Sunday, November 4, 2012

Forgetfulness in Aging Men – Not Necessary Signs of Alzheimer’s

"Will you get me a bowl of ice cream?"
"Don't you think you should write it down so you can remember it?"
she asks.
"No, I can remember it."
"Well, I'd like some strawberries on top, too. Maybe you should write
it down, so's not to forget it?"
He says, "I can remember that. You want a bowl of ice cream with
"I'd also like whipped cream. I'm certain you'll forget that, write
it down?" she asks.
Irritated, he says, "I don't need to write it down, I can remember
it! Ice cream with strawberries and whipped cream - I got it, for
goodness sake!"
Then he toddles into the kitchen. After about 20 minutes, the old man
returns from the kitchen and hands his wife a plate of bacon and
eggs. She stares at the plate for a moment. "Where's my toast?"

*   *   *   *   *

Many older people worry about becoming more forgetful. They think forgetfulness is the first sign of Alzheimer's disease. In the past, memory loss and confusion were considered a normal part of aging. However, scientists now know that most people remain both alert and able as they age, although it may take them longer to remember things.

A lot of people experience memory lapses. Some memory problems are serious, and others are not. People who have serious changes in their memory, personality, and behavior may suffer from a form of brain disease called dementia. Dementia seriously affects a person's ability to carry out daily activities. Alzheimer's disease is one of many types of dementia.

However, it is perfectly normal to forget things from time to time, and it is also normal to become somewhat more forgetful as you age. As people get older, changes occur in all parts of the body, including the brain. As a result, some people may notice that it takes longer to learn new things, they don't remember information as well as they did, or they lose things like their glasses. These usually are signs of mild forgetfulness, not serious memory problems.

Some older adults also find that they don't do as well as younger people on complex memory or learning tests. Scientists have found, though, that given enough time, healthy older people can do as well as younger people do on these tests. In fact, as they age, healthy adults usually improve in areas of mental ability such as vocabulary.

But how much forgetfulness is too much? How can you tell whether your memory lapses are within the scope of normal aging or are a symptom of something more serious?

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Typical Memory Issues

Healthy people can experience memory loss or memory distortion at any age. Some of these memory flaws become more pronounced with age, but — unless they are extreme and persistent — they are not considered indicators of Alzheimer’s or other memory-impairing illnesses. Let’s review some normal memory issues in more details:
1.       Transience. This is the tendency to forget facts or events over time. You are most likely to forget information soon after you learn it. However, memory has a use-it-or-lose-it quality: memories that are called up and used frequently are least likely to be forgotten. Although transience might seem like a sign of memory weakness, brain scientists regard it as beneficial because it clears the brain of unused memories, making way for newer, more useful ones.
2.       Absentmindedness. This type of forgetting occurs when you don’t pay close enough attention. You forget where you just put your pen because you didn’t focus on where you put it in the first place. You were thinking of something else (or, perhaps, nothing in particular), so your brain didn’t encode the information securely. Absentmindedness also involves forgetting to do something at a prescribed time, like taking your medicine or keeping an appointment.
3.       Blocking. Someone asks you a question and the answer is right on the tip of your tongue — you know that you know it, but you just can’t think of it. This is perhaps the most familiar example of blocking, the temporary inability to retrieve a memory. In many cases, the barrier is a memory similar to the one you’re looking for, and you retrieve the wrong one. This competing memory is so intrusive that you can’t think of the memory you want. Scientists think that memory blocks become more common with age and that they account for the trouble older people have remembering other people’s names. Research shows that people are able to retrieve about half of the blocked memories within just a minute.
4.       Misattribution. Misattribution occurs when you remember something accurately in part, but misattribute some detail, like the time, place, or person involved. Another kind of misattribution occurs when you believe a thought you had was totally original when, in fact, it came from something you had previously read or heard but had forgotten about. This sort of misattribution explains cases of unintentional plagiarism, in which a writer passes off some information as original when he or she actually read it somewhere before. As with several other kinds of memory lapses, misattribution becomes more common with age. As you age, you absorb fewer details when acquiring information because you have somewhat more trouble concentrating and processing information rapidly. And as you grow older, your memories grow older as well. And old memories are especially prone to misattribution.
5.       Suggestibility. Suggestibility is the vulnerability of your memory to the power of suggestion — information that you learn about an occurrence after the fact becomes incorporated into your memory of the incident, even though you did not experience these details. Although little is known about exactly how suggestibility works in the brain, the suggestion fools your mind into thinking it’s a real memory.
6.       Bias. Even the sharpest memory isn’t a flawless snapshot of reality. In your memory, your perceptions are filtered by your personal biases — experiences, beliefs, prior knowledge, and even your mood at the moment. Your biases affect your perceptions and experiences when they’re being encoded in your brain. And when you retrieve a memory, your mood and other biases at that moment can influence what information you actually recall. Although everyone’s attitudes and preconceived notions bias their memories, there’s been virtually no research on the brain mechanisms behind memory bias or whether it becomes more common with age.
7.       Persistence. Most people worry about forgetting things. But in some cases people are tormented by memories they wish they could forget, but can’t. The persistence of memories of traumatic events, negative feelings, and ongoing fears is another form of memory problem. Some of these memories accurately reflect horrifying events, while others may be negative distortions of reality. People suffering from depression are particularly prone to having persistent, disturbing memories. So are people with post-traumatic stress disorder (PTSD). PTSD can result from many different forms of traumatic exposure — for example, sexual abuse or wartime experiences. Flashbacks, which are persistent, intrusive memories of the traumatic event, are a core feature of PTSD.

