Study helps explain why motivation to learn declines with age
Research suggests that aging affects a brain circuit critical for learning and decision-making.
27 October, 2020
Photo by Reinhart Julian on Unsplash
As people age, they often lose their motivation to learn new things or engage in everyday activities. In a study of mice, MIT neuroscientists have now identified a brain circuit that is critical for maintaining this kind of motivation.
<p>This circuit is particularly important for learning to make decisions that require evaluating the cost and reward that come with a particular action. The researchers showed that they could boost older mice's motivation to engage in this type of learning by reactivating this circuit, and they could also decrease motivation by suppressing the circuit.</p><p>"As we age, it's harder to have a get-up-and-go attitude toward things," says Ann Graybiel, an Institute Professor at MIT and member of the McGovern Institute for Brain Research. "This get-up-and-go, or engagement, is important for our social well-being and for learning — it's tough to learn if you aren't attending and engaged."</p><p>Graybiel is the senior author of the study, which appears today in <em>Cell</em>. The paper's lead authors are Alexander Friedman, a former MIT research scientist who is now an assistant professor at the University of Texas at El Paso, and Emily Hueske, an MIT research scientist.</p>
<h3>Evaluating cost and benefit</h3><p>The striatum is part of the basal ganglia — a collection of brain centers linked to habit formation, control of voluntary movement, emotion, and addiction. For several decades, Graybiel's lab has been studying clusters of cells called striosomes, which are distributed throughout the striatum. Graybiel discovered striosomes many years ago, but their function had remained mysterious, in part because they are so small and deep within the brain that it is difficult to image them with functional magnetic resonance imaging (fMRI).</p><p>In recent years, Friedman, Graybiel, and colleagues including MIT research fellow Ken-ichi Amemori have discovered that striosomes <a href="https://news.mit.edu/2015/brain-circuit-controls-decisions-causing-anxiety-0528" target="_blank" rel="noopener noreferrer">play an important role</a> in a type of decision-making known as approach-avoidance conflict. These decisions involve choosing whether to take the good with the bad — or to avoid both — when given options that have both positive and negative elements. An example of this kind of decision is having to choose whether to take a job that pays more but forces a move away from family and friends. Such decisions often provoke great anxiety.</p><p>In a <a href="https://news.mit.edu/2016/neural-connections-linked-emotional-decision-making-0919" target="_blank" rel="noopener noreferrer">related study</a>, Graybiel's lab found that striosomes connect to cells of the substantia nigra, one of the brain's major dopamine-producing centers. These studies led the researchers to hypothesize that striosomes may be acting as a gatekeeper that absorbs sensory and emotional information coming from the cortex and integrates it to produce a decision on how to act. These actions can then be invigorated by the dopamine-producing cells.</p><p>The researchers later discovered that chronic stress has a major impact on this circuit and on this kind of emotional decision-making. In a <a href="https://news.mit.edu/2017/stress-can-lead-risky-decisions-1116" target="_blank" rel="noopener noreferrer">2017 study</a> performed in rats and mice, they showed that stressed animals were far more likely to choose high-risk, high-payoff options, but that they could block this effect by manipulating the circuit.</p>
<p>In the new <em>Cell</em> study, the researchers set out to investigate what happens in striosomes as mice learn how to make these kinds of decisions. To do that, they measured and analyzed the activity of striosomes as mice learned to choose between positive and negative outcomes.</p><p>During the experiments, the mice heard two different tones, one of which was accompanied by a reward (sugar water), and another that was paired with a mildly aversive stimulus (bright light). The mice gradually learned that if they licked a spout more when they heard the first tone, they would get more of the sugar water, and if they licked less during the second, the light would not be as bright.</p><p>Learning to perform this kind of task requires assigning value to each cost and each reward. The researchers found that as the mice learned the task, striosomes showed higher activity than other parts of the striatum, and that this activity correlated with the mice's behavioral responses to both of the tones. This suggests that striosomes could be critical for assigning subjective value to a particular outcome.</p><p>"In order to survive, in order to do whatever you are doing, you constantly need to be able to learn. You need to learn what is good for you, and what is bad for you," Friedman says.</p><p>"A person, or this case a mouse, may value a reward so highly that the risk of experiencing a possible cost is overwhelmed, while another may wish to avoid the cost to the exclusion of all rewards. And these may result in reward-driven learning in some and cost-driven learning in others," Hueske says.</p><p>The researchers found that inhibitory neurons that relay signals from the prefrontal cortex help striosomes to enhance their signal-to-noise ratio, which helps to generate the strong signals that are seen when the mice evaluate a high-cost or high-reward option.</p>
