CHAPTER 6: Confusion and Memory Loss in Old Age - It's Not What You Think

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CHAPTER 6: Confusion and Memory Loss in Old Age - It's Not What You Think

Many people are afraid that growing old means losing the ability to think, reason, or remember. They worry when they feel confused or forgetful that these feelings are the first signs of senility. Fortunately, most of them do not have the diagnosis they have heard about the most - Alzheimer's disease (pronounced ALTZ-hi-merz). On the other hand, feeling that your thinking is not very good can be bothersome.

Memory: What To Look For

There are many conditions with symptoms that look like Alzheimer's disease but aren't. These reversible conditions can be caused by things such as a bad reaction to a medicine or thyroid problems. Medications for sleep, allergies, or "nerves" may make thinking worse. Pills called "beta-blockers" may also cause this problem. However, before stopping these medications, you must talk to a doctor.

Some older people have emotional problems that are mistaken for dementia. Less than 10% (10 of 100) of older patients are bothered by their memory if they are not depressed; more than 20% of older depressed persons are bothered by their memory. Feeling depressed, sad, lonely, anxious, or bored may be more common for people facing retirement or handling the death of a relative or friend. Adapting to changes can leave persons feeling confused or forgetful. Emotional problems can be helped by supportive friends and family, or by professional help from others.

If you are worried about your thinking, your doctor will talk to you about this feeling and order some tests. Your doctor also needs to know if you regularly feel "down" or depressed.

Memory: What You Can Do

Developing interests or hobbies and staying involved in activities which keep the mind and body active are among the best ways that older people can remain sharp and keep their mental abilities. Careful attention to physical fitness, including a balanced diet, may also go a long way to help people keep a healthy state of mind. For most people the mild memory loss they notice as they get older can be controlled by using the least expensive approach - a notepad and pencil. Other tricks include:

doing new things at a time of day when you do not feel fatigued
keeping a door-side list of things to take when leaving the house
using calendars
avoiding alcohol and some medications

Memory Loss

Some people who experience changes in their personality, behavior, or skills may be suffering from a form of brain disease called dementia. The term dementia is used to describe a group of symptoms that are caused by changes in the normal activity of very sensitive brain cells. Dementia seriously interferes with a person's ability to carry out his or her daily activities. Dementia is irreversible-- it cannot be cured. The two most common forms of dementia are vascular dementia (sometimes called multi-infarct dementia) and Alzheimer's disease.

In vascular dementia changes in the brain's blood vessels result in widespread death of brain tissue. Telltale signs of vascular dementia include vision or speech problems, and/or numbness or weakness on one side of the body. People with vascular dementia are likely to show signs of improvement or remain stable for long periods of time, then quickly develop new symptoms.

In Alzheimer's disease nerve cell changes in certain regions of the brain result in the death of a large number of cells. Symptoms begin slowly and become steadily worse.

Both forms of dementia can exist together which makes it hard for the doctor to diagnose either. The diagnosis, however, is less important than management. If we diagnose an irreversible disorder, there is still much that can be done to treat the patient and to help the family cope.

Family members and friends can help people with dementia maintain their daily routines, physical activities, and social contacts. However, they should not be allowed to drive.

People with dementia should be kept informed about the details of their life -- the time of day, where they live, and what is happening at home or in the world. This may help stop brain activity from failing at a more rapid pace. Memory aids can help in day-to-day living. Some families find that a big calendar, a list of daily plans, notes about simple safety measures, and written directions describing how to use common household items can be very helpful.

Proper diet is important, although special diets or supplements are usually not necessary. Medications are usually not needed; but for some people, the careful use of drugs can reduce agitation, anxiety, and depression, and can help the person sleep. Estrogen, vitamin E, ginko, donezepil and other prescription medicines for Alzheimer's may also have some benefit for some people, but they do not slow down the progression of the illness.

Dementia patients lose their abilities at different rates. Even so, there is enough common experience for patients and their families (loneliness, frustrations, lack of information, and resources) to have led to the development of family support groups. around the country.

Tips for Communicating with Someone when Memory is a Problem:

Remember, a person with a poor memory will still sense your mood and attitude regardless of what you say. A person with poor memory will often have "good" days and "bad" days. Help them have as many good days as possible by being positive: say "let's do", rather than "let's not do something". When they are not doing well, let them know it's OK to feel sad or frustrated because these feeling happen to all of us.

Do:

Introduce yourself. This puts the person at ease.
Make eye contact.
Use short, simple sentences.
Ask one question at a time. Do one task at a time.
Give suggestions if the person is unable to make a choice.
When bad moments happen, give compliments. Compliments are pleasant distractions.

Don't:

Talk about your problems.
Correct the person if he or she misidentifies you or drifts into the past.
Argue. You will never win.
Use "he or she" when talking about the person when the person is present.

For resources use the web and type in the word "dementia." In the United States also consider www.healthfinder.gov or www.medlineplus.gov or www.alz.org.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.

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