Differences Between Dementia and Aging | Senior Memories | Possible Explanations for Change in Memory | Structural Changes | Beyond Normal Aging | Conditions That Impare Memory

According to the Census Bureau, the elderly population will more than double between now and the year 2050, to 80 million. By that year, as many as 1 in 5 Americans could be over the age of 65. With the growing number of elders today, more and more people are beginning to notice changes in their memory with age. Within memory clinics across the U.S. the most common patient complaints involve the normal changes in memory associated with aging.

With normal aging, it is common to forget the content of a memory (e.g. forgetting an item at the grocery). It is not a normal part of aging to forget the context of a memory (e.g. forgetting that you went to the grocery or forgetting how to get home).

"With sixty staring me in the face, I have developed inflammation of the sentence structure and definite hardening of the paragraphs." James Thurber (1894-1961), U.S. humorist, illustrator. Quoted in: New York Post (June 30, 1955).

Differences Between Dementia and Aging:

What is the difference between memory changes expected with normal aging and dementia? A dementia such as Alzheimer’s Disease is characterized by a selective severe deterioration in the consolidation and storage of new information into long-term memory. Severe rapid forgetting of newly acquired information marks this type of deterioration. In contrast, memory deficits associated with normal aging are the result of inconsistent encoding and retrieval strategies. There is conscious awareness that something can’t be remembered, although the individual is usually able to compensate for the loss of words by circumnavigating the lost ideas with similar concepts. Dementia and memory changes associated with normal aging present a much different pattern of memory difficulties. In normal aging there is a sense of frustration when we can’t recall an item from a memo that we left at the office. We feel frustrated as the items that we wish to recall lies on the tip of our proverbial temporal lobe. In Alzheimer’s disease, we forget the memo, the context in which the memo is to be remembered, the memory of creating the memo, and probably will deny that the memo ever existed. With age, remembering takes more effort. Our attention begins to wander more, and we are no longer able to apply passive attention toward the item to be remembered. Other specific changes take place as we age. Our ability to judge visual-spatial relationships becomes less reliable and our ability to identify objects may begin to show lapses. This is in part due to the slowing within the connections between the inner part of the brain and its outer layers. These connections are in part responsible for the identification of visual form and for the processing of spatial relations. Motor functions and problem-solving abilities also begin to slow with age.

What’s Behind Those Senior Moments?

You obviously feel there is room for improvement where your memory is concerned, otherwise you wouldn’t be reading this right now. Maybe you don’t recall things at the effortless, lightning speed that you once did. Perhaps it takes a little more effort now to recall a familiar route or the street on which to turn. Possibly once-simple tasks such as cooking or shopping have become more tedious, frustrating, and require more effort. What’s the explanation for these noticeable changes? Well, quite simply, your memory changes as you age. But remember, these age-related changes do not equal deterioration. It is a well known fact that the most common cause of memory complaints in the elderly is not brain disease but rather the normal aging of the nervous system . . .” Different people experience these noticeable memory changes to different degrees as they age.

Unfortunately as we age, some of the effortless memory strategies that worked in the past may no longer work. With age we may find that well-established memory systems that we once relied on may no longer be as reliable, and we don’t inherently know how to compensate for this. This change leads to frustration and can be the beginning of a potentially vicious cycle of perceived impaired memory. After all, which is worse? Thinking you have a memory impairment when you don’t or having a memory impairment and adjusting to it?

Remember that memory does not necessarily worsen with age—it only changes. One of the changes identified throughout the literature is that memory becomes more accurate with age. Information may be processed at a slower speed, but there may be some silver lining found with slower processing. After all, isn’t wisdom more a function of accuracy than speed? As we age we have more information to sift through before we can recall the specific kernel of knowledge that we desire. Slightly slower processing may also lead to greater awareness of nuances, shades of gray, or alternative perspectives. The wisdom we acquire through aging allows us to see things from a wider perspective. We have more internal data to bring into our working memory for comparisons before final decisions are made. Did you know that older adults have been shown to have a greater sense of understanding of these subtle qualities of life than younger adults?

