It may be the TV remote that is not where it should be and appears later in a closet drawer or in the refrigerator. It can also happen to be talking and suddenly lose the thread and ask “where was I?” It’s even perfectly possible to forget the name of a good friend’s daughter. The question is: what are these forgetfulness? Are they worrying?
“Senior moments,” as the Harvard School of Public Health calls losing the phone in your hands and similar mistakes, lead more and more people to visit Neurology clinics in hospitals.
Because… when is it normal to have small forgetfulness and when should you start worrying? “It is one of the million-dollar questions,” answers Raquel Sánchez-Valle, Coordinator of the Behavior and Dementia Study Group of the Spanish Society of Neurology and Head of the Neurology Service at the Hospital Clínic of Barcelona. “What is changing the most is that now many people visit us concerned about small changes in their cognition, while before we received patients in more advanced stages with severe problems. But we must discern between Alzheimer’s and the normal cognition problems caused by aging,” she highlights.
The good news is that in the same way that you don’t run as fast at 35 as at 65 – “although you can still walk perfectly,” Sánchez-Valle points out –, the brain’s ability to remember, learn and solve problems It also slows down with age. Starting in your sixties, it is completely normal to concentrate less or have more difficulty remembering facts without this having anything to do with an underlying illness.
There are symptoms, however, that are worrying. The first is to lose things, but not from time to time, but constantly and more and more. “An alarm sign is that the losses are persistent and progressive,” emphasizes Sánchez-Valle, who is also the clinical coordinator of the Neurological Tissue Bank of the Hospital Clínico-IDIBAPS. “It is not one day being worse and the next worse and fluctuating, but rather they are persistent memory problems that get worse with each passing day,” she adds.
Another warning sign is remembering things from a long time ago and, on the other hand, being unable to remember what happened a while ago. “It is not so much about going to the refrigerator and not remembering what you went to do there, something that is often a more attentional problem, but rather not remembering if you have eaten, what you have eaten or what you did half an hour ago” , continues the neurologist.
“Another symptom is repeating the same thing five or more times,” he says. “Basically, they are these four things: persistence, progressive nature, remembering the old more than the new and repeating comments or questions without being conscious,” he explains from an office at the Hospital Clinic.
“Even so, we often have doubts and have to resort to markers such as cerebrospinal fluid, amyloid protein, etc. and other biological tests,” explains this doctor who enjoyed a postdoctoral fellowship at the Memory and Aging Center of the University of California.
“There is another thing,” he continues, “that people who go to the Neurology services complain about a lot but that for neurologists no longer has so much to do with memory: not remembering a person’s name at a given moment or having a word on the tip of my tongue but not being able to find it,” he says. “We call this lexical access: although we know some words, within them there are gradients of complexity, in the sense that forgetting the name of a neighbor’s cousin is not the same as remembering the name of our partner,” gives an example.
The same familiarity factor occurs with words: it is not as important to forget how to say “table” as it is to unsuccessfully try to remember the word “paralepiped.” In Sanchez-Valle’s opinion, it is as if there were a kind of warehouse in our brain and with age it will be more difficult for us to reach the drawer where a word is that we do not use every day.
This phenomenon, very common after a certain age, is related to the fact that as the years go by the brain no longer processes as quickly as it used to, in the same way that it is more difficult for the gray matter to find the access route that it used to. leads to certain words.
In general, the mistakes related to “normal” aging begin to occur after the age of 60, although there is great variability between people: there are those who are eighty years old still have an elephant’s memory and also those who are fifty-something begin to experience difficulties, as women especially do. In addition, females have a greater risk of suffering from Alzheimer’s in a ratio of 60-40.
“It is true that women in the perimenopausal period (or around menopause) have more sleep disorders and sometimes begin to notice cognitive changes, which does not mean that they are permanent,” confirms Sánchez-Valle.
In 90% of cases, Alzheimer’s is related in its initial phase to memory problems and behavioral changes, in the sense of losing initiative or feeling more dull, which is sometimes confused with depression or laziness in the care. The remaining 10% of patients, however, do not start with memory problems but rather lose their language, reports Sánchez-Valle. “It’s no longer that they have trouble finding a word at any given moment, but rather that they lose it forever, which is why it becomes increasingly difficult for them to follow a conversation. It is also common to have spatial orientation problems and get lost in the city,” she details.
Experts who study aging believe it is important to develop a “cognitive reserve.” The concept “cognitive reserve” (or cognitive resilience) originated in the late 1980s and refers to the brain’s ability to improvise and find alternative ways of doing a job. Cognitive reserve, experts point out, is developed thanks to curiosity and practicing some type of mental gymnastics. Having a robust cognitive reserve helps you better cope with unexpected events or pure stress. To explain it graphically, it is as if a car had to change gears.
Researchers at the Harvard School of Public Health have identified the six cornerstones of any brain health program aimed at achieving greater cognitive fitness: eating a diet rich in vegetables (as proposed by the ancient Mediterranean diet), being active exercise regularly, get enough sleep, manage stress, encourage social contacts and continue to challenge the brain into older ages.
To the previous factors, Sánchez Valle adds not smoking and not drinking alcohol, in line with the WHO. “More recently, some new studies also recommend early detection of deafness, since it also makes it difficult to acquire information,” he explains.
However, the Harvard School of Public Health points out that these factors do not work in isolation. That is, eating more fiber or adding a morning walk to your daily routine is not enough to prevent mental deterioration. In practice, doing physical activity, controlling your diet (the ancient Greek word diaita means lifestyle), sleeping the necessary hours, controlling stress, interacting socially, having emotional relationships that are truly affectionate, and stimulating the mind act together. when it comes to obtaining results.
Sánchez-Valle offers some data for optimism: although the prevalence of Alzheimer’s is increasing in developed countries as life expectancy increases, in percentage terms, the number of people suffering from this disease is decreasing per million inhabitants in the age groups in which the disease usually develops. “This means that the health of the population in general, thanks to health advances but also to greater social awareness, is improving,” he concludes.