<h3>Loss of motivation</h3><p>Next, the researchers found that in older mice (between 13 and 21 months, roughly equivalent to people in their 60s and older), the mice's engagement in learning this type of cost-benefit analysis went down. At the same time, their striosomal activity declined compared to that of younger mice. The researchers found a similar loss of motivation in a mouse model of Huntington's disease, a neurodegenerative disorder that affects the striatum and its striosomes.</p><p>When the researchers used genetically targeted drugs to boost activity in the striosomes, they found that the mice became more engaged in performance of the task. Conversely, suppressing striosomal activity led to disengagement.</p><p>In addition to normal age-related decline, many mental health disorders can skew the ability to evaluate the costs and rewards of an action, from anxiety and depression to conditions such as PTSD. For example, a depressed person may undervalue potentially rewarding experiences, while someone suffering from addiction may overvalue drugs but undervalue things like their job or their family.</p><p>The researchers are now working on possible drug treatments that could stimulate this circuit, and they suggest that training patients to enhance activity in this circuit through biofeedback could offer another potential way to improve their cost-benefit evaluations.</p><p>"If you could pinpoint a mechanism which is underlying the subjective evaluation of reward and cost, and use a modern technique that could manipulate it, either psychiatrically or with biofeedback, patients may be able to activate their circuits correctly," Friedman says.</p><p>The research was funded by the CHDI Foundation, the Saks Kavanaugh Foundation, the National Institutes of Health, the Nancy Lurie Marks Family Foundation, the Bachmann-Strauss Dystonia and Parkinson's Foundation, the William N. and Bernice E. Bumpus Foundation, the Simons Center for the Social Brain, the Kristin R. Pressman and Jessica J. Pourian '13 Fund, Michael Stiefel, and Robert Buxton.</p><p>Reprinted with permission of <a href="http://news.mit.edu/" target="_blank" rel="noopener noreferrer">MIT News</a>. Read the <a href="https://news.mit.edu/2020/why-learn-motivate-age-decline-1027" target="_blank">original article</a>.</p>
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Keep your brain healthy well into old age with brain training
CogniFit's Brain Fitness Program is the training you need to stay mentally healthy as you age.
27 October, 2020
Credit: MclittleStock / AdobeStock
<script async="true" src="https://widgets.stackcommerce.com/js-deal-feed/0.1/widget.js" type="text/javascript"></script><p>There are many reasons our memories are getting worse: Poor diet, lack of exercise, dependence on navigational tools, Googling information instead of memorizing it. Beyond memory, things like concentration, coordination, perception, and reasoning also tend to fade with age. But there are ways to enhance those cognitive domains, rather than sitting back and watching them diminish. <br></p><p>Exercising your brain, like exercising your body can help keep your mind sharp no matter your age. And <strong>CogniFit</strong> was designed to do just that—like a personal trainer for your brain. For a limited time, a one-year subscription to this groundbreaking service is <a href="https://shop.bigthink.com/sales/cognifit-premium-1-year-subscription?utm_source=bigthink.com&utm_medium=referral&utm_campaign=cognifit-premium-1-year-subscription&utm_term=scsf-442913&utm_content=a0x1P000004Yaj0QAC&scsonar=1" target="_blank">on sale for $49.99</a>.</p><p>CogniFit measures, trains, and monitors your cognitive skills and their relation to neurological pathologies through scientifically proven tasks and games. The app lets you personalize your training regimen as well: You choose your preferred programs. By inputting your age, CogniFit picks the best choices for you.</p><p>Cognifit's personalized brain games help stimulate cognitive functions and improve neuroplasticity. Even better, the app can detect risk factors by assessing alterations in cognitive functioning using neuropsychological assessments. CogniFit helps you stay on track and lets you know when warning signs appear.</p><p>Users seem to love CogniFit, rating it 4.4 out of 5 stars on the App Store and Google Play Store. Learn more about CogniFit by watching it in action: </p><p class="shortcode-media shortcode-media-youtube">
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How a 15-minute 'awe walk' drastically improves mental health
Move over, forest bathing.
