It is easy to find information in the newspaper or popular magazines about the incidence and devastating effects of Alzheimer’s Disease. We also see TV commercials for medications that may help to slow the progression. But, how do we know if we or someone close to us is exhibiting normal age related forgetfulness or the more serious signs of cognitive decline typically found in Alzheimer’s Dementia?
As we age there is a greater amount of information cataloged within our memory bank and thus it takes longer to retrieve specific details. In normal aging, the ability to perform tasks quickly or to multi-task becomes more difficult as the brain begins to process information at a slower pace. However, although the speed of processing slows, this should not interfere with the performance of daily activities.
Normal cognitive aging is inherent in all humans. It is a gradual, ongoing process that is highly variable from individual to individual and will progress regardless of a person’s initial cognitive function. However, that some cognitive functions, such as wisdom, knowledge, satisfaction and happiness actually improve with age.
In Normal Age-Related Forgetfulness, people may experience situations that are often referred to as a “senior moment.” These incidents may include forgetting where we left our glasses or keys or substituting names of family members or acquaintances, such as calling a grandson by a son’s name. We may occasionally forget an appointment or enter a room and forget why we are there. We can become easily distracted and forget a passage that was just read or a conversation that just took place. We may also have difficulty retrieving information quickly: the infamous: “it’s on the tip of my tongue.” These situations or “moments” are more likely to happen or will become more apparent in fast-paced environments, pressured tasks, highly technical or new learning situations, stressful events, and if the individual is otherwise distracted or their attention is engaged elsewhere. Such situations are less likely to happen when the individual is in a familiar or comfortable environment.
However, cognitive decline or “dementia,” the loss of basic mental functions—thinking, remembering, learning and reasoning—and behavioral abilities, does interfere with activities of daily life. Common signs of declining cognitive abilities include memory loss, problems with language skills, visual perception, and the ability to pay attention. Some individuals can also experience personality changes. Dementia is not a part of healthy aging. There are multiple forms of dementia; Alzheimer’s being the most common form seen in individuals over the age of 65.
A person in the beginning stages of abnormal cognitive decline is labeled as having Mild Cognitive Impairment (MCI). Individuals with MCI will develop increasing problems with memory, language, thinking and judgement. This is an intermediate stage, and although the individual is usually still functioning, they will display increasing difficulty in maintaining the “status quo.” They will frequently lose and misplace things, forget conversations, appointments and events, have difficulty remembering the names of new acquaintances, and have problems following the flow of a conversation. Early diagnosis yields better outcomes as cognitive decline can be slowed and possibly halted with early intervention. Its impact can be minimized with lifestyle supports, behavior modifications and dietary improvements.
As an individual progresses to more advanced stages of cognitive decline, they will have difficulty performing the simple tasks of daily life, things like dressing themselves or paying the bills. They will be unable to recall or describe instances of memory failure or the consequences associated with that failure. They will become lost or disoriented in familiar places, will be unable to follow directions and may lack an understanding of the passage of time. In conversation, they will have difficulty with word recall, pronunciation, and proper word usage, and will frequently repeat phrases, stories and questions. They will display poor judgement, have difficulty making choices, and may behave in socially inappropriate ways. Finally, they may exhibit wide fluctuations in their moods and behaviors, especially in unfamiliar or stressful environments.
If you are noticing cognitive changes in yourself or a loved one, remember, there are a number of reversible causes that can be identified and managed by your healthcare provider. These conditions include: depression, the side effects of some medications, B-12 deficiency, thyroid problems, alcohol abuse, and dehydration.
In our May article, we will outline ways a person can protect their cognitive abilities and possibly slow the inevitable decline.
—Nancy Frodermann, RN, MSN, Farmington Valley VNA