Table 11.1. Differences between Normal Aging and Alzheimer Disease
This section includes text excerpted from “Memory and Thinking: What's Normal and What's Not?” National Institute on Aging (NIA), National Institutes of Health (NIH), July 23, 2017.
Many older people worry about their memory and other thinking abilities. For example, they might be concerned about taking longer than before to learn new things, or they might sometimes forget to pay a bill. These changes are usually signs of mild forgetfulness—often a normal part of aging—not serious memory problems.
Talk with your doctor to determine if memory and other thinking problems are normal or not, and what is causing them.
What's the difference between normal, age-related forgetfulness, and a serious memory problem? Serious memory problems make it hard to do everyday things like driving and shopping. Signs may include:
Some older adults have a condition called mild cognitive impairment, or MCI, in which they have more memory or other thinking problems than other people their age. People with MCI can take care of themselves and do their normal activities. MCI may be an early sign of Alzheimer, but not everyone with MCI will develop Alzheimer disease. Signs of MCI include:
If you have MCI, visit your doctor every 6 to 12 months to see if you have any changes in memory or thinking skills over time. There may be things you can do to maintain your memory and mental skills. No medications have been approved to treat MCI.
Dementia is the loss of cognitive functioning—thinking, remembering, learning and reasoning—and behavioral abilities to such an extent that it interferes with daily life and activities. Memory loss, though common, is not the only sign. A person may also have problems with language skills, visual perception, or paying attention. Some people have personality changes. Dementia is not a normal part of aging.
There are different forms of dementia. Alzheimer disease is the most common form in people over age 65. Table 11.1 below explains some differences between normal signs of aging and Alzheimer disease.
If you, a family member, or friend has problems remembering recent events or thinking clearly, talk with a doctor. He or she may suggest a thorough checkup to see what might be causing the symptoms. The annual Medicare wellness visit includes an assessment for cognitive impairment. This visit is covered by Medicare for patients who have had Medicare Part B insurance for at least 1 year.
Memory and other thinking problems have many possible causes, including depression, an infection, or a medication side effect. Sometimes, the problem can be treated, and the thinking problems disappear. Other times, the problem is a brain disorder, such as Alzheimer disease, which cannot be reversed. Finding the cause of the problems is important to determine the best course of action.
A note about unproven treatments: Some people are tempted by untried or unproven “cures” that claim to make the brain sharper or prevent dementia. Check with your doctor before trying pills, supplements or other products that promise to improve memory or prevent brain disorders. These “treatments” might be unsafe, a waste of money, or both. They might even interfere with other medical treatments. Currently there is no drug or treatment that prevents Alzheimer disease or other dementias.
This section includes text excerpted from “Cognitive Health and Older Adults,” National Institute on Aging (NIA), National Institutes of Health (NIH), August 21, 2017.
Cognitive health—the ability to clearly think, learn, and remember—is an important component of brain health. Others include:
The following steps can help you function every day and stay independent—and they have been linked to cognitive health, too.
Taking care of your physical health may help your cognitive health. You can:
A healthy diet can help reduce the risk of many chronic diseases, such as heart disease or diabetes. It may also help keep your brain healthy.
In general, a healthy diet consists of fruits and vegetables; whole grains; lean meats, fish, and poultry; and low-fat or nonfat dairy products. You should also limit solid fats, sugar, and salt. Be sure to control portion sizes and drink enough water and other fluids.
Researchers are looking at whether a healthy diet can help preserve cognitive function or reduce the risk of Alzheimer disease. For example, there is some evidence that people who eat a “Mediterranean diet” have a lower risk of developing mild cognitive impairment.
Researchers have developed and are testing another diet, called MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay), a combination of the Mediterranean and DASH (Dietary Approaches to Stop Hypertension) diets. One study suggests that MIND may affect the risk of Alzheimer disease.
Being physically active—through regular exercise, household chores, or other activities—has many benefits. It can help you:
Studies link ongoing physical activity with benefits for the brain, too. In one study, exercise stimulated the human brain's ability to maintain old network connections and make new ones that are vital to cognitive health. Other studies have shown that exercise increased the size of a brain structure important to memory and learning, improving spatial memory.
Aerobic exercise, such as brisk walking, is thought to be more beneficial to cognitive health than nonaerobic stretching and toning exercise. Studies are ongoing.
Federal guidelines recommend that all adults get at least 150 minutes of physical activity each week. Aim to move about 30 minutes on most days. Walking is a good start. You can also join programs that teach you to move safely and prevent falls, which can lead to brain and other injuries. Check with your healthcare provider if you haven't been active and want to start a vigorous exercise program.