Although research has shown that attention may be the most important factor in the differences noted in memory performance as we age (McCrae et al. 1987), other functions related to immediate memory usually remain relatively intact (Siegler et al. 1995). With age, memory changes often reveal themselves as difficulties in retrieval of newly learned information (Welsh-Bohmer and Ogrocki 1998).

So, in older adults, long-term memory tends to go unchanged, while short-term memory tends to slow down. This is why you can remember your wedding in rich detail but can’t remember what you needed from the store. It now requires more conscious effort to move data from the working memory into long-term memory. The changes in memory may be bothersome, but they are not debilitating. We must change the false presumption that we lose the capacity to remember as we age. At the very least, this notion is overly simplistic. Items to be memorized must be meaningful and useful in order to pass your attention threshold. You must apply your concentration on things that used to come naturally to you.

Possible Explanations for Changes in Memory as We Age:

For a memory to be established for later use it must be actively experienced rather than just passively noted. In normal aging, research shows that memory lapses are typically due to ineffective processes that occur when initially attempting to establish or encode what will later become a memory (Perlmutter 1978; Smith 1980; Zarit, et al. 1981; Loewen et al. 1990). Possible explanations as to why older adults may have more inconsistent memory encoding include:

  • Lifestyle changes (retirement, financial difficulties, changes in family structure)
  • Medical conditions experienced with age that effect memory
  • Emotional belief factors (fear of age-related failures, belief that memory is uncontrollable and will inevitably decline)
  • Less-receptive senses
  • Less attentive/more distractible
  • More reliance on information from within rather than from the environment

The problem resides in what you do when trying to learn new information. Given this simple premise, memory becomes something that you can gain more control over and utilize effectively as needed. You have more control over memory acquisition than retrieval. Therefore, you must actively change the way in which you go about learning information. As you've already learned, the approach we support and the techniques we teach are simply that: techniques for remembering to remember. Simply put, take the time and effort needed to commit something to memory. Develop effective new strategies to remember, and your memory will improve. It’s time to remove the chains that bind you to the illusions of eternal youth and accept the changes that come with age and wisdom. With this said, let's examine some of the changes that take place in the brain as we age.

Structural Changes in the Brain with Age:

During the teenage years through early adulthood, the brain is busy developing the covering for nerve tissue. This nerve insulator consists of a fatty substance that acts as a conductor and serves to speed up cognitive processing. There is some normal breakdown of this conductor (called myelin) as we reach middle and late adulthood (Hachinski et al. 1987). As a result, by middle age we begin to notice that our cognitive functioning begins to slow. We often begin to feel this slowing more as we enter our fifties and sixties. Just as hair begins to gray and skin begins to wrinkle, memory functions also make some natural changes. This is not the beginning of the end. It’s not downhill from here. Through our sixties and seventies, the body’s metabolism slows down as a result of normal biochemical changes taking place. As metabolism slows down, the body does not require the calories that it once did, although the same nutrients are required. Sensory and perceptual abilities begin to dull, and it takes more time to remember and to recall information. In addition, you also become more susceptible to distraction, which further derails efficient memory functioning. But remember, the trade off is that many studies have shown that the information recalled tends to be more accurate with age. Neuroscientists speculate that the complex cognitive challenges of daily life are more competently negotiated as we age. In other words, you’re not losing your memory—you’re just slowly getting more accurate!

Biological Changes in the Brain With Age:

There are several other normal biological changes in the brain associated with aging. Your overall brain mass decreases by as much as 10 percent by the time you reach your eighties. The greatest amount of cell decay takes place in the frontal lobes, which essentially facilitates the application of the memory process. The number of connections between nerves (synapses) in the brain decreases with age and twisting of nerve fibers (neurofibrillary tangles) and hardening of nerve fibers (plaques) may become more prevalent after the age of fifty. The brain’s blood supply naturally declines and waste products accumulate in cell bodies. As you grow older, the tissues within your brain become less elastic or less sponge-like. Your brain is no longer the empty sponge capable of absorbing all the new information that surrounds you. Finally, parts of the hippocampus (the major memory structure within the brain) deteriorate and communication between the two hemispheres of the brain becomes less effective. Different people experience these changes to different degrees.

