Mental changes

Memory

There are over 70 conditions that contribute to memory problems. And age is certainly a “risk factor” for Alzheimer’s, stroke and other brain illnesses.

Alzheimer’s is the second most dreaded disease, second only to cancer.

But sometimes the worry about dementia can create its own problems. Mental health issues are very stigmatized in our society. They bring with them feelings of shame, not only for the patient, but sometimes even for family members.

Anxiety and shame about potential dementia can lead to depression, which in turn leads to isolation and low self-esteem.

Depression
Depression itself is one of those conditions that exhibits symptoms of fuzzy thinking and memory loss. Ironically, the fear of dementia can trigger dementia-like symptoms.

Forgetting serves a purpose
It’s important to keep memory in perspective. This is not to deny the impact of a brain disease. But a little forgetting is not a terrible thing. It’s actually quite healthy in a normal brain.

• Not all memories are worth saving, or retrieving!
• Our brains continue to take in new data all the time.
• There simply isn’t room to store all the details of all the things we have ever experienced over all the years.

It’s quite adaptive of the brain to jettison some facts or events in favor of keeping others that are much more critical to our survival.

The normal forgetfulness of aging

Forgetfulness is the inability to retrieve information we think we have committed to memory. Normal forgetfulness falls in two basic categories:

• Can’t retrieve it quickly. It’s not that the fact or the recollection of an event is gone altogether. With the normal forgetfulness of aging, that stored item just isn’t as easy to find it as it used to be. The older brain quite simply has more to sort through than a younger brain. And the speed of the sorting is slower. Often a person will remember the “lost” word later in the conversation, or the next day, when the pressure is off.
• Had it, but it wasn’t important enough to stick around. This is what is called short term or working memory. And it definitely gets shorter and less reliable as we age. It’s what causes us to forget what we went into the bedroom to retrieve. Or why we have to write down a phone number, or look twice as we key it in. Our personal RAM simply isn’t what it used to be. Inconvenient, yes. Frustrating, sometimes. A sign of a larger problem. No.

What memories stay the same or improve?
There are many different types of memory. While short term memory declines with age, other types of memory stay the same. Barring a brain disease, these types of memory tend to be pretty stable over the years:

• Memories of major emotional events. Those turning points in life where we suddenly realized things were quite different than we had thought. These can be happy strokes of joy or insight, like the day we get married, or the birth of a child. Or they can be sad or upsetting events (9/11, or the day President Kennedy was shot).
• Skills that become second nature. Taking a shower, tying a shoe or riding a bike. We don’t even have to engage our conscious mind to do them much. We have a body memory of how to do them.
• Accuracy improves. While memory recall is slower for older adults than for those who are younger, speed is not everything. It turns out that older adults are more cautious and focus on accuracy. As a rule, older adults remember facts more accurately than people of younger generations.

When memory loss is a problem
There is no denying that brain conditions that impact memory are more common in our older years. They are not a “normal” part of aging. They are a sign of a brain disease.

But how to know when memory issues are simply normal aging vs. when to get checked?

Oddly, people who do have some form of dementia often don’t realize it. It’s their families who notice, especially at the middle stage.

Conversely, people who are worried about their memory stumbles often have no disease at all.

Signs that something more serious may be going on include

• difficulty with a common task, for example cooking a meal.
• trouble balancing the checkbook when it used to be easy.
• not recognizing people you see regularly.
• problems judging distance, even with glasses.
• putting things away in odd places.
• fairly sudden mood swings or personality changes.
• changes in personal hygiene.

Of the 70 dementing conditions, some are treatable—depression for example—and some are not.

• Alzheimer’s Disease is the most common;
• Next is vascular dementia (from strokes);
• and then Parkinson’s.

If you are concerned, get a full neurological workup. We can help you find the appropriate doctors and be sure you get all the tests needed to paint an accurate picture of your brain’s state of health. Give us a call at 585-271-0400.

Intelligence

What is intelligence? It’s not just book-learning or the ability to take tests. (Although, ironically, books and tests do tend to be the way we measure intelligence!)

A definition
At its simplest, intelligence is the ability to perceive what is around us and process many different types of input. Based on what we notice, we then make decisions about what we want to do to achieve a desired goal.

Types of intelligence
Intelligence can involve logic and language. Planning and problem-solving are also part of the intelligence equation. Then there are sensitivities like emotional awareness of others, the ability to recognize patterns. Even self-awareness is a part of intelligence. Howard Gardner, a professor of Education at Harvard, found IQ tests too limiting in what they measured. He proposed multiple types of intelligence:

• Linguistic intelligence (“word smart”)
• Logical-mathematical intelligence (“number/reasoning smart”)
• Spatial intelligence (“picture smart”)
• Bodily-Kinesthetic intelligence (“body smart”)
• Musical intelligence (“music smart”)
• Interpersonal intelligence (“people smart”)
• Intrapersonal intelligence (“self smart”)
• Naturalist intelligence (“nature smart”)

Changes in mental processing
As mentioned in the context of memory, the speed of our brains definitely slows down with age. It takes longer to learn new things.

