THINKING, AGING AND MENOPAUSE: IS THIS NORMAL OR DO I HAVE DEMENTIA?
By
What was her name?
By the year 2030, roughly 20% of the American population will be over 65. This raises serious concerns for the amount of people who will have dementia or some form of cognitive(thinking ability) decline. So what is normal aging and how do we define cognitive impairment?
Normal aging of the brain usually involves some gradual structural and functional changes that can result in up to 10% loss of brain volume by the age of 80. There is shrinking of brain parenchyma (basic functional brain tissue), especially in the frontal region, there is a reduction of blood flow and lower levels of chemical neurotransmitters (used for brain cells to communicate). Senile plaques (are related collections of protein that inhibit cell to cell communication) and neuro fibrillary tangles (short circuits between brain cells) can accumulate which often does not cause problems with memory and function, however these changes also occurs in Alzheimer’s Disease in a much more numerous and widespread manner. Most people know someone with Alzheimer’s Disease and this can be a frightful change to contemplate, but it is important to remember that many changes in the brain as we age do not result in significant impairment.
On the positive side, there is evidence that the adult brain is resilient and able to undergo cortical (cortex is the area where thinking takes place and memory is stored) remodeling. This is called brain plasticity and refers to the brains ability to adapt and change as it ages. Cerebral (pertaining to the brain) blood flow studies reveal that some areas of the brain experience a decrease in blood flow, while other areas experience an increase. This suggests the brain is able to reorganize itself as it experiences normal aging.
Cognitive health is measured by the quality of 9 elements. These include :
- Language 4. executive function 7. attention
- Thought 5. perception 8. remembered skills (driving)
- Memory 6. judgment 9. ability to live a purposeful life
In addition to cognitive health, emotional health associated with aging is also considered when observing total brain function. Emotional health while aging is measured by the absence of psychiatric issues and presence of positive emotional adaptation. There is a lifetime risk of depression of 17% for combined men and women. For women alone, the prevalence is up to twice that or roughly 35%. There is an increased occurrence of depression in women during hormonal swings, and this can occur with the menopause transition. Interestingly, 37% of schizophrenic women develop their illness after 45, however this has not directly been tied to lower estrogen levels or hormonal changes associated with menopause transition.
How do we decide if we or a loved one has a problem? Mild cognitive impairment (MCI) is defined as an impairment of memory that is evident to others although the individual can still perform most activities of daily living. Many experts feel that MCI is a transition state between normal aging and AD; and that MCI is a precursor to dementia. Up to 22% of people over 71 will have MCI without developing full dementia. Dementia is a cognitive deficit(reduction of normal function and ability) which includes memory impairment and at least one other cognitive problem such as those listed above.
Alzheimer’s Disease (AD) is the most common form of dementia and includes
- memory loss,
- damaged brain cells associated with behavioral changes and
- deteriorating functioning in daily living.
Individuals with AD are unable to learn, comprehend or retain new information and often have limited ability to express themselves verbally. Individuals with AD are often unable to think abstractly nor can they make sound judgments or carry out complex tasks.
Developing dementia is often a risk factor out of our control.
However there are things we can do to maintain brain health and minimize damage to brain cells.
- important to reduce vascular risk factors by maintaining healthy blood pressure and cholesterol levels;
- reduce blood glucose and
- limit weight gain.
- Increased exercise
- reducing inactivity improves blood flow to the brain and improves glucose metabolism.
- important to avoid head injuries.
Equally important to physical health is to
- stay mentally active.
- Treat any emotional issues and
- remain socially active.
Stay curious and involved with life time learning by
- reading,
- writing,
- working on puzzles
- pursuing memory exercises.
As we age, it is ever more important to make good choices day to day in regards to our activities and how we choose to spend our time. It is important to optimize treatment of any medical conditions through medical treatment, in addition to diet and physical activities. Who are the elder people you most admire and aspire to age in a similar fashion? Most likely they are persons who continue to be very engaged with life on many levels.
What is YOUR experience? Do you think these are valid points? Please leave me your comments and use the box on the home page to sign up for all our Free Stuff!
