December 5, 2020

The aging brain

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The International Medical Group is a multi-disciplinary medical practice that offers professional and personalized care. We have recently welcomed a new general practitioner, an internist and a registered dietician into our realm. Dr Lynn Dawber is a South African national who joined us from New Zealand where she has been practicing for a number of years.  She is a welcome additional to our family and we look forward to our patients (new and existing) meeting her. The International Medical Group performs a wide range of services from general family medicine and specialist services to Botox, dermal fillers and natural hormone replacement therapy. We always welcome new patients and will assist you in any way that we can to ensure that you get the treatment and care that you need. Stop by our offices or call us with any questions. We look forward to meeting you.

As we age, brain volume shrinks, multiple changes occur and we become less efficient at carrying information. This process begins in our 20s and starts to accelerate at around age 50, when changes may become more noticeable.

A person in their 50s may take longer to recall names and words, learn new tasks or multi-task and attention to detail declines. In their 60s, these changes become more perceptible. It becomes harder to concentrate and to tune out distractions, new memories are more difficult to form and it takes longer to recall information.

The rate at which the brain ages is dependent on factors such as genetics, hormones, neurotransmitters (e.g. dopamine, serotonin), other illnesses, experiences and environmental factors.

Is this memory loss normal?

1. Other causes for memory loss

Are there any potentially reversible factors in this case which may explain the memory loss?

 2. Normal age-related cognitive decline vs early stage dementia

The main distinction between memory loss due to aging and memory loss due to dementia is that problems in age-related memory loss do not affect daily functioning or the ability to live independently. Most people are able to maintain their cognitive ability at a functioning level throughout their life.

3. Memory tests

A diagnosis of mild cognitive impairment or dementia is predominantly made from the clinical history provided by the patient and a significant other or close friend. Memory tests can be used to help confirm cognitive impairments.

Early diagnosis allows people to make arrangements such as appointing Enduring Powers of Attorney, updating wills, moving homes and visiting family overseas. It also can provide an explanation for changes that have been occurring in the person for a long time (sometimes years) before they come to see the doctor. There is no cure for dementia but there are treatments that can alter the course of the illness.

How to keep your brain healthy

Lifestyle interventions to reduce cardiovascular risk such as regular exercise, eating a balanced diet, low to moderate alcohol intake and being a non-smoker also seem to protect against age-related cognitive decline. A healthy lifestyle, both mental and physical, is the best preventative defence.

Hypertension, stroke and small vessel disease, diabetes, high cholesterol, obesity and have all been associated with an increased risk of age-related cognitive decline.

Exercise

An increased level of fitness is associated with improved memory and learning and a reduction in age-related cognitive decline.

Alcohol

Consumption of small quantities of alcohol (one standard unit of alcohol a day) on a regular basis is thought to stimulate the brain therefore counteracting cognitive decline.

Diet

A healthy, balanced diet rich in antioxidants (e.g. blueberries, strawberries, cocoa, tea) and omega-3 (e.g. oily fish) may help to slow age-related cognitive decline. It is preferable (and safer) to use naturally occurring sources of antioxidants and omega-3 oils than supplement forms.

Supplements

Gingko biloba is a commonly used supplement for memory loss

Antioxidant supplements such as vitamin A, vitamin E and beta-carotene show no significant improvement in longevity, in fact they may actually increase mortality.

Pharmacological treatments

Medication is often used to temporarily stop or slow cognitive and functional decline in people with Alzheimer-type dementia and dementia associated with Parkinson’s disease.

Brain exercises

It is never too late to start exercising the brain. There is growing evidence that participating in activities such as reading, puzzles, computer activities and crafts reduces the risk of age-related cognitive decline. Social interaction is beneficial too. In addition to exercising the brain, there are several strategies that can be adopted to help memory recall:

  • Place commonly lost items in the same spot every time
  • Write things down e.g. make a “to do” list
  • Say words out loud e.g. “I have turned off the iron”, repeat a person’s name after being introduced
  • Use memory aids e.g. notepad, diary, wristwatch alarm, voice recorder
  • Group items using mnemonics e.g. alphabetize a list, create an acronym, use rhymes or create a story to connect the information
  • Concentrate and relax when trying to remember
  • Sleep on it – research has shown that the brain continues to solve a problem while we sleep

Elderly people are encouraged to take up dancing! This combines physical activity, brain exercise (counting rhythms, learning steps etc) and social interaction. Some patients may prefer to join a walking or exercise group.

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