Some mild forgetfulness is a normal part of aging. But when does this occasional absentmindedness become something we should be concerned about? And are there measures we can take to minimize or even prevent those episodes? Medical News Today spoke to experts about how to recognize the differences between normal memory lapses and neurocognitive issues, such as dementia, and looked at research into how we might keep our aging brains alert.
We all forget things sometimes. Who among us has not mislaid their keys or phone, or struggled to locate their car in a car park?
As we age, our brains change, and these memory lapses seem to become more frequent. But is memory loss a normal part of aging?
According to the National Institute on Aging (NIA), many older adults worry about their memory, but taking longer to learn new skills and occasionally forgetting details are usually not serious age-related memory problems.
And although normal brain aging may mean slower processing speeds and more trouble multitasking, the Centers for Disease Control and Prevention (CDC) advise that routine memory, skills, and knowledge are stable and may even improve with age.
According to the Alzheimer’s Society, normal aging leads to most of the following, which people usually start to notice from their 40s or 50s:
Although this may be frustrating, for most people, it is a natural part of aging, and it is not a sign of dementia.
However, around 40% of people aged 65 and over do have some age-associated memory impairment. But of these, only 1% will progress to develop a form of dementia.
Speaking to Medical News Today, Dr. Emer MacSweeney, CEO and consultant neuroradiologist at Re:Cognition Health, advised that people should not regard age-related memory loss as inevitable.
“It’s not normal to develop cognitive issues and short-term memory loss as we get older. As everyone knows, lots of elderly people do not develop this problem,” she said.
And Dr. Miriam Weber, clinical neuropsychologist and associate professor of neurology at the University of Rochester Medical Center, agreed:
“Many cognitive functions change across the entire lifespan, not just in older adulthood. Memory — learning new information and holding on to that information over time — may decline slightly beginning when one is in their 60s (usually later 60s), with perhaps more notable declines in the 70s and 80s.”
“However, this is based on group averages, and not everyone experiences this decline. There are also groups of people — sometimes called “super agers” — who are in their 80s or older, who show cognitive performance comparable to middle-aged adults,” she added.
Those more frequent memory lapses as we age are not necessarily a sign of any cognitive impairment, added Dr. MacSweeney.
“When we are more relaxed and not rising to challenges at work every day, we may not concentrate with the same level of focus and effort, and therefore not be so energetic about remembering details of events and conversations,” she explained.
“Also, as people develop problems with hearing and eyesight they may actually miss items of conversation and ‘appear’ not to have remembered,” Dr. MacSweeney continued.
Hearing problems may not just cause people to appear not to have remembered — a new study suggests that treating hearing loss with hearing aids might reduce the risk of developing dementia by up to 19%. This study adds to the growing evidence of a link between hearing loss and cognitive impairment.
“Problems with memory can occur at any age, especially with brain fog from [COVID-19] and for lots of other reasons. However, new onset of short-term memory loss after the age of 65 should certainly raise the possibility of the early stages of mild cognitive impairment [MCI] due to Alzheimer’s disease.”
– Dr. Emer MacSweeney
In some people, MCI is caused by a hormonal imbalance or nutrient deficiency, so once this is resolved, the MCI can be reversed.
In others, it may be the first sign of dementia. People with MCI have mild memory and thinking problems, but can usually take care of themselves and carry out normal daily activities.
Symptoms of MCI may include:
Although MCI may develop into dementia, for many the condition does not progress further.
However, if the symptoms persist, or start to impact daily functioning, this may mean that the person is developing dementia. In this case, they must seek medical help and diagnosis.
“Normal age-related declines might include occasionally having trouble finding a word mid-conversation — that may come to you later — occasionally misplacing objects, occasionally repeating yourself in conversation, occasionally missing a monthly payment. In dementia, these things happen much more frequently and are more consequential, and the cognitive difficulties interfere with one’s function.”
– Dr. Miriam Weber
Dr. MacSweeney emphasized that “[t]esting is essential, as there are lots of reversible causes of short-term memory loss, too, and it’s important to get a diagnosis.”
“If due to a reversible problem, this needs to be corrected, as quickly as possible, and if due to the early stages of [Alzheimer’s disease] or another neurodegenerative disease, it’s important to seek help, as early as possible,” she advised.
