Forgetfulness: Remembering what’s normal and what’s not
AN APPLE A DAY - Tyrone M. Reyes M.D. (The Philippine Star) - April 20, 2015 - 10:00am

Have you ever walked into a room, then suddenly stopped, as you forgot what brought you there in the first place?  Have you run into someone you know but for the heck of it, cannot recall his or her name, however hard you tried?  Do you often engage in a frantic search for misplaced car keys, glasses, cell phones or other everyday items?

Well, hindi ka nag-iisa! For many of us, these types of memory lapses become more common as we get older.  Consider the results of the following study, reportedly done on normal individuals, which looked into the percentage of adults, by age, who sometimes or frequently have trouble remembering names:  At age 18, 13 percent. At 45, 35 percent.  At 55, 38 percent.  And at 75, 51 percent!

“Normal changes in mental function are just part of aging,” says Dr. Aaron Nelson, chief of Psychology and Neuropsychology at the Brigham and Women’s Hospital in Boston.  “Just as other systems in the body change — like bones, joints, muscles, and organs — the brain is not exempt from the aging process.”  Our brains are forming fewer connections as we age, so the memory is not as strong as it used to be. It may take us longer to remember basic information such as names, dates, or where we left our car keys.  “As we get older, the processing speed of our brain slows down, so we can’t recall information as quickly as we used to,” explains Dr. Anne Fabiny, chief of Geriatrics at the Cambridge Health Alliance in Boston.

“Memory lapses are unsettling, but they don’t necessarily herald impending dementia,” says Dr. Gad Marshall, assistant professor of Neurology at Harvard Medical School.  The key is how often these slips occur.  “You really need to figure out the pattern,” he says.  “Is it happening several times a week or is it happening once or twice a month?  Is it a change compared to five or 10 years ago?  Is it getting gradually worse?

To help you tell the difference and know whether to call your doctor, take note of the following:

Probably normal forgetfulness:

1. You forget the name of a friend you haven’t seen in years.

2. You can’t find your car keys.

3. You get lost while driving to your new doctor’s office.

4. You forget to balance the checkbook one month.

5. You forget what you ate for dinner last night, but you remember as soon as someone gives you a clue.

6. You forget to take your pills on time.

7. You joke about your own forgetfulness to friends and family members.

Consider talking to your doctor:

1. You struggle to remember the name of a family member you see every week.

2. You have trouble remembering how to drive.

3. You get disoriented while driving to a familiar location and can’t figure out where to go.    

4. You forget to pay the bills month after month.

5. You forget what you ate for dinner last night, and no reminders can jog your memory.

6. You forget to take your pills for several days in a row.

7. A spouse or family member expresses concern about your memory lapses.

Normal aging or dementia?

To assist you further in differentiating between a person in normal aging and a person with dementia, here are some practical guides:

A person in normal aging:

1. remains independent in daily activities.

2. complains of memory loss but can provide considerable detail regarding incidents of forgetfulness.

3. is more concerned about perceived forgetfulness than close family members are.

4. can recall recent important events, affairs, and conversations.

5. has occasional difficulty finding words.

6. does not get lost in familiar territory, but may have to pause momentarily to remember the way.

7. can operate common appliances even if she or he is unwilling to learn how to operate new  devices.

8. maintains interpersonal social skills.

9. performs normally on mental status examinations relative to the individual’s age, education,  and culture.

A person with dementia:

1. is critically dependent on others for key daily living activities.

2. complains of memory problems only if specifically asked and cannot recall instances when memory loss was noticeable.

3. is less concerned about memory loss than family members and friends are.

4. has trouble remembering recent events and conversations.

5. makes frequent word-finding pauses and substitutions.

6. gets lost in familiar territory while walking or driving and may take hours to return home.

7. cannot operate common appliances and is unable to learn to operate even simple new appliances.

8. may lose interest in social activities or exhibit socially inappropriate behavior.

9. demonstrates below-normal performance on mental status examinations in ways not  accounted for by educational or cultural factors.

When to see a doctor

“Don’t be alarmed by everyday forgetfulness.  The time to call your doctor is when you have more persistent or worsening memory loss that’s interfering with your daily activities and routine and starting to affect your daily functioning.  If you have other new cognitive problems accompanying memory loss — such as difficulties with language, organization, visual perception, or sense of direction — or if you have a change in personality or behavior, that would be even more concerning,” says Dr. Marshall.

If you or a loved one has noticed any of these changes in your abilities or personality, call your doctor.  You may need to see a neurologist or geriatrician or psychiatrist who is a specialist in dementia.  Tests will assess your memory, attention, problem-solving ability, language, and other skills. You may also have a neurological exam and an MRI scan of your brain to look for changes that could explain the cause of the cognitive impairment, such as Alzheimer’s disease or vascular disease.

Tips to help you remember

• Get organized.  Write to-do items in a calendar, notebook, or smart phone. Create labeled containers in accessible locations for car keys, eyeglasses, and other items you regularly use.  Place visual reminders, such as sticky notes, around your house to jog your memory.

Repeat.  “If you’re being introduced to somebody and you really want to remember the person’s name, don’t just nod and smile.  Say the person’s name,” suggests Dr. Fabiny.  For example, say, “It was wonderful to meet you, Emily.”  Paying attention to details — like the color of Emily’s hair or her occupation — will also help you remember her name later.

Banish distractions.  Try to do only one thing at a time.  Turn off the TV, computer, phone, and any other devices that might distract you from the task at hand.

• Break it up. It’s easier to remember new information when you divide it into smaller chunks.  For example, try to memorize only one section of a friend’s phone number at a time. Read just a few pages of a difficult book at one time.  Make sure you’ve learned the first piece of information before moving on to the next.

 Record it.  Carry a notebook or pocket recorder with you to capture new information.  The act of recording or writing down information helps cement it in your memory.

Getting frustrated about memory slips doesn’t make them stop. The brain’s processing speed — how fast you can perform a mental task — may slow down with aging.  But given time and attention, your memory will continue to function.  It just may take longer to learn new things and recall existing memories!

                                * * *                 

Source:  Diagnosis, Management, and Treatment of Dementia:  A Practical Guide for Primary Care Physicians (American Medical Association).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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