01 October, 2020
Credit: Robsonphoto / Shutterstock
- A new study found that weekly 15-minute "awe walks" have positive effects on mental health.
- Volunteers reported higher levels of gratitude and compassion after eight weeks of these short walks.
- Researchers believe this low-cost intervention could help prevent cognitive decline in older adults.
<p>Watch out <a href="https://bigthink.com/surprising-science/ecotherapy-benefits" target="_blank">forest bathers</a>, you have competition.</p><p>Perhaps better put, you have an addition to your ritual. According to a <a href="https://psycnet.apa.org/doiLanding?doi=10.1037/emo0000876" target="_blank">new study</a>, published in the journal Emotion, one surefire way to improve your mental health is by taking regular 15-minute "awe walks." </p><p>Researchers at the UC San Francisco Memory and Aging Center and the Global Brain Health Institute wanted to see if these focused walks in the woods could improve prosocial emotions in seniors. The team chose this cohort due to longstanding links between cognitive decline and mental health problems associated with anxiety and depression. </p><p><a href="https://www.ucsf.edu/news/2020/09/418551/awe-walks-boost-emotional-well-being" target="_blank">According to</a> associate professor Virginia Sturm, loneliness is particularly damaging to older adults and can help drive the onset of Alzheimer's disease. She was quite happy with the results. </p><p style="margin-left: 20px;">"What we show here is that a very simple intervention – essentially a reminder to occasionally shift our energy and attention outward instead of inward – can lead to significant improvements in emotional well-being."</p><p>The walking group was comprised of volunteers in their sixties to eighties. Each participant was told the study was about exercise, when in reality their task—taking a selfie at the end of each walk—revealed the actual intentions of researchers. </p>
Finding Happiness Through "Awe Walks"
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="0988a4421b47d7cdc45d740014a53b17"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/-nVx6SriWPM?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span><p>Importantly, participants were instructed to observe details while walking around the forest. If the goal was only exercise, volunteers were likely to power through trails without noticing their surroundings. This is where awe comes into the picture.</p><p>UC Berkeley psychologist Dacher Keltner <a href="https://www.ucsf.edu/news/2020/09/418551/awe-walks-boost-emotional-well-being" target="_blank">explains</a> the relevance, noting that feelings of awe help us feel more generous and humble, while increasing our overall well-being. </p><p style="margin-left: 20px;">"Awe is a positive emotion triggered by awareness of something vastly larger than the self and not immediately understandable — such as nature, art, music, or being caught up in a collective act such as a ceremony, concert or political march."</p><p>The post-walk selfie is key. Week after week, their smiles grew larger. Incredibly, their bodies shrunk in the photos—the photographer stepped back to include more of nature. Instead of the normal close-ups we associate with selfies, volunteers naturally became more integrated with their environment, without any prompting from the research team.</p><p><a href="https://bigthink.com/21st-century-spirituality/individualism-is-spreading-and-thats-not-good" target="_self">Research</a> on individualist versus collectivist societies shows that the members of individualist societies tend to prioritize independence and autonomy. These seem like positive qualities, though higher rates of anxiety and depression are reported in such cultures. By contrast, collectivist societies emphasize interdependence, which ultimately makes members feel like they're part of a bigger landscape. </p><p>This is exactly what was reflected in those selfies. </p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQ1MzQ0NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxNTg1ODkzMX0.x8zLKLALb_kM43eNALUrRhMB_GKkjCxkPdjdgaYgSrM/img.jpg?width=1245&coordinates=0%2C43%2C0%2C164&height=700" id="7e1fa" class="rm-shortcode" data-rm-shortcode-id="ec4fd502a5e6a273154a44a7a6591a33" data-rm-shortcode-name="rebelmouse-image" />
<p class=""><br></p>Credit: Rudmer Zwerver / Shutterstock
