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Marla Shapiro Add to ...

Most of us are familiar with Alzheimer's, one of a group of diseases called dementia. One in 13 Canadians over age 65 has Alzheimer's or a related dementia - a number that increases to one in three over age 85. But Alzheimer's is not a normal part of aging.

A reader asks: "How do families distinguish between the 'normal' effects of aging in their parents, versus the onset of serious illness, such as dementia or Alzheimer's? Are we, as a generation, becoming too quick to pathologize normal aging due to our fears?"

According to the Alzheimer Society of Canada, the disease accounts for 64 per cent of all dementias. Alzheimer's is a degenerative brain disorder, characterized by the buildup of plaque in the brain. Various factors are believed to contribute to Alzheimer's, including genetics, medical conditions such as diabetes and cardiovascular disease, obesity, poor nutrition and head injuries.

Dementias share some common symptoms: loss of memory, loss of judgment and reasoning, changes in mood and behaviour, and changes in ability to communicate. These symptoms eventually lead to a significant impairment in ability to function; people become disoriented and dependent on others to manage simple physical activities.

Our reader adds, "My siblings worry every time my 77-year-old mother forgets a conversation or needs to be reminded of a recent event. She manages to live alone in a retirement home . . . Can she reprogram her TV and VCR remote? . . . No."

Truth is, most people can't easily reprogram their remotes; it isn't a sign of impaired brain function!

Memory loss and an aging brain are normal events in the passage of time. And it doesn't happen only to the over-50s. Anyone, at any age, is capable of forgetting dates, meetings or names.

Dr. Stuart Zola, a psychiatrist, describes memory as occurring in three stages. First, we take in information, which is called encoding. Then we process and store that information, known as consolidation. Finally, when we want to use the information, we retrieve it from our memory bank.

As time marches on, we often have distortion of that memory, and our ability to retrieve it is altered. The more time that passes between the event and retrieval, the more likely this is to happen. This is normal; research tells us that up to half of people over 50 have mild forgetfulness.

There are several other reasons why your memory might deteriorate, such as stress, anxiety, depression, physical illness, alcohol abuse, vitamin B12 deficiency, drugs and infection.

Tips to improve memory include: Slow down and focus to make sure your encoding is the best it can be; reduce your level of stress; get enough sleep; use memory aids to help you remember names and events.

The best way to keep your brain fit and healthy is to adopt that familiar phrase, "use it or lose it." Anything from word games to crossword puzzles, to playing bridge, to reading a book or staying active at work are just some ways in which we exercise our brain. Being physically fit, eating well, not smoking, drinking alcohol in moderation, and reducing stress are ways to protect your brain.

That said, there are differences in memory loss. So when should you worry about dementia or Alzheimer's?

While it may be normal to forget part of an experience, it is not normal to forget the experience entirely. Forgetting where the car is parked isn't unusual, but forgetting how to drive a car is. Meeting someone new and having trouble recalling his name is common, but completely forgetting you know someone is worrisome.

Dementia worsens over time. There is no one test to diagnose it (and no current cure, though there are medications useful in treating mild to moderate disease), but the Alzheimer Society has a list of warning signs. These include:

  • Memory loss affecting day-to-day functions;
  • Difficulty performing familiar tasks;
  • Problems with language;
  • Disorientation of time and place;
  • Poor or decreased judgment;
  • Problems with abstract thinking;
  • Misplacing things;
  • Changes in mood, behaviour or personality.

Like our reader's mother, I can't program my VCR. I often forget where my car keys are, and drive my kids to distraction looking for them. And I agree that we don't want to pathologize the normal aging process.

But I caution that if memory loss becomes progressive, along with the symptoms listed above, it is time to seek the advice of a physician.

Dr. Marla Shapiro can be seen daily on Balance: Television for Living Well on CTV. Questions about general health issues can be sent to her at: health@globeandmail.ca

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