Cognitive Changes Associated with Typical Aging:

  1. Intelligence: Crystallized abilities (e.g. knowledge of facts) remain intact.  Decrease noted in fluid abilities
  2. Attention: (slight) in simple attention (e.g. ability to recite a phone number), divided and sustained attention
  3. Language: Many functions – well preserved or mild in vocabulary
    1. Word finding (search longer)
  4. Memory: Episodic (declarative) memory and working memory (ability to manipulate information mentally, i.e. working a math problem in your head)   Ability to retain learned information – intact
  5. Spatial abilities:  common with normal aging
  6. Executive Functions:

                        Mild declines in concept formation
                        Abstractions – more concrete
                        Slower cognitive processing speed

Sounds Scary, but What Does It All Mean:

As a result of these changes, your memory and other brain functions also make some very natural changes when you age. It may be more difficult to recall information already stored in the brain, and also harder to learn and store new information. Verbal abilities such as vocabulary, comprehension, and speech production are fully developed in our thirties and should remain intact well into our nineties. Immediate and long-term memory also remains relatively intact with age. New learning and recent memory is also resistant to aging but not to the same degree as immediate and long-term memory (Kaye 1998, S46)*. Some older adults may experience decreased motivation and changed perceptual abilities. Elders tend to have more difficulty deliberately focusing their attention and online processing becomes more effortful. “Motor slowing and decline in visual and auditory acuity are common in the elderly” (Ogrocki and Welsh-Bohmer 2000). The trick is to not beat up on yourself in the process and to realize that these are normal memory dynamics associated with aging. These dynamics are not a sign that your memory will continue to get worse! Start now by getting comfortable with the discomfort of being a little different than you used to be. It’s normal. Remember, patience is a virtue. It is essential that you learn how to not let your fight or flight response kick in, when you run into a memory glitch. Next, let’s try an attention exercise to assist you in demonstrating the importance of not allowing yourself to become overwhelmed by negative views of the aging.

Memory Tip: Are You Drinking Enough Water?

Older adults are more prone to dehydration and should therefore make the effort to drink plenty of water. Water helps balance the sodium in the body and also assists in maintaining mental alertness, improving digestion and kidney function, assisting in absorbing medications, and helping the body to absorb nutrients. Therefore, to help your body and mind, it is recommended that you drink six to eight glasses of water daily.

Beyond Normal Aging:

If you are concerned that you may be suffering from one of the following disorders we strongly urge you to get a comprehensive neurological examination. Symptoms that might warrant a neurological work-up include: memory dysfunction that influences your daily functioning, periods of confusion, getting lost in familiar places, apathy or a loss of motivation, severe symptoms of depression with no apparent cause, difficulty with motor skills, tremors, paralysis, difficulty speaking or poor articulation, comprehension impairments, difficulty with reading or writing, acute changes in personality, visual problems, and dizziness. Review the following conditions. If any apply to you, then we recommend that you consult your physician. The presence of any of these conditions may indicate that your memory functioning is being influenced beyond the normal aging process.

Conditions That Impair Memory Beyond Normal Aging (Crook et al., 1986)

  • Current use of psychiatric drugs
  • Current struggle with a psychiatric disorder (like depression or anxiety)
  • Alcohol or drug dependency • Medical conditions that impair memory functioning
  • Delirium or an acute confusional state • Neurological disorder that impairs memory functioning (like Parkinson’s disease, stroke, Alzheimer’s disease)
  • History of significant head injury resulting in unconsciousness or multiple minor head injuries
  • Exposure to toxins with noted cognitive decline afterwards • History of inflammatory or infectious disease (syphilitic, viral)
  • History of significant vascular disease

Memory changes as we age.

However dementia is NOT a normal part of aging.

In NORMAL AGING, we may experience changes in our memory.  These memory slips are frustrating but they do NOT signal a serious cognitive disorder.  As we age, it requires more effort to recall short term memories.

We need to pay more ATTENTION to information we want to recall later.  This involves ENCODING strategies.  We need to take more time and pay more attention to things we want to remember.  We need to slowly and carefully place the information in our brain, taking the time to link the memory.

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