<p>Classical Japanese art offers plenty of examples of interdependence. Humans are rarely the focal point in these landscape paintings. People only appear as part of a much larger scene. This trend cuts across Buddhist art, perhaps unsurprisingly given the philosophy stresses collectivity. Happiness levels tend to be higher in these societies than in individualist nations.</p><p>America, arguably the global leader in individualism, has <a href="https://worldhappiness.report/ed/2019/the-sad-state-of-happiness-in-the-united-states-and-the-role-of-digital-media/" target="_blank">continually ranked lower</a> on world happiness charts over the last 40 years. Meanwhile, our rates of Alzheimer's disease <a href="https://bigthink.com/mind-brain/alzheimers-risks" target="_self">rise</a> every year.</p><p>Can a 15-minute awe walk change all of that? Not completely, but we'll take whatever help we can get. As mythologist Joseph Campbell <a href="https://www.jcf.org/works/quote/awe-is-what-moves-us-forward/" target="_blank">once remarked</a>, "awe is what moves us forward." He cited awe as a primary driver in the creation of mythology: the overwhelming sensation that you're part of something grand. </p><p>As Sturm says, this is a low-cost, worthwhile means for alleviating distress and filling people with gratitude and compassion. Given the state of the world, those qualities are in high demand. </p><p style="margin-left: 20px;">"I find it remarkable that the simplest intervention in the world – just a three-minute conversation at the beginning of the study suggesting that participants practice feeling awe on their weekly walks – was able to drive significant shifts in their daily emotional experience. This suggests promoting the experience of awe could be an extremely low-cost tool for improving the emotional health of older adults through a simple shift in mindset." </p><p>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank" rel="noopener noreferrer">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank" rel="noopener noreferrer">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>
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Think everyone died young in ancient societies? Think again
In fact, the maximum human lifespan has barely changed since we arrived.
30 September, 2020
Photo by Juliet Furst on Unsplash
You might have seen the cartoon: two cavemen sitting outside their cave knapping stone tools. One says to the other: 'Something's just not right – our air is clean, our water is pure, we all get plenty of exercise, everything we eat is organic and free-range, and yet nobody lives past 30.'
<p>This cartoon reflects a very common view of ancient lifespans, but it is based on a myth. People in the past were not all dead by 30. Ancient documents confirm this. In the 24th century BCE, the Egyptian Vizier Ptahhotep wrote verses about the disintegrations of old age. The ancient Greeks classed old age among the divine curses, and their tombstones attest to survival well past 80 years. Ancient artworks and figurines also depict elderly people: stooped, flabby, wrinkled.</p><p>This is not the only type of evidence, however. Studies on extant traditional people who live far away from modern medicines and markets, such as Tanzania's Hadza or Brazil's Xilixana Yanomami, have demonstrated that the most likely age at death is far higher than most people assume: it's about 70 years old. One study found that although there are differences in rates of death in various populations and periods, especially with regards to violence, there is a remarkable similarity between the mortality profiles of various traditional peoples.</p><p>So it seems that humans evolved with a characteristic lifespan. Mortality <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1728-4457.2007.00171.x">rates</a> in traditional populations are high during infancy, before decreasing sharply to remain constant till about 40 years, then mortality rises to peak at about 70. Most individuals remain healthy and vigorous right through their 60s or beyond, until senescence sets in, which is the physical decline where if one cause fails to kill, another will soon strike the mortal blow.</p><p>So what is the source of the myth that those in the past must have died young? One is to do with what we dig up. When ancient human remains are found, archaeologists and biological anthropologists examine the skeletons and attempt to estimate their sex, age and general health. Markers of growth and development, such as tooth eruption, provide relatively accurate age estimates of children. With adults, however, estimates are based on degeneration.</p>
