Aging or Alzheimer’s?
By Betty Weiss

Think back to your childhood and chances are there were times when you forgot to carry your lunch to school, forgot to do your homework or forgot to brush your teeth. People forget—that’s normal. For most, it’s all acceptable until they begin to reach middle age, then forget something and--aghwaaaah, panic attack, panic attack, I forgot a word, I’m getting Alzheimer’s! Statistics say you are not—until you start pushing 85 when you’ve got pretty good odds of about 50-50, and anyway, something else will likely get you first. If such forgetfulness does not interfere with taking care of your daily needs, it just means you need a little more time to remember, like needing more time to walk across the street. Forgetting a word for a bit, remembering it later, is only a little ‘hiccup’ in your memory—it happens.

Our brains have billions of nerve cells. Unless you have done something self-destructive to kill your own brain cells faster, like excessive alcohol or drug use, few die over a lifetime, but they do shrink. Such shrinkage may partially explain why mental functioning slows as we age. However, serious memory loss can occur when whole clusters of cells are destroyed by something like Alzheimer’s. Both situations may cause minutely similar memory loss, but they are two completely different things. Forgetting because of shrinkage is annoying but wholly benign. It may progress somewhat, but it’s a world away from the unrelenting progression of Alzheimer’s.

Around middle age, we begin to produce smaller quantities of the chemicals we need to relay messages between cells. And, between ages 30 to 70, brain blood flow reduces 15-20%, bringing less oxygen. Maybe the shrinking tissues require less blood, or does less blood cause the shrinkage? Either way, it’s normal, not a disease and not to worry.

Attitudes also play a part. In research, elderly Chinese performed as well as their younger counterparts and were less forgetful than older Americans who had the preconceived idea that aging causes an inevitable decline in memory. The implication being that if you expect your memory to worsen, you may be less inclined to try to remember.

Research also indicates that the mental process to remember something new is the same as that needed to retrieve something from long ago. Most elderly remember distant events quite well. Maybe their inability to recall new things is because they don’t think it’s all that important, they just don’t pay close attention. If you don’t stay active, have an interest in different things, then why bother to remember something new? Although, if you feel all you want to do in your golden years is to watch the grass grow—well, that’s OK, too.

But there are stark differences between memory loss with aging and that due to Alzheimer’s. If you forgot the name of someone you just met yesterday, that’s normal, but if you can’t remember who your wife is, that’s serious.

If you forget to set your alarm for the right time, that’s normal, but when you can’t remember how to operate the clock to set the alarm, something you’ve done daily for years, then that’s serious. If you forget the exact balance in your checkbook, that’s normal, but if you forget how to make change or figure out the tip, that’s serious. If you forget where you parked your car at the mall, that’s normal, but if you are driving and find yourself in a strange neighborhood with no idea of how you got there and don’t know which direction is home, then it’s past time to see a doctor.

Besides aging, memory loss can be from depression, side effects of medications, stroke, insufficient vitamins, emotional stress, anxiety, lack of sleep, dehydration, maybe an undiagnosed concussion after a fall—lots of common things. It is not unusual for some older people to become momentarily confused, maybe need a helping hand, but if they do not have difficulty performing familiar tasks, do not have serious language problems, if they are not putting shoes in the microwave, or wandering naked outside in the snow, chances are forgetting a word now and then is just not something to be concerned about.

Betty Weiss is the author of the best selling Alzheimer's Surgery: An Intimate Portrait, and When The Doctor Says, "Alzheimer's:" Your Caregiver's Guide to Alzheimer's & Dementia. She does not give medical advice.                           
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