Being intellectually engaged may benefit the brain. People who engage in meaningful activities, like volunteering or hobbies, say they feel happier and healthier. Learning new skills may improve your thinking ability, too. For example, one study found that older adults who learned quilting or digital photography had more memory improvement than those who only socialized or did less cognitively demanding activities.
Lots of activities can keep your mind active. For example, read books and magazines. Play games. Take or teach a class. Learn a new skill or hobby. Work or volunteer. These types of mentally stimulating activities have not been proven to prevent serious cognitive impairment or Alzheimer disease, but they can be fun!
Scientists think that such activities may protect the brain by establishing “cognitive reserve.” They may help the brain become more adaptable in some mental functions, so it can compensate for age–related brain changes and health conditions that affect the brain.
Formal cognitive training also seems to have benefits. In the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) trial, healthy adults 65 and older participated in 10 sessions of memory training, reasoning training, or processing–speed training. The sessions improved participants' mental skills in the area in which they were trained. Most of these improvements persisted 10 years after the training was completed.
Be wary of claims that playing certain computer and online games can improve your memory and other types of thinking. Evidence to back up such claims is evolving. National Institute on Aging (NIA) and others are supporting research to determine if different types of cognitive training have lasting effects.
Connecting with other people through social activities and community programs can keep your brain active and help you feel less isolated and more engaged with the world around you. Participating in social activities may lower the risk for some health problems and improve well-being.
So, visit with family and friends. Join programs through your Area Agency on Aging, senior center, or other community organizations.
It's not known for sure yet if any of these actions can prevent or delay Alzheimer disease and age-related cognitive decline. But some of them have been associated with reduced risk of cognitive impairment and dementia.
This section includes text excerpted from “Healthy Living—Memory and Healthy Aging,” Centers for Disease Control and Prevention (CDC), September 22, 2015.
Physical activity, social engagement, and a healthy diet help prevent chronic conditions and increase the longevity and quality of life of older adults, but despite engaging in these healthy activities, some adults may develop memory loss or dementia. Some declines in memory are a normal part of aging, but sometimes they can signal a problem. Learn how to tell the difference.
Cognition is a combination of mental processes that include intuition, judgment, language, remembering, and the ability to learn new things. When cognition is impaired (referred to as cognitive impairment or decline), a person has trouble with these processes that begins to affect the things he or she can do in everyday life.
The decline of cognitive health—from mild cognitive decline to dementia—can have profound implications for an individual's health and well-being. Older adults and others experiencing cognitive decline may be unable to care for themselves or conduct necessary activities of daily living, such as meal preparation and money management, cooccurring medical conditions, and the inability to effectively manage medications are particular concerns when an individual's memory is impaired.
Forgetfulness can be a normal part of aging. 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 a serious memory problem.
Some memory problems are related to health issues that may be treatable. For example, medication side effects, vitamin B 12 deficiency, chronic alcoholism, tumors or infections in the brain, or blood clots in the brain can cause memory loss or possibly dementia. 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.
A person with dementia should be under a doctor's care. The doctor might be a neurologist, family doctor, internist, geriatrician, or psychiatrist. He or she can treat the patient's physical and behavioral problems (such as aggression, agitation, or wandering) and answer the many questions that the person or family may have. At this time, however, there are no effective treatments to slow the progression, or to cure dementia or Alzheimer disease.
Family members and friends can help people in the early stages of dementia to continue their daily routines, physical activities, and social contacts. People with dementia should be kept up to date about the details of their lives, such as the time of day, where they live, and what is happening at home or in the world. Memory aids may help. Some families find that a big calendar, a list of daily plans, notes about simple safety measures, and written directions describing how to use common household items are useful aids.
According to a study published in a March 2015 release of Centers for Disease Control and Prevention (CDC)'s journal Preventing Chronic Disease, a total of 12.6 percent of households reported at least one adult who experienced increased confusion or memory loss, and in nearly 6 percent of households all adults experienced increased confusion or memory loss. Based on these results, an estimated 4 million households in the 13 U.S. states included in the study have a family member with increased confusion or memory loss, potentially affecting more than 10 million people. This leaves many people who are left with the task of caring for someone suffering from a memory problem.
If you're concerned that you or someone you know has a serious memory problem, talk with your doctor. He or she may be able to diagnose the problem or refer you to a specialist, such as a neurologist or geriatric psychiatrist. Healthcare professionals who specialize in Alzheimer disease and other dementias can recommend ways to manage the problem or suggest treatment or services that might help.