BRAIN HEALTH - THE AGING MIND

If you have ever forgotten where you left your car keys or drawn a blank on a familiar name, you may have wondered if these "senior moments" were the first subtle signs of age-related memory loss. As we get older, our speed of processing information, and the efficiency of our short and long term memory naturally decline. It is also a fact that the brain regions dedicated to these functions actually shrink in size as we age. This could certainly make you worry about losing your mental edge with each passing birthday.

However, these changes are not as dire as they may seem. Several years ago, researchers at Princeton University found new nerve cells being created in the brains of monkeys. According to their study, neurons are regenerated deep in the center of the brain. Once reborn, they move to other parts of the brain associated with higher mental functions, like the hippocampus, the major neural region associated with long-term memory storage. This study may have implications for human memory function. In other words, the aging human brain may be more resilient than we thought.

Age-Related Memory Loss

Memory loss is a normal part of the aging process. As we age, blood flow to the brain decreases, causing it to use oxygen and protein less efficiently. In addition, the number of receptors associated with memory function declines and aging brain cells may stop sending and receiving chemi-cal signals. The aging brain also loses some of its ability to protect itself against inflammation and free radicals. But having an occasional memory lapse or needing more time to process new information does not always mean your brain is suffering from old age. Memory loss or a loss of con-centration can also be caused by such things as dehydration, a poor diet, fatigue or stress.

Memory and cognition are also affected by changes in the level of sex hormones. For example, menopausal women may complain of "brain fade" due to declining levels of estrogen. This hormone protects hip-pocampal neurons and promotes the formation of new neurons, which might explain a connection with memory.

Two studies, each following hundreds of women over time to see who developed Alzheimer's dis-ease, found that those who received estrogen during or shortly after menopause even for as little as six months were less likely to later develop Alzheimer's disease than the women who had not used estro-gen replacement therapy. While pharmaceutical estrogen replacement has been shown to increase many health risks, these studies point to the important role this hormone plays in cognition and memory. There are several possible explanations for such effects. For example, estrogen increases the concentration of an enzyme that is needed to synthesize acetylcholine, a brain chemical essential for memory function. Estrogen also enhances communication between neurons in the hippocampus, an area of the brain that is important for verbal memory.

Although men do not have such a dramatic decline of hormones as they get older, research shows that men with high levels of testosterone have better visual and verbal memory skills than men with low levels. Conversely, low testosterone levels have been observed in patients with Alzheimer's disease and mild cognitive impairment.

Certain diseases and medications can affect memory too. For instance, people with high blood pressure are more prone to memory impairment than people with normal blood pressure. People with diabetes may experi-ence memory problems due to high levels of blood sugar. Drugs, includ-ing sleeping pills, sedatives, painkillers, some antidepressants and even eye drops for glaucoma, can cause forgetfulness. If you are experiencing mem-ory problems and suspect that one or more of your medications is respon-sible, make a list of all the drugs you are taking and talk with your doctor.

Dementia

Usually a small mental lapse is nothing to worry about, but if you find that memory problems are interfering with your daily life, it is wise to see a health care practitioner. He or she can tell you if the problem is serious or is triggered by something temporary, like a medication or stress.

Seek help if you:

•  Forget things much more often than you used to.
•  Forget simple words or use the wrong words when trying to explain something.
•  Forget how to do something you have done many times before.
•  Have trouble learning new things.
•  Repeat the same phrase or story in the same conversation.
•  Have trouble making choices or handling money.
•  Cannot keep track of what happens each day.
•  Have trouble doing things that involve a series of steps, like following a recipe.
•  Experience sudden mood swings, going from calm to tears to anger in a few minutes.

Chronic or severe forgetfulness does not automatically mean Alzheim-er's disease. There are several other types of dementia that can interfere with a person's ability to function on a daily basis. Some, like Alzheimer's, are progressive and very serious. Others, however, can be halted or reversed by treating underlying conditions that may contribute to the dementia.

Common types of untreatable dementia include dementia with Lewy bodies (closely allied to Parkinson's disease) and frontotemporal demen-tia. Lewy bodies are clumps of proteins in neurons that accumulate in the brain, and are similar to the proteins found in the brains of people with Alzheimer's and Parkinson's diseases. Frontotemporal dementia affects areas of the brain responsible for judgment and social behavior. As a result, people with this type of dementia can display inappropriate social behavior. Several disorders, such as Huntington's disease and AIDS, can also result in dementia.

Another type of dementia, known as vascular dementia, occurs when the arteries that feed the brain become blocked or narrowed. This decreases blood flow depriving brain cells of the nutrients and oxygen they need to function normally. Vascular dementia often occurs after a stroke. Prevent-ing further strokes by treating the underlying diseases high blood pres-sure or unhealthy cholesterol levels may slow or stop the progression of vascular dementia.

Some types of dementia are associated with reversible diseases like hypothyroidism (decreased thyroid function) and severe hypoglycemic episodes, where there is too little sugar in the bloodstream. Severe infec-tions, like cryptococcal meningitis in people with a compromised immune system (such as AIDS patients), and chronic alcoholism can also cause reversible dementia.

Alzheimer's Disease

Alzheimer's disease is far and away the most common type of demen-tia, accounting for 50 to 70 percent of all dementia cases. Although early onset can occur, Alzheimer's and dementia in general are much more common after age 60. While no one knows the exact cause of Alzheimer's, scientists have discovered that plaques fibrous deposits made of protein fragments play a key role in the disease. As these plaques build up in the brain they cause abnormal degeneration and eventual death of brain cells, particularly in regions of the brain associated with memory. Eventually, these abnormalities and the loss of neurons extend into other areas of the cortex.

As we age, much can go wrong with the brain. It is impossible to change your genetics or turn back time, but you may be able to maintain your memory and acuity into your seventies, eighties and nineties by being mindful of what you eat and keeping your mind in good shape with regu-lar physical and mental exercise.

We all forget things from time to time, whether it's due to age-related memory loss or just from having too much on our minds. To help you remember more, more easily, the American Academy of Family Physicians recommends a few techniques:

•     Keep lists.Routinely making grocery lists, to-do lists, lists of projects or goals can prevent everyday tasks and special "to dos" from falling through the cracks.
•     Follow a routine.Doing the same activity at the same time each day helps cement them in your memory.
•     Make associations(connect things in your mind), such as using landmarks to help you find places.
•     Keep a detailed calendar, in a place where you will see it every day, so you never miss another birthday or appointment.
•     Put important items, such as your keys or glasses, in the same place every time you are finished using them.
•     Repeat names when you meet new people. "It's nice to meet you, Henry."
•     Do things that keep your mind and body busy. For example, gardening or redecorating a room require both mental and physical work.
•     Run through the ABCsin your head to help you remember a word or name. "Hearing" the first letter of a word may jog your memory.