Keeping physically healthy can help protect against memory loss and dementia. The NIA recommends regular aerobic exercise, and a healthy diet with plenty of fresh fruit and vegetables.
In addition, getting the right amount of sleep, socializing, minimizing stress, and keeping health conditions such as high blood pressure and diabetes under control will help reduce the risk of cognitive decline.
Dr. MacSweeney reiterated this advice:
“It has been shown that as a population we can reduce risk of cognitive impairment due to Alzheimer’s by adhering to healthy lifestyle habits including exercise, diet (Mediterranean diet high in fish oils) and keep[ing] sugar intake low — the brain hates sugar. High levels of mental and social activity. The brain needs to be exercised just like our bodies to stay in good condition. Avoid excess alcohol and smoking.”
A new study has also highlighted the importance of vitamin D in preserving cognitive function. In this study of postmortem brains, the brains of people with higher cognitive function before death contained higher levels of vitamin D.
The researchers found that although the higher levels of vitamin D were associated with up to 33% lower odds of dementia symptoms, they were not associated with any decrease in post-mortem dementia neuropathology.
Therefore, they could not suggest a mechanism for the potentially protective effect of vitamin D, or show a causative link.
They advised that ensuring you get sufficient vitamin D from sunlight and from foods such as oily fish might be beneficial. However, they warned against taking high doses of the vitamin to try and prevent dementia, as this can cause other health problems.
“Engaging in cognitively stimulating activities is also beneficial. We also know that depression and anxiety can negatively impact cognition, so it is important to treat those conditions if present. Maintaining social connections, engaging in meaningful activities, and exercising also help mood, which in turn, can impact cognition. It is not only your body that benefits from exercise, keeping the brain exercised can help preserve your mental abilities well into older age.”
– Dr. Miriam Weber
Although keeping active and engaged as you age may not prevent dementia, mentally stimulating activities, such as volunteering, reading, playing games, or learning new skills could help lower the risk.
Doing word games, such as crosswords, has long been advocated in the popular press as a means of keeping yourself sharp, but until recently, there has been little evidence in peer-reviewed journals.
Now, a new study published in NEJM Evidence has demonstrated their efficacy in a small group of people with MCI.
The participants, who had an average age of 71, and some degree of mild cognitive impairment, did either intensive crossword puzzle training or intensive cognitive games training on a computer for 12 weeks. They continued with booster sessions to 78 weeks.
At 78 weeks, crossword puzzles had improved both a primary cognitive outcome measure (ADAS-Cog) and a measure of daily functioning more than cognitive games. More strikingly, brain shrinkage — measured using MRI — was less in those who did the crossword training.
So, you can reduce your risk of memory issues, but once the memory starts to fail, can the problem be reversed?
There is some evidence that it may be possible. In a mouse study, researchers managed to reverse memory loss using chondroitin-6-sulphate, a substance that has also been shown to increase lifespan in the nematode worm Caenorhabditis elegans. It might have similar effects in people, but has yet to be tested.
In a more recent study, researchers improved memory function in adults aged between 65 and 88 years using electrical stimulation via a wearable cap.
The researchers found that giving 20 minutes of electrical stimulation on 4 consecutive days led to an improvement in both working memory and long-term memory for at least 1 month. They could focus the stimulation to affect different types of memory.
Dr. Robert Reinhart, of Boston University, corresponding author on the study, explained: “We developed two brain stimulation protocols — one for selectively improving short-term memory via low-frequency parietal stimulation, and another protocol for selectively improving long-term memory via high-frequency prefrontal stimulation.”
However, the improvement was only tested over one month, so the researchers call for further investigation into whether similar treatments might have a long-term benefit.
As we age, many of us will find we experience more frequent memory lapses, but unless these start to interfere with daily functioning, they are unlikely to be a sign of impending dementia.
To minimize the occurrence of memory issues, the advice is to keep active, eat well, look after your health, and stay engaged in lots of social and stimulating activities. And remember, like any part of the body, the brain will function better if it is exercised.
So keep up the daily word puzzle, and for even greater benefit tackle it with a friend. It could well be doing you more good than you realize.
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