Like many of you, I am a baby boomer. I was born in January of 1946 so I'm right at the tip of the spear of the generation that was born between World War II and 1964. We baby boomers are an interesting group. We did a lot of new things and revolutionized quite a bit of popular culture from movies to music and progressive politics.
Many of my baby boomer patients notice that from time to time they forget things like a name, face, or where they put their keys. Is this normal, they wonder? Or, as many of them ask, "Is this a sign of Alzheimer's?" It's a reasonable worry, as Alzheimer's disease is reaching epidemic proportions and recent surveys suggest that it is the baby boomers' number one fear. Beyond that, according to AARP, the number one priority of 94 percent of people as they age is, "keeping my brain sharp."
In my capacity as president and medical director of The Alzheimer's Research and Prevention Foundation, it's my job to keep abreast of advances in the field of Alzheimer's research. Recently, I've been thinking about this particular memory issue. At the same time, there have been a number of articles in the medical literature about it. The basic question is this:
"Is any memory loss normal with age?"
That's a heck of a question, especially for us 50-year-old baby boomers. Indeed, it used to be thought that as you age, a little memory loss is an expected and accepted part of the normal aging process. There was a term for it: "age associated memory impairment," or AAMI. It included a general slowing of mental functions such as processing, storing and recalling new information. It also included a general decline in the ability to perform tasks related to cognitive function such as memory, concentration and focus.
That idea really bothered me because from my recent study, I knew it was an outdated concept and there was newer work that redefined this issue. Now elite brain scientists divide aging memory concerns into the following:
- No Cognitive Impairment or NCI.
- Subjective Cognitive Impairment or SCI. SCI is when a person feels that their memory is not working as well as it should or once did and they tell their doctor. People have complaints including remembering names, words and numbers. Their memory tests, however, are normal.
- Mild Cognitive Impairment or MCI, which is defined by memory loss that usually doesn't interfere with everyday life but is more pronounced than the changes people complain about in SCI. Moreover, there are abnormalities in objective testing.
- Alzheimer's disease in each of its various stages from early to advanced.
So what happened to AAMI or memory loss of normal aging? Does it still exist?
To elucidate the difference between AAMI and SCI, I called one of the world's expert on the subject, Barry Reisberg, M.D. Professor of Psychiatry and Director of The Aging and Research Center at New York University. Quite miraculously, he himself, answered his office telephone at 4:30 p.m. on a Friday afternoon.
I asked him my basic question, "What's the difference between AAMI and SCI?" I also wanted to know if, in fact, any memory loss with age is normal. There was a deafening silence on the telephone before he answered. "That's a great question," he said.
Here is his answer: "Memory loss may be normative, [average] but that doesn't mean it's normal. The real question is what is progressive over time."
When you have no memory complaints it's called "No Cognitive Decline," or NCI. Moreover, he went on, "AAMI is determined by a test, not clinical symptoms. SCI, on the other hand, is a clinical diagnosis. Patients complain about it"
SCI has been studied since 1986. In landmark research, Dr. Reisberg had a total of 213 subjects, 60 with NCI and 200 with SCI. After seven years, seven people with NCI (15 percent) and 90 with SCI (54.2 percent) declined. Of the people with NCI, five went to MCI and two to probable Alzheimer's. On the other hand, of the 90 people with SCI who progressed, 71 went to MCI and 19 declined all the way to Alzheimer's.
What this study reveals is that people with memory complaints or SCI decline faster and over a shorter period of time than those with no memory complaints or NCI.
According to Dr. Reisberg, at age 65, 25 percent to 55 percent have SCI After 15 years, up to 55 percent of people with SCI will have progressed to Mild Cognitive Impairment (MCI), which most experts think is essentially an early form of Alzheimer's and is defined by dense short-term memory loss.
This is critically important because only 15 percent of people without SCI develop MCI. Recall that someone with MCI can balance their check book, for instance, hold a conversation and get along well, but please don't ask them to find their car in the parking lot if they go to the mall.
What's more, a high number of people with MCI will progress to the dreaded Alzheimer's. Indeed, according to resources from the National Institutes of Health, one study found that approximately 40 percent of people over age 65 who were diagnosed with MCI developed dementia within three years.
And beyond that, at age 85, 55 percent of all people have Alzheimer's. No wonder there is an expected epidemic of Alzheimer's as the population of baby boomers ages. I hope you can see how this can stack up over time. Indeed, according Dr. Reisberg, if someone with memory complaints doesn't progress it is simply a matter of not enough time having passed.
But is it hopeless? Are we all doomed to lose our memory?
I believe that the answer is a resounding, "No." Why? Because recall that not everyone does worsen! Although we're not sure why I believe there are actions or lifestyle measures that you can take that to maintain your mental sharpness with age.
Here are the main ideas:
- Keep your brain strong. This is called building cognitive reserve or resiliency. To do that, you must discover ways to keep your brain blood flow optimal and your brain big. Why? Brain shrinkage in key areas such as your memory center, or hippocampus, leads to memory loss.
- Mind the gap, the place where your nerve cells communicate known as the synapse. To stay sharp with age, you have to help your all-important brain chemicals, called neurotransmitters, remain in abundance. That will give you the spark that is the hallmark of a youthful brain.
- Love your genes. Many people still think that the genes you inherit determine your health. But many recent studies have revealed that not all people with the Alzheimer's gene for example, come down with the disease. There are lifestyle measures that you can follow that will keep your genes healthy.
- Create high levels of well-being. It has been shown, for example, that people who are happy, spiritually attuned, and have a clear picture of their mission in life have less Alzheimer's.
It's time to change the channel on thinking that memory loss is normal with age. We are not doomed! For one thing, subjective complaints can be caused by conditions such as depression that may not be progressive. Moreover, there are many things you can do to keep your mind strong starting right now. Put your health first, make a plan and stick to it. I'll have more to share in future articles on how you can do just that.
Best of Blessings,
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