Verified by The Aging Brain
Age brings wisdom and temperance, but it can bring that proverbial senior moment as well. It’s that instant when you cannot recall the name of your longtime neighbor, or you forget where you put your glasses, or whether you turned off the stove. Granted, the task of remembering a name is not easy in itself. The name is filed into your long-term memory, and you may need a cue or trigger to retrieve it. Blanking out like this gives an idea of what age-related cognitive decline can entail. Fortunately, there are ways to stave off this decline.
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Mild cognitive impairment (MCI) is the term that is used when critical thinking, memory, and/or language and communication skills are somewhat compromised, but do not prevent day-to-day functioning. For some, MCI progresses to more significant cognitive diminishment in the form of dementia and Alzheimer’s disease. But for the majority of people with MCI, it is simply a "new normal" to which self and loved ones must acclimate. And one in five actually witness a reversal of the symptoms and regain more cognitive faculties over the span of months or years.
A loved one with this level of impairment may show these signs and symptoms:
● Compromised reasoning and judgment
● Can’t make decisions
● Gets distracted and loses focus
● Forgets and repeats conversations
● Forgets appointments
● Forgets names of people
● Cannot always remember words
The brain's cortical thickness and volume do shrink to a degree with age, especially in the frontal cortex. This loss of brain mass has cognitive consequences, but need not fundamentally alter a person's ability to navigate the world. Beyond this normal shrinkage, the loss of gray matter can be much greater for people with dementia.
According to the American Academy of Neurology, AAN, mild impairment shows up in 8 percent of people age 65 to 69, up to 15 percent of people age 75 to 79, and up to 37 percent of people age 85 and older.
Yes. You may notice that your loved one is more forgetful and will need more time to organize themselves and worry about declines in memory and thinking. However, the person’s day-to-day function remains normal, they can manage their schedule, grocery shop, prepare meals, drive, and complete other chores and tasks. This type of impairment is not a disease, it’s a description.
People with MCI can return to their normal level of cognitive functioning. In fact, one out of five people who have MCI will return to prior functioning in three to four years after their initial diagnosis.
Not necessarily. However, it can lead to dementia. The AAN reports that of the people with mild cognitive impairment aged 65 and over, the development of dementia happens at these rates: 7.5 percent will develop dementia in the first year after diagnosis of MCI, 15 percent in the second year, and 20 percent in the third year.
A study from UC San Francisco examined the experimental drug ISRIB, the researchers found that a few doses of this drug in mice can reverse age-related function in mental flexibility as well as memory. This drug has been studied previously, and it has helped memory function in cases of Down’s syndrome and traumatic brain injury.
Dementia is a more serious impairment than MCI. It is an umbrella term and Alzheimer’s is its most common form. In fact, Alzheimer’s accounts for 60 to 80 percent of all dementias. Also, dementia is not a specific disease; there are different types of dementia including Creutzfeldt-Jakob disease, frontotemporal, Huntington's disease, vascular dementia, among others. All of these can affect a person’s memory, judgment, attention, language, and more. Alzheimer’s disease causes dementia in 70 percent of cases, therefore it’s easy to confuse Alzheimer’s with dementia.
Here are signs and symptoms you may see in your loved one:
● Loss of memory
● Loss of reasoning and judgment
● Poor decision-making
● Cannot focus
● Forgets and repeats conversations
● Forgets appointments
● Forgets names of people
● Cannot remember words, phone numbers
● Trouble with communication
● Trouble with visual and spatial tasks
● Cannot problem-solve
● Feels confused
● No sense of time and place
● May wander off
● Cannot carry out everyday chores and tasks
● Mood swings, angry outbursts
● Personality changes
In the early stages of dementia, your loved one may be aware that something is wrong, but they may not be sure why. Largely, they are not aware that they have dementia, and trying to convince them that there is a problem can be difficult. It may lead to arguments and mistrust on your loved one’s part. Instead, remain calm and loving to reduce their agitation and confusion.
The risk of dementia increases as we age. Alzheimer’s disease, for example, occurs in 5 percent of people between 65 and 75, with risk steadily increasing the older we get. In fact, almost half of people age 85 or older develop Alzheimer’s, and about 5 to 6 percent of these people will show symptoms before age 65. While it is rare, early-onset Alzheimer’s can appear in people in their 30s and 40s.
This impairment affects both men and women equally, but more women are diagnosed. On average, women with Alzheimer’s show memory loss as a primary presenting symptom, while men with the disease show changes in behavior, motor, and language skills. In addition, men tend to show signs earlier at around age 60; and women are diagnosed later, after age 70.
If your loved one is able to manage day-to-day activities, such as dressing and bathing, they can be left alone for short periods. But when they require help with these basic activities, or if they are anxious or paranoid, it is unwise to leave them on their own. They would not be able to handle emergencies, such as a fire or if a stranger came to the door. There is also the potential for your loved one to wander out of the house and down the street, an occurrence that is commonplace enough that so-called Silver alerts have been instituted in many states.
Upon diagnosis, people with dementia survive an average of four and a half years. However, it depends on the age of your loved one at diagnosis. If grandpa was in his early 70s at diagnosis, he may live up to a decade or even longer, according to research at the University of Cambridge in the UK, if he was diagnosed in his 90s, he may live for up to four years. In addition, women live longer than men after diagnosis, and people who are frailer die sooner than do others.
Alzheimer’s develops when the brain builds up plaque and neurons die off. These plaques are known as amyloid plaques made up of beta-amyloid protein cells, they are hard and tough and they gather between nerve cells. According to research from Boston University, when the plaques first form, they don’t necessarily cause problems, but once the brain's clean-up cells arrive for the body’s immune response, they begin to react to the plaques, and an inflammatory reaction occurs that disrupts communication between brain cells and interferes with brain function.
Alzheimer’s disease starts in the brain years before symptoms are noticeable. Over time, day-to-day function may be normal while thinking and memory become affected. In this stage, sometimes called mild cognitive impairment due to Alzheimer’s disease, it becomes too hard to learn new things and remember things, like a doctor's appointment. Your loved one may also misplace their belongings and have difficulty in finding the words they want to express.
In subsequent stages, memory loss and confused thinking may interfere with managing everyday life, such as shopping for groceries and paying bills. Later, dressing and bathing become difficult. In acute stages, the sufferer may become incontinent, not recognize family members, and have difficulty communicating. The progression from mild to severe can take from four to 12 years.
In the lion’s share of cases, Alzheimer’s is not inherited. In fact, most dementias are not heritable. Certain rarer types of dementia, such as early-onset dementia or familial prion disease, may have a genetic component, but a person’s age is the biggest risk factor for more serious impairment.
Your loved one will be easily distracted, as attention and focus are difficult. Speak with him one-on-one and look him in the eyes. Don't rush him. He will repeat words, rely on familiar words, prefer hand gestures, and he will describe things and not use the identifying words, as he may not remember those words. Do not talk through another person, and do not correct him. And sometimes, just being there to hold his hand is worth more than words.
Alzheimer’s disease is named after the German psychiatrist Alois Alzheimer, who discovered amyloid plaques and neurofibrillary tangles while examining the brain tissue of patient Auguste Deter, who died in 1906. Deter suffered memory loss and delusions, with no sense of place and time. This discovery was the first of its kind, showing that a protein is linked to a mental illness.
