The distraction of older relatives may simply be a sign of age, or it may signal the first signs of a disease. How can you tell if the situation is serious? Narrated by neurologist Andrew Budson.
With parents, grandparents, many of us, even living in the same city, see each other mainly on holidays. Having met after a long separation, we are sometimes surprised to notice how inexorable time is. And along with other signs of aging of relatives, we can notice their absent-mindedness.
Is it just an age-related phenomenon or a sign of Alzheimer’s disease? Or maybe another memory disorder? Sometimes we watch with anxiety their forgetfulness and think: is it time to see a doctor?
Professor of neurology at Boston University and lecturer at Harvard Medical School Andrew Budson explains the complex processes in the brain in an accessible and understandable way. He prepared a «cheat sheet» for those who are worried about memory changes in elderly relatives.
Normal brain aging
Memory, as Dr. Budson explains, is like a registration system. The clerk brings in information from the outside world, stores it in a filing cabinet, and then retrieves it when needed. Our frontal lobes work like a clerk, and the hippocampus works like a filing cabinet.
In old age, the frontal lobes no longer function as well as in youth. Although none of the scientists dispute this fact, there are different theories as to what causes this. This may be due to the accumulation of tiny strokes in the white matter and pathways to and from the frontal lobes. Or the fact is that with age there is a destruction of neurons in the frontal cortex itself. Or maybe it’s a natural physiological change.
Whatever the reason, when the frontal lobes get older, the «clerk» does less work than when he was young.
What are the general changes in normal aging?
- In order to remember information, a person needs to repeat it.
- It may take longer to absorb the information.
- You may need a hint to retrieve information.
It is important to note that in normal aging, if the information has already been received and assimilated, it can be retrieved — it’s just that it may now take time and prompts.
Alarms
In Alzheimer’s disease and some other disorders, the hippocampus, the file cabinet, is damaged and will eventually be destroyed. “Imagine that you open a drawer with documents and find a large hole in its bottom,” explains Dr. Budson. “Now imagine the work of a wonderful, efficient clerk who extracts information from the outside world and puts it in this box … so that it disappears into this hole forever.
In this case, the information cannot be extracted even if it was repeated during the study, even if there were prompts and enough time for recall. When this situation arises, we call it quick forgetting.”
Rapid forgetting is always abnormal, he notes. This is a sign that something is wrong with the memory. It is important to understand that this is not necessarily a manifestation of Alzheimer’s disease. The causes can be many, including fairly simple ones like a side effect of a drug, a vitamin deficiency, or a thyroid disorder. But in any case, it is worth our attention.
Rapid forgetting is accompanied by a number of manifestations. So, the patient
- He repeats his questions and stories.
- Forget about important meetings.
- Leaves potentially dangerous or valuable items unattended.
- Loses things more often.
There are other signs to watch out for as they may indicate a problem:
- There were difficulties with planning and organization.
- Difficulties arose with the selection of simple words.
- A person can get lost even on familiar routes.
Specific situations
For clarity, Dr. Budson offers to consider some examples of situations in which our older relatives may find themselves.
Mom went to get groceries, but she forgot why she went out. She did not buy anything and returned without remembering why she went. This may be a normal age-related manifestation — if the mother was distracted, met a friend, talked and forgot what exactly she needed to buy. But if she didn’t remember why she left at all, and returned without shopping, this is already a cause for concern.
Grandpa needs to repeat the instructions three times so that he remembers them. Repetition of information is useful for remembering it at any age. However, once learned, quick forgetting is a warning sign.
Uncle can’t remember the name of the cafe until we remind him. Difficulty remembering people’s names and places may be normal and becomes more common as we age. However, having heard the name from us, a person should recognize it.
Grandma asks the same question several times an hour. This repetition is a wake-up call. Previously, my aunt could keep track of her things, but now every morning for 20 minutes she is looking for one thing or another. An increase in this phenomenon may be a sign of rapid forgetting and also deserves our attention.
The father can no longer complete simple home repair tasks like he used to. Due to problems with thinking and memory, he is no longer capable of everyday activities that he calmly performed throughout his adult life. This may also indicate a problem.
Sometimes it is a break between meetings with relatives that helps to look at what is happening with a fresh look and evaluate the dynamics. Making diagnoses is the task of doctors, but close and loving people are able to be attentive to each other and notice when an elderly person needs help and it’s time to turn to a specialist.
About the author: Andrew Budson is Professor of Neurology at Boston University and an instructor at Harvard Medical School.