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Causes of Memory Loss

Some memory problems are related to health issues that may be treatable. For example, medication side effects, vitamin B12 deficiency, chronic alcoholism, tumors or infections in the brain, or blood clots in the brain can cause memory loss or possibly dementia (see more on dementia, below). Some thyroid, kidney, or liver disorders also can lead to memory loss. A doctor should treat serious medical conditions like these as soon as possible.

Emotional problems, such as stress, anxiety, or depression, can make a person more forgetful and can be mistaken for dementia. For instance, someone who has recently retired or who is coping with the death of a spouse, relative, or friend may feel sad, lonely, worried, or bored. Trying to deal with these life changes leaves some people confused or forgetful.

The confusion and forgetfulness caused by emotions usually are temporary and go away when the feelings fade. The emotional problems can be eased by supportive friends and family, but if these feelings last for a long time, it is important to get help from a doctor or counselor. Treatment may include counseling, medication, or both.

Aging and Forgetfulness

Scientists and physicians have come up with various ways to describe memory loss due to normal aging. The most basic definition is simply that, as we grow older, the ability to learn new information and recall it at will declines somewhat; for most of us, this decline falls within the average (i.e. normal) range expected for people our age. Forgetfulness is only a cause for concern when the severity of it falls below that normal range.

Forgetfulness due to aging goes by different names. One name in wide use is age-associated memory impairment, or AAMI. This diagnostic category is used to identify people who show a minor-to-moderate decline in memory, but who remain essentially healthy. To be diagnosed with AAMI, you must meet all of the following criteria:
  • You are at least 50 years old.
  • You have noticed that your memory is not as sharp as it used to be.
  • Other possible causes for your memory slips besides the effects of aging have been ruled out. These other factors include a recent heart attack, chronic insomnia, reactions to medications, and Alzheimer's disease.
  • Your score on a standardized memory test is lower than that of an average 25-year-old. This is a way of confirming that your memory is likely to have declined since you were younger.

According to psychologist Steven Ferris, Ph.D., director of the Silberstein Aging and Dementia Research Center at New York University School of Medicine, research conducted to date suggests that up to half of all people 50 or older would meet the criteria for AAMI. Clearly, age-related forgetfulness is widespread. Not everybody over age 50 becomes noticeably forgetful; but many of us will show some degree of AAMI at some point in our lives.

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What is Forgotten?

Thanks to a lot of research on healthy aging people, the effects of ordinary forgetfulness are well understood. Clearly, AAMI doesn’t affect the recall of established memories, such as where you grew up, or the songs you learned how to play on the piano. What AAMI does affect is the ability to learn and recall new information, as in: "Where did I leave those darn scissors? I just put them down!" As such, what we think of as age-associated memory loss is really more like age-associated learning loss.

Many studies on healthy volunteers back this up. For example, research by Marilyn Albert, Ph.D., a professor of psychiatry and neurology at the Harvard Medical School, suggests that the rate at which people acquire new information slows down as they age. Unfortunately, the rest of the world doesn’t always slow down along with our aging brains. Information floods into our lives–new names, new faces, new skills to master–but not all of it gets stored as enduring memories. As a result, we may think we’ve forgotten things that were never really stored in memory in the first place.

On the plus side, although it takes older people longer to learn new information, once they do so they can usually recall it just as well as a younger person. For most of us, mild forgetfulness can be overcome with a little extra effort: by paying closer attention when meeting new people, or by taking things a little more slowly. AAMI "shouldn’t even impair fairly complex activities of daily living, such as filling out a tax return," Ferris emphasizes. "It may take you a while longer to do your tax return, but you’re still going to get it done, and it’s going to be accurate."

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Hereditary or Not?

What we do know is that memory loss or age related forgetfulness is only 50% hereditary. It means we can do a lot to prevent these common signs of aging even if we don’t take into account our genetic disposition. Fortunately for us we can even alter the expression of certain genes to assist in the anti aging battle. Some evidence that genetics play a part in memory loss is apparent when you consider the different symptoms shown in ageing men and women. As men get older they lose their ability to sort out difficult problems and their command of speech deteriorates. As women get older they lose their ability to process information quickly and lose their sense of spatial awareness. Research has also shown that people tend to lose competency more quickly in those areas in which they are already weak. Knowing this gives us an advantage because we can start to strengthen those areas of competency in which we are weak whilst reinforcing those areas in which we are not.

Sources and Additional Information:

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