found a higher intake of vegetables and fruits, a lower intake of sugar-sweetened beverages, trans-fats, and sodium, and a moderate alcohol intake, were each significantly associated with reduced rates of physical impairment. Among individual foods, the strongest relations were found for increased intakes of oranges, orange juice, apples and pears, romaine or leaf lettuce, and walnuts. However, researchers noted specific foods generally had weaker associations than the overall score, which indicates that overall diet quality is more important than individual foods.

“We think a lot about chronic diseases, cancer, heart disease, and tend not to think of physical function. Physical function is crucial as you age; it includes being able to get yourself dressed, walk around the block, and could impact your ability to live independently,” says Kaitlin Hagan, ScD, MPH, first author and a postdoctoral fellow at BWH.

Future research is needed to better understand dietary and lifestyle factors that influence physical function.

Source: Brigham and Women’s Hospital


Today’s Comic

Fiber: The Rx for Disease-Free Aging

Foods rich in fiber not only keep you “regular,” they may help you live longer without disease, new research suggests.

Among more than 1,600 Australian adults, the top fiber consumers were 80 percent more likely to remain fully functional and disease-free as they aged, the study found.

Fiber-rich foods include fruits and whole grains.

“Our observations need to be confirmed by other large studies, and we can’t make recommendations at this stage such as pushing for a more plant-based diet,” said study lead author Bamini Gopinath, an associate professor in the University of Sydney’s Westmead Institute for Medical Research. Her Australian team only found an association rather than a cause-and-effect link.

Still, Gopinath and her colleagues weren’t surprised by the findings, “given that there are numerous studies showing fiber’s protective influence against a host of chronic diseases,” she said.

“Successful aging” was defined in the study as the continued absence of physical disability, depression, breathing problems, or chronic health issues such as cancer, high blood pressure, diabetes or heart disease.

“People can achieve the recommended intake of fiber consumption — around 30 grams per day — by eating a wide range of foods such as whole-grain breads and cereals, fruits, vegetables and legumes,” Gopinath noted.

The researchers tracked the study participants, who were 49 years and older, for a decade starting in 1994. At the start, all were free of cancer and heart disease.

Surveys assessed dietary routines, with a specific focus on fiber, carbohydrates and sugar intake.

By those measures, the study team concluded that 15.5 percent of the participants had aged “successfully” over the 10-year time frame.

By contrast, those whose fiber consumption was pegged at below-average levels were least likely to have aged well.

Blood sugar levels and the impact of carbohydrates on blood sugar levels did not seem to play a role in how successfully people aged, the team noted.

The researchers also found that only 25 percent of study participants were meeting daily fiber intake recommendations. Gopinath said this accurately reflects general population habits.

Certain fruits and vegetables contain more fiber than others, said Lona Sandon, an assistant professor of clinical nutrition at the University of Texas Southwestern Medical Center at Dallas. Tops on her list are nuts, seeds, beans, avocados, strawberries, raspberries, blueberries, oranges, carrots, leafy greens, corn, peas, popcorn, bran cereals and oatmeal.

“A plant-based diet is the best way to go to get the fiber your body needs for optimal health,” Sandon said.

But what exactly is it about fiber that promotes longevity?

“Based on our study we can’t exactly pinpoint as to how fiber influences aging status,” said Gopinath. But she said that her team speculates that fiber may affect blood sugar levels, minimizing inflammation throughout the body.

“Inflammation is a key factor in aging and many chronic conditions. Also, fiber is known to increase satiety, which is likely to explain some of its health benefits,” she explained.

Sandon added: “What makes fiber so beneficial is up for a great deal of debate, and it is probably more than one thing.”

For one thing, not all fiber is the same, she said, noting soluble and insoluble dietary fiber have different functions in the body.

“Different fibers also provide food for the bacteria in the gut,” Sandon added. “These bacteria may produce substances that help promote health such as hormones that help regulate appetite and blood sugar.”

The study results were published recently in the Journals of Gerontology.

Source: U.S. Department of Health and Human Services


Today’s Comic

Dietary Fiber Intake Tied to Successful Aging, Research Reveals

Dietary Fiber Intake Tied to Successful Aging, Research Reveals

See large image . . . . .

Most people know that a diet high in fiber helps to keep us “regular.” Now Australian researchers have uncovered a surprising benefit of this often-undervalued dietary component.

A new paper — published in The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences by scientists from The Westmead Institute for Medical Research — reports that eating the right amount of fiber from breads, cereals, and fruits can help us avoid disease and disability into old age.

