When Memory is Normal and Not-So-Normal

Memory and aging

Memory: "The power or process of reproducing or recalling what has been learned and retained" (Merriam-Webster Dictionary). Our ability to remember and to recall our past is what links us to our families, to our friends, to our community.

• As we age, subtle changes in memory occur, sometimes unnoticed, but at other times disturbing to ourselves or others.
• Most normal changes in memory and cognition ("The act or process of knowing including both awareness and judgment") are of little importance, as they do not interfere with our daily activities or our quality of life.
• But when memory loss prevents us from performing daily tasks and our accustomed roles in life it becomes a health concern that needs further evaluation by health care professionals.

What is normal aging and memory?

As we age, slight changes occur in our cognition that affect memory. Simple forgetfulness (the "missing keys") and delay or slowing in recalling names, dates, and events can be part of the normal process of aging. Memory has various forms, though, that might be affected differently by aging.

Preserved memory functions

• Remote memory
• Procedural memory (performing tasks)
• Semantic recall (general knowledge)

Declining memory functions

• Learning new information
• Recalling new information (takes longer to learn something new and to recall it)

What other changes occur with normal aging and cognition?

• Language ("The words, their pronunciation, and the methods of combining them used and understood by a community") is modestly affected by aging.
• Language comprehension (understanding the rules of language) is preserved, as are vocabulary (semantic memory) and syntax (the way in which words are put together).
• Some modest decline is seen with spontaneous word finding ("tip of the tongue") and verbal fluency (takes longer to "get the words out").
• While verbal intelligence (vocabulary) remains unchanged with aging, the speed of information processing gradually slows (such as problem-solving skills).
• Executive functions (planning, abstracting) remain normal for everyday tasks, but are slowed when faced with novel tasks or divided attention ("multi-tasking").
• A slowing of the speed of cognitive processing and reaction time ("hitting the buzzer") occur with aging.

When is memory not so normal?

Amnesia ("memory loss") is not a part of the normal aging process. While it may take longer to learn new information (for example, names of people) or to recall learned information (for example, names of friends in photos), with a little time and extra effort memory occurs. Some people are more forgetful, but this might be because of health conditions (for example, depression, heart disease, thyroid disease and vitamin deficiencies) or medication effects.

Memory loss is abnormal in people with mild cognitive impairment or dementia (a loss of intellectual functions severe enough to interfere with everyday social or occupational functioning).

Mild cognitive impairment

• Important memory impairments occur without loss of independent functioning.
• Forgetfulness and struggling to perform self-care tasks (for example, taking medications, paying bills) but still able to do so without the direct help of another person.

Dementia

Memory, language, and cognition are so impaired that self-care tasks can no longer be performed without assistance from another person.

Not-so-normal memory

Mild cognitive impairment

Condition

• Aging
• Pre-Alzheimer’s
• Silent "strokes" (infarcts)
• