Memory changes or dementia?

by Dr. Andrea Hilborn, ND Often while I’m listening to patients sitting across from me describe their memory problems, I’m secretly thinking, ‘My memory is worse than that and I’m 20 years younger!’

For many people, memory appears to naturally mildly decline with age. That is not something to worry about, but rather to learn to manage. Menopause can cause a temporary worsening of memory. This will get better as time goes by.

When should you worry about your memory? The answer is that you probably shouldn’t worry about it. You could go crazy trying to assess your own memory. An article from the Mayo Clinic suggests the following as early signs of dementia: forgetting common words when speaking, misplacing items in inappropriate places, and undergoing sudden changes in mood for no apparent reason. Personally, I do all these things. I expect most people do. A general rule of thumb is that sudden changes in memory, and extreme memory problems, should be investigated. By extreme memory problems, I mean you look at your coffee mug and you aren’t sure what it is. Or, a family member comes to your door and you are not sure who they are.

Consider that your memory may seem bad because you have so very much to remember. I think that is the case for me. I have found technology to be enormously helpful. I use a program called Evernote to store most of the information I might ever need. It is a searchable program that can be installed on your computer, smart phone and tablet. Want to make that recipe you found four months ago? Just search ‘kale salad’ and you can pull it up. I also use an electronic calendar to remember everything that has a date attached to it from bill payments to friends’ children’s birthdays. For me, everything must be written down and that’s just the way I am.

Dementia is different from normal memory changes. According to the Diagnostic and Statistical Manual of Mental Disorders, dementia is “the presence of an acquired impairment in memory, associated with impairment in one or more cognitive domains, including: executive function (e.g., abstract thinking, reasoning, judgment); language; learned motor sequences; and ability to recognize faces, objects,or other sensory information.” These impairments have to be severe enough to interfere with work, social activities or relationships in order to meet the definition of dementia.

Dementia is not a natural process but a disease process. If a person has dementia, then their healthcare provider(s) need to search for a cause of it. Common causes of dementia are Alzheimer’s disease, blood vessel problems and alcohol abuse.

People who have true dementia often aren’t worried about their memory — it is their family members that detect the problem. The diagnosis of dementia is a complex process that involves looking at your history, performing mental status tests, talking to family members and doing certain physical exams.

If you have concerns, you are always welcome to speak to your doctor. Your doctor should take your concerns seriously and investigate them, and you should be open to your doctor’s assessment.

Memory is best preserved by all the usual good health suspects: good diet, good sleep and good exercise. No surprises there.

Common sense tells us that sleeping well improves our memory, and nearly a century of scientific study backs the assumption up. We now think that the brain is active during sleeping hours, consolidating memories. As we sleep, our brain goes over our recent memories repeatedly, in order to strengthen them. For any students reading this — don’t pull all-nighters!

A review of how physical activity affects memory found that aerobic exercise improved scores on memory tests and actually altered the structure of the brain. The hippocampus is a brain structure involved in memory. With more physical activity, the hippocampus increases in size.