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Forgetfulness in Old Age - It's not what you think
National Institute on Aging
Age Page
Forgetfulness in Old Age: It's Not What You Think
Many people are afraid that growing old means losing the
ability to think, reason, or remember. They worry when they feel
confused or forgetful that these feelings are the first signs of
senility. In the past, doctors dismissed memory loss, confusion, or
similar behaviors as a normal part of aging. However, scientists
now know that most people remain alert and capable as they age.
They also know that people who experience changes in personality,
behavior, or skills may be suffering from a form of brain disease
called dementia.
The term dementia describes a group of symptoms that usually
are caused by changes in the normal activity of very sensitive
brain cells. Dementia seriously interferes with a person's ability
to carry out daily activities. Dementia is irreversible-it cannot
be cured. However, there are many conditions with symptoms that
seem like dementia but aren't. These reversible conditions can be
caused by problems such as a high fever, poor nutrition, a bad
reaction to a medicine, or a minor head injury. Although not
dementia, medical problems like these can be serious and should be
treat- ed by a doctor as soon as possible
Sometimes older people have emotional problems that are
mistaken for dementia. Feeling sad, lonely, worried, or bored may
be more common for older people facing retirement or handling the
death of a relative or friend. Adapting to these changes can leave
some people feeling confused or forgetful. Emotional problems can
be helped by supportive friends and family, or by professional help
from a counselor.
Diagnosis
People who think they might have a form of dementia should
have a thorough physical, neurological, and psychiatric evaluation.
They also should have a complete medical exam, as well as tests of
mental abilities. Some tests, such as a brain scan, can help the
doctor rule out a curable disorder. Such a scan also may show signs
of normal age-related changes in the brain. It may be necessary
to repeat the scan at a later date to see if there have been
further changes in the brain.
A complete medical exam also includes getting information
about the person's medical history, including use of prescription
and over-the-counter medicines, diet, and general health. Because
a correct diagnosis depends upon recalling these details
accurately, the doctor also may ask a close relative for
information.
The two most common forms of dementia are multi-infarct
dementia (sometimes called vascular dementia) and Alzheimer's
disease (pronounced ALTZ-hi-merz). In multi-infarct dementia,
changes in the brain's blood vessels result in wide-spread death of
brain tissue. Symptoms that begin suddenly may be a sign of this
kind of dementia. Telltale signs of multi-infarct dementia
include vision or speech problems, and/or numbness or weakness on
one side of the body. People with multi-infarct dementia are likely
to show signs of improvement or remain stable for long periods of
time, then quickly develop new symptoms.
Scientists once thought that multi-infarct dementia and other
types of vascular dementia caused many cases of irreversible mental
impairment. They now believe that most older people with serious
mental problems suffer from Alzheimer's disease. In Alzheimer's
disease, nerve cell changes in certain parts of the brain result in
the death of a large number of cells. Symptoms begin slowly and
become steadily worse. Both forms of dementia can exist together,
making it hard for the doctor to diagnose either.
Treatment
If the doctor diagnoses an irreversible disorder, there is
still much that can be done to treat the patient and to help the
family cope.
Family members and friends can help people with dementia
maintain their daily routines, physical activities, and social
contacts. People with dementia should be kept informed about the
details of their lives-the time of day, where they live, and what
is happening at home or in the world. This may help stop brain
activity from failing at a more rapid pace. Memory aids can help in
day-to-day living. Some families find that a big calendar, a list
of daily plans, notes about simple safety measures, and written
directions describing how to use common household items can be very
helpful.
Proper diet is important. Although no special diets or
supplements have been found to prevent or reverse dementia, a
balanced diet helps maintain overall good health. In cases of
multi-infarct dementia, changes in diet may prevent more strokes.
Many people with dementia do not need medication. For some,
the careful use of drugs can reduce troublesome symptoms. The
doctor may prescribe medications for people with dementia who
experience agitation, anxiety, depression, or problems sleeping.
Although family and friends can help, a person with
multi-infarct dementia or Alzheimer's disease should be under the
care of a physician. A neurologist, psychiatrist, family doctor,
internist, or geriatrician may be the primary care doctor. The
doctor will continue to treat the patient's physical and emotional
problems and answer the many questions that the person or family
may have.
Dementia patients lose their abilities at different rates.
Even so, patients and their families have many common
experiences-loneliness, frustration, and lack of information and
resources. Family support groups around the country provide a
valuable resource for patients and their families. For example,
they can help family caregivers lean how to cope with the behavior
changes patients may experience.
The Alzheimer's Association, Suite 1000, 919 N Michigan
Avenue, Chicago, IL 60611-1676, phone (800) 272-3900, has more than
200 chapters across the country. It sponsors support groups,
encourages research, provides family services, and distributes
information and education on all forms of dementia.
Accurate, current information about dementia also is
important. The Alzheimer's Disease Education and Referral Center
(ADEAR) is a clearinghouse supported by the National Institute on
Aging. It provides information about Alzheimer's disease and
multi-infarct dementia. The address of the ADEAR Center is P.O. Box
8250, Silver Spring, MD 20907-8250; phone (800) 438-4380. Hope for
Tomorrow Diet, the development of new medications, and lifestyle
may someday help prevent or reverse the damage caused by
multi-infarct dementia or Alzheimer's disease. Some doctors
believe it is very important for people suffering multi-
infarct dementia to try to prevent further damage by controlling
high blood pressure, monitoring and treating high blood
cholesterol, and not smoking.
Developing interests or hobbies and staying involved in
activities that keep the mind and body active are among the best
ways older people can remain sharp and keep their mental abilities.
Careful attention to physical fitness, including a balanced diet,
also may go a long way to help people keep a healthy state of mind.
Some physical and mental changes occur with age even in healthy
persons, but much pain and suffering can be avoided if older
persons, their families, and their doctors realize that dementia is
a disease, not part of normal aging.
The ADEAR Center provides health professionals and the general
public information about Alzheimer's disease diagnosis, treatment,
resources, and research. The Center also distributes printed
information and makes referrals to other organizations. The
services of the ADEAR Center are provided free of charge.
Limited quantities of the following publications are available
by calling or writing the ADEAR Center:
* Alzheimer's Disease Fact Sheet
* Multi-Infarct Dementia Fact Sheet
* Progress Report on Alzheimer's Disease
* Alzheimer's Disease Centers Program Directory
* ADEAR Center Brochure
ADEAR Center
P.O. Box 8250
Silver Spring, MD 20907-8250
Telephone: (800) 438-4380
National Institute on Aging
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
National Institutes of Health
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