<p>We are all able to instinctively label people as 'young', 'middle-aged' or 'old' based on appearance and the situations in which we encounter them. Similarly, biological anthropologists use the skeleton rather than, say, hair and wrinkles. We term this 'biological age' as our judgment is based on the physical (and mental) conditions that we see before us, which relate to the biological realities of that person. These will not always correlate with an accurate calendar age, as people are all, well, different. Their appearance and abilities will be related to their genetics, lifestyle, health, attitudes, activity, diet, wealth and a multitude of other factors. These differences will accumulate as the years increase, meaning that once a person reaches the age of about 40 or 50, the differences are too great to allow any one-size-fits-all accuracy in the determination of the calendar age, whether it is done by eye on a living person or by the peer-preferred method of skeletal ageing. The result of this is that those older than middle age are frequently given an open-ended age estimation, like 40+ or 50+ years, meaning that they could be anywhere between forty and a hundred and four, or thereabouts.</p><p>The very term 'average age at death' also contributes to the myth. High infant mortality brings down the average at one end of the age spectrum, and open-ended categories such as '40+' or '50+ years' keep it low at the other. We know that in <a href="http://www.who.int/gho/publications/world_health_statistics/2017/en/" target="_blank">2015</a> the average life expectancy at birth ranged from 50 years in Sierra Leone to 84 years in Japan, and these differences are related to early deaths rather than differences in total lifespan. A better method of estimating lifespan is to look at life expectancy only at adulthood, which takes infant mortality out of the equation; however, the inability to estimate age beyond about 50 years still keeps the average lower than it should be.</p><p>Archaeologists' age estimates, therefore, have been squeezed at both ends of the age spectrum, with the result that individuals who have lived their full lifespan are rendered 'invisible'. This means that we have been unable to fully understand societies in the distant past. In the literate past, functioning older individuals were mostly not treated much differently from the general adult population, but without archaeological identification of the invisible elderly, we cannot say whether this was the case in non-literate societies.</p><p>My colleague Marc Oxenham and I wanted to understand early societies more fully so we <a href="https://onlinelibrary.wiley.com/doi/abs/10.1002/oa.2408" target="_blank" rel="noopener noreferrer">developed</a> a method for bringing to light the invisible elderly. This method is applicable only to cemetery populations that have seen little change over the life of the cemetery, and without massive inequality between the inhabitants. That way it can be assumed that the people ate similar foods, and behaved in similar ways with their teeth. One such cemetery is Worthy Park near Kingsworthy, Hampshire, where Anglo-Saxons buried their loved ones some 1,500 years ago. It was excavated in the early 1960s.</p>
<p>We measured the wear on the teeth of these people, and then seriated the population from those with the most worn teeth – the oldest – to those with the least worn. We did this for the whole population, not just the elderly, to act as a control. We then matched them against a known model population with a similar age structure, and allocated the individuals with the most worn teeth to the oldest ages. By matching the Worthy Park teeth to the model population, the invisible elderly soon become visible. Not only were we able to see how many people lived to a grand old age, but also which ones were 75 years or older, and which were a few years past 50.</p><p>Seeing the invisible elderly has led to other discoveries. It has often been suggested that more men than women lived to older age in the past because of the dangers of pregnancy and childbirth, but our study suggests otherwise. We <a href="https://www.researchgate.net/publication/319845926_Sex_and_the_elderly_Attitudes_to_long-lived_women_and_men_in_early_Anglo-Saxon_England" target="_blank">applied</a> our method to two other Anglo-Saxon cemeteries as well – Great Chesterford in Essex and the one on Mill Hill, in Deal, Kent – and found that, of the three oldest individuals from each cemetery, seven were women and only two were men. Although not conclusive proof, this suggests that older age spans for women might be part of the human condition.