Using data compiled from the Blue Mountains Eye Study, a benchmark population-based study that examined a cohort of more than 1,600 adults aged 50 years and older for long-term sensory loss risk factors and systemic diseases, the researchers explored the relationship between carbohydrate nutrition and healthy aging.

They found that out of all the factors they examined — which included a person’s total carbohydrate intake, total fiber intake, glycemic index, glycemic load, and sugar intake — it was the fiber that made the biggest difference to what the researchers termed “successful aging.”

Successful aging was defined as including an absence of disability, depressive symptoms, cognitive impairment, respiratory symptoms, and chronic diseases including cancer, coronary artery disease, and stroke.

According to lead author of the paper, Associate Professor Bamini Gopinath, PhD, from the Institute’s Centre for Vision Research, the study is the first to look at the relationship between carbohydrate intake and healthy aging, and the results were significant enough to warrant further investigation.

“Out of all the variables that we looked at, fiber intake — which is a type of carbohydrate that the body can’t digest — had the strongest influence,” she said. “Essentially, we found that those who had the highest intake of fiber or total fiber actually had an almost 80 percent greater likelihood of living a long and healthy life over a 10-year follow-up. That is, they were less likely to suffer from hypertension, diabetes, dementia, depression, and functional disability.”

While it might have been expected that the level of sugar intake would make the biggest impact on successful aging, Gopinath pointed out that the particular group they examined were older adults whose intake of carbonated and sugary drinks was quite low.

Although it is too early to use the study results as a basis for dietary advice, Gopinath said the research has opened up a new avenue for exploration.

“There are a lot of other large cohort studies that could pursue this further and see if they can find similar associations. And it would also be interesting to tease out the mechanisms that are actually linking these variables,” she said.

This study backs up similar recent findings by the researchers, which highlight the importance of the overall diet and healthy aging.

In another study published last year in The Journals of Gerontology, Westmead Institute researchers found that, in general, adults who closely adhered to recommended national dietary guidelines reached old age with an absence of chronic diseases and disability, and had good functional and mental health status.

Source: The Gerontological Society of America

The Social Lives of the Elderly Mirror How They Grow Older

Small changes in the social lives of older people are early red flags showing that their thought processes and brain functioning could be on the decline. This is according to Ashwin Kotwal of Brigham and Women’s Hospital in the US, who led a study¹ in the Journal of General Internal Medicine², published by Springer.

Data from the National Social Life Health and Aging Project (NSHAP)³ was analyzed. This nationally representative survey included 3,310 people between 62 and 90 years old still living in their communities. Respondents were screened for early evidence of cognitive decline, and they were categorized into three groups: those having normal brain functioning, those with mild cognitive impairment (MCI) and those suffering from dementia. Participants were questioned about the density and size of their social networks, the support they receive from others, the amount of social strain they experience, and their attendance at community events. They were also asked with whom they discussed important matters and how much they socialized with family and friends.

Important changes were noted in the social lives of people who have signs of early cognitive decline. Their social networks are smaller, more interconnected, and contain a higher proportion of relatives (65 percent for the normal group versus 73 percent for the dementia group). According to Dr. Kotwal, this could be because lower cognition makes it difficult to maintain diverse and distant ties, such as their usual circle of friends. It could also reflect how people and families start to compensate when their loved ones have cognitive losses and need more support.

“Such new circumstances may require more densely linked, family-centered networks to help monitor and support the health of individuals showing signs of even early impairment,” Kotwal adds.

Men in the group with MCI or dementia felt they received more encouragement from their spouses than before. Women in these groups said there was a drop in the support from friends. According to Kotwal, even a mild decrease in cognition could change how women mobilize needed social support.

Findings from these same two groups (MCI and dementia) also showed that, while there was no difference in how much women socialized with friends and neighbors, men socialize nearly 15 percent more than before. This could reflect the way men become more reliant on those closer to them, as they start to suffer from the effects of old age including cognitive decline and the contraction of their larger network. Kotwal says it could also be that people close to them tend to check in more on men with cognitive difficulties than they do when women are in the same position. People whose cognitive abilities are declining also participated less in community activities, group activities and volunteer work.

These results can help clinicians better understand how changes in an older person’s social relationships could be signalling the onset of cognitive impairment, something that should be rasied with a person’s medical provider.

“We hope that these findings will help clinicians better identify social vulnerabilities in those at risk for early cognitive loss. The information could help ease the transition to overt dementia for both patients and caregivers, should progression occur,” says Kotwal.

Source: EurekAlert!