• In a normal, aging brain, reasoning and solving problems—especially if they require new skills or new information—take a hit on laboratory tests. So do hand-eye coordination and reaction time.
• Attention span gets shorter as we age.
• Concentration can become more difficult. It’s easier to get distracted and move our focus to something new. This may be part of the problem with short term memory. We drop what we were working on and replace it with a new item of interest.

Mental abilities that defy dementia
With so much fear about Alzheimer’s and memory loss, people “forget” that there are different aspects to our mental capabilities. These mental skills remain, and sometimes get keener, even in the face of dementia:

• Music and singing!
  In this case, even people with advanced dementia, who are unable to talk much, can still sing along with a favorite song. And someone who was musically inclined in youth will retain that gift unless other non-mental diseases get in the way. (Arthritis, for instance)
• Intuition or emotional perception.
  If you have ever spent time with an older relative who has moderate dementia, you will recognize that they become very perceptive emotionally. While they may not follow words as much, they definitely track tone of voice. Adult children who adopt the view that they are “parenting their parent” quickly get called up short on that one. A parent will always be a parent. And people with dementia, unless it is quite advanced, know what disrespect sounds like. That skill does not go away.

What stays the same or improves?

• Our vocabulary and general knowledge stays the same, or even expands as we get older. The physical skills we have learned and use regularly tend to stay the same. Absent a brain disease, it’s generally problems of arthritis that get in the way of performing well-practiced activities.
• Comparing and contrasting stays the same. In fact, as we age, we have so much more to draw upon that we often rise to the overview. We notice similarities and draw associations more effectively than younger adults.
• The joy of learning remains. Unless there is a brain disease, most people continue to enjoy learning. As long as the environment is safe and there’s no pressure, we get the same delight in a new perspective or hearing a new story that we experienced as younger adults. Plus, we even enjoy revisiting old stories. Our thinking deepens and we see the value in reflection, even on the familiar.

The pros and cons of habits

• Habits are handy.
  They allow us to do things by rote. We don’t have to take up precious energy focusing on the mundane. Over time, we have learned what we like. And we know the easiest way to achieve it. We are not challenged much and we don’t feel stupid if we do the same things the same way. Very efficient!
• Change is stressful.
  It takes us out of our comfort zone. Change may actually signal a threat. And at the least it can threaten our confidence in our abilities. We know we can cope with the tried and true. We may or may not have the resources or confidence to effectively address a new situation.
• But challenge is how the mind grows and renews itself.
  If we force it down new pathways, it expands. Many people find travel stimulating for this very reason. It brings in new sites, sounds tastes and smells. Travel also forces us to do our normal routines in different ways.

We don’t have to travel to break up our routines, however. Walk or drive on a different route now and then. Prepare a new meal. Mix up your daily grooming pattern.

Remember, intelligence is the ability to take in information and process it to reach a desired end. Things are always changing as we age, so staying nimble in the face of change—thinking creatively—is to your benefit. Challenging your brain to look at the same activities in new ways is a great technique for keeping your mind sharp. And creative thinking does not decline with age.

Creativity

Defining creativity
There are many definitions of creativity. Loosely it can be defined as the ability to solve a problem by taking insights from one situation and applying it to another. Artists may do this with a design or aesthetic problem.

Frank Lloyd Wright, for instance, had the problem of how to provide lots of wall space for hanging and viewing art in the Guggenheim Museum. He did not want a building made up of small rectangular rooms. As an answer to that challenge, he designed the now famous spiral building in New York City. He was 80 when he designed this masterpiece.

Creativity does not expire
Creative thinking is a component of intelligence that does not diminish in the aging brain! There is no expiration date on creativity.

In fact, older adults have so many more experiences to draw from, they have an advantage. With such a superb inventory, they can bring thinking or strategies from one context and apply it to another.

Famous older artists

• Verdi was 72 when he composed Otello and 76 when he wrote Falstaff.
• Picasso painted up until he died at 92.
• Bach, Stravinsky, Beethoven and Monteverdi also composed with innovation, right up to the year of their passing.

And physical handicaps do not need to get in the way.

• The Spanish painter, Goya, was very productive in his 60’s and 70’s, despite deafness and needing two pairs of glasses to see.
• Georgia O’Keefe did not let failing eyesight get in her way either. She painted well into her late 90’s.

Creativity is not just for artists
We don’t have to be artists or musicians to exhibit creativity. Our everyday lives provide numerous opportunities for creatively addressing problems.

Creative thinking in daily life
Dr. Mark Williams, author of The Art and Science of Aging Well, tells the story of an older couple in New York. They took the subway late one winter afternoon to get to their son’s apartment for dinner. As they emerged from underground, they realized that the snow was coming down too hard. They would not be able to walk to their son’s apartment. No one was home just yet. And all the taxis were full already with commuters. The gentleman in the couple spied a pizza parlor that advertised “home delivery.” They went to the restaurant and ordered a pizza to go. When the cashier asked for the address to deliver the pizza, the man asked to ride with the delivery person to their son’s house. They arrived warmly and safely and with dinner in tow. That is creative thinking!