</p><p>We also looked at the treatment of the elderly in their graves. Anglo-Saxon men were often buried with weapons while women were buried with brooches and jewellery including beads and pins. This suggests that men were identified by their martial qualities, while women were admired for their beauty. Men also maintained or increased their status in their graves well into their 60s, while women's 'value' peaked in their 30s and declined further as they aged. Intriguingly, the class of item most likely to be found in the graves of the elderly rather than younger individuals was the grooming tool. The most common of these was tweezers, and most of these were buried with old men. Did this mean that old men were concerned about their looks? Or that old women were too far from beauty for tweezers or other grooming items to help? Findings such as these provide a glimpse into the lives of people of the past, a glimpse that was impossible without identifying the invisible elderly.</p><p>The maximum human lifespan (approximately 125 years) has barely changed since we arrived. It is <a href="https://www.nature.com/articles/35041709" target="_blank" rel="noopener noreferrer">estimated</a> that if the three main causes of death in old age today – cardiovascular disease, stroke, and cancer – were eliminated, the developed world would see only a 15-year increase in life expectancy. While an individual living to 125 in the distant past would have been extremely rare, it was possible. And some things about the past, such as men being valued for their power and women for their beauty, have changed little.<img src="https://metrics.aeon.co/count/3669011d-3efb-478d-9b7b-17022345451f.gif" alt="Aeon counter – do not remove"></p><p>Christine Cave</p><p>This article was originally published at <a href="https://aeon.co/?utm_campaign=republished-article" target="_blank">Aeon</a> and has been republished under Creative Commons. Read the <a href="https://aeon.co/ideas/think-everyone-died-young-in-ancient-societies-think-again" target="_blank">original article</a>.</p>
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Does forgetting a name or word mean that I have dementia?
The number of people with dementia is expected to triple by 2060.
24 September, 2020
Photo by Connor Wang on Unsplash
The number of cases of dementia in the U.S. is rising as baby boomers age, raising questions for boomers themselves and also for their families, caregivers and society.
<p> <a href="https://www.cdc.gov/aging/dementia/index.html" target="_blank">Dementia</a>, which is not technically a disease but a term for impaired ability to think, remember or make decisions, is one of the most feared impairments of old age.
</p><p>
Incidence increases dramatically as people <a href="https://news.umich.edu/one-in-7-americans-over-age-70-has-dementia/" rel="noopener noreferrer" target="_blank">move into their 90s</a>. About 5% of those age 71 to 79 have dementia, and about 37% of those about 90 years old live with it.
</p><p>
Older people may worry about their own loss of function as well as the cost and toll of caregiving for someone with dementia. A 2018 study estimated that the lifetime cost of care for a person with Alzheimer's, the most common form of dementia, to be <a href="https://www.cbsnews.com/news/alzheimers-costs-americans-277-billion-a-year-report/" rel="noopener noreferrer" target="_blank">US$329,360</a>. That figure, too, will no doubt rise, putting even more burdens on family, Medicare and Medicaid.
</p><p>
There's also been a good deal of talk and reporting about dementia in recent months because of the U.S. presidential election. Some voters have asked whether one or both candidates might have dementia. But, is this even a fair question to ask? When these types of questions are posed – adding further stigma to people with dementia – it can unfairly further isolate them and those caring for them. We need to understand dementia and the impact it has on more than 5 million people in the U.S. who now live with dementia and their caregivers. That number is <a href="https://www.cdc.gov/aging/dementia/index.html" rel="noopener noreferrer" target="_blank">expected to triple</a> by 2060.
</p><p>
First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor's exam for a diagnosis. Sometimes, brain imaging is required. And, forgetting an occasional word – or even where you put your keys – does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.
</p><p>
Older people wonder and worry about so-called senior moments and the memory loss they perceive in themselves and others. <a href="https://uvahealth.com/findadoctor/profile/laurie-r-archbald-pannone" rel="noopener noreferrer" target="_blank">I see patients like this</a> every week in my geriatric clinic, where they tell me their stories. They forget a word, get lost in a story, lose keys or can't remember a name. Details vary, but the underlying concern is the same: Is this dementia?
