In 1900 the average life span of the American male was about 44 to 45 years. Due to enormous progress in medical care his life span today is about 73 years (women live about five years longer). Thus, diseases that were rare a hundred years ago are common today, primarily because they occur in older people. Alzheimer's disease is one of these and severe memory loss occurs more often in people over the age of 60 and particularly those in their mid 80's and above.
Let's define the word dementia. This is a rather broad term that encompasses severe memory loss, impaired thinking and an altered personality. And, of course, Alzheimer's disease is the most common form of dementia and patients characteristically have memory loss that is progressive and eventually becomes severe and associated with altered thinking. The Harvard Health Letter, published in August 1998, goes into this in considerable detail and is excellent.
But, first, think about what is normal in an aging individual: Because someone forgets where his keys or eyeglasses are it does not mean there is impairment in thinking or memory loss - this is a common finding in all people (sometimes young ones, too) and should not cause concern. One real difference, however, between the older person and the younger one is that it takes an older person longer to absorb new material, such as complex directions or recently learned names. Also, older people are sometimes more easily distracted than younger individuals. The older person can't comprehend how a teenager can listen to music while supposedly studying at the same time (I often wonder how successful this is anyway). While it takes an older person longer to absorb new information - they are just as capable as the younger person in retaining this information and processing it in an effective way. Furthermore, older individuals have little or no change in their ability to recall long term memories and don't really lose any of their "wisdom." That is, experience, vocabulary, comprehension, etc. that has been accumulated over many years.
There are other factors that may come into play that have nothing to do with memory or comprehension, but may impair the individual. Such factors include heart disease, visual difficulties, poor hearing, depression, and even certain medications such as beta blockers (e.g. Inderal).
Depression may pose a problem in diagnosis: A depressed person may not focus on conversation or pay much attention to his surroundings and erroneously they are diagnosed as having memory impairment or even Alzheimer's disease. I believe this to be important because depression - masquerading as memory loss - can be treated and effective anti-depressant therapy is available now.
There are some recent studies that suggest estrogen improves memory in post-menopausal women. Of course, estrogen also helps in preventing heart disease, but, on the negative side, there is a slight statistical increase in the incidence of breast cancer. Actually, numerically, the reduction in heart disorders is considerable and many-fold times greater than the increased risk of breast cancer. This finding of estrogen helping to preserve mental faculties adds more evidence for post-menopausal women to take estrogen.
Exercising regularly is also of great help. This should be done at least three to four times a week and for a minimum period of twenty minutes. There are many articles detailing this, but now it seems that good physical conditioning may also be of some help, both generally and perhaps in helping to preserve thinking processes. We might also think of exercising our brain more with the maintenance of good intellectual habits such as reading and remaining curious, by focusing intently on what one reads, keeping track of important things and perhaps writing them down as need be, and to reduce as much stress in one's life as is practical. At times workshops on aging are of help.
Research-wise, trials of medication to improve brain function are rampant today. Numerous studies are being conducted. I believe that a breakthrough in therapy is imminent - and I hope this will eventuate within the next several years. The medicines that currently are being tried, such as ibuprofen, Cox-2 inhibitors, and vitamin E, are still in the preliminary stage. The same applies to the herbal extract know as Ginkgo Biloba.September 1998
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