</p>
<h2>Normal memory loss</h2><p>As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is normal. Ever have trouble fetching a fact from the deep back part of your "mind's Rolodex"? Suppose you spot someone at the grocery store you haven't seen in years. Maybe you recognize the face, but don't remember their name until later that night. This is normal, part of the expected changes with aging.</p><p>What's more of a <a href="https://geriatricscareonline.org/" target="_blank" rel="noopener noreferrer">potential problem</a> is forgetting the name of someone you see every day; forgetting how to get to a place you visit frequently; or having problems with your activities of daily living, like eating, dressing and hygiene.</p><p>When you have troubles with memory – but they don't interfere with your daily activities – this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.</p><p>You want to note the timing of any impairment. Was there a gradual decline? Or did it happen all of a sudden? This too you should discuss with your doctor, who might recommend the MoCA, or <a href="https://www.mocatest.org/" target="_blank" rel="noopener noreferrer">Montreal Cognitive Assessment</a> test, which screens for memory problems and helps determine if more evaluation is needed.</p><p>Also, the Centers for Disease Control and Prevention lists problems in these areas as <a href="https://www.cdc.gov/aging/dementia/index.html" target="_blank" rel="noopener noreferrer">possible signs of dementia</a>:</p><ul><li>Memory</li><li>Attention</li><li>Communication</li><li>Reasoning, judgment and problem solving</li><li>Visual perception beyond typical age-related changes in vision</li></ul>
<h2>More severe issues</h2><p>When memory loss interferes with daily activities, see your doctor about what to do and how to make sure you're safe at home.</p><p>There are numerous types of severe memory loss. Dementia tends to be a slow-moving progression that occurs over months or years. Delirium is more sudden and can occur over hours or days, usually when you have an acute illness. Depression can also cause memory changes, particularly as we get older.</p>
<h2>Dementia and other brain issues</h2><p>Alzheimer's dementia is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or an inability to do calculations like balance the checkbook. Certain medical conditions – thyroid disorders, syphilis – can lead to dementia symptoms, and less common types of dementia can have different kinds of symptoms. Alzheimer's has a distinct set of symptoms often associated with certain changes in the brain.</p><p>Focusing on safety and appropriate supervision, particularly in the home, is critical for all people with dementia. Your doctor or a social worker can help you <a href="https://www.alz.org/" target="_blank" rel="noopener noreferrer">find support</a>.</p><p>It's also important to be aware of two other things that can lead to decreased mental functioning – delirium and depression.</p><p>Delirium, a rapid change in cognition or mental functioning, can occur in people with an acute medical illness, like pneumonia or even COVID-19 infection. Delirium can occur in patients in the hospital or at home. Risk for delirium increases with age or previous brain injuries; symptoms include decreased attention span and memory issues.</p><p>Depression can happen at any time, but it's more common with aging. How can you tell if you're depressed? Here's one simple definition: when your mood remains low and you've lost interest or joy in activities you once loved.</p><p>Sometimes people have recurring episodes of depression; sometimes, it's prolonged grieving that becomes depression. Symptoms include anxiety, hopelessness, low energy and problems with memory. If you notice signs of depression in yourself or a loved one, see your doctor. If you have any thoughts of harming yourself, call 911 to get help instantly.</p><p>Any of these conditions can be frightening. But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It's the first step toward figuring out what is happening and making sure your health is the best it can be.</p><p>And, as with any disease or disease group, dementia is not a "character flaw," and the term should not be used to criticize a person. Dementia is a serious medical diagnosis – ask those who have it, the loved ones who care for them or any of us who treat them. Having dementia is challenging. Learn <a href="https://www.alz.org/alzheimers-dementia/facts-figures" target="_blank" rel="noopener noreferrer">what you can do </a>to support those with dementia in your own community.<img src="https://counter.theconversation.com/content/144565/count.gif?distributor=republish-lightbox-basic" alt="The Conversation"></p><p><a href="https://theconversation.com/profiles/laurie-archbald-pannone-894205" target="_blank">Laurie Archbald-Pannone</a>, Associate Professor Medicine, Geriatrics, <em><a href="https://theconversation.com/institutions/university-of-virginia-752" target="_blank" rel="noopener noreferrer">University of Virginia</a></em></p><p>This article is republished from <a href="https://theconversation.com/" target="_blank" rel="noopener noreferrer">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-forgetting-a-name-or-word-mean-that-i-have-dementia-144565" target="_blank" rel="noopener noreferrer">original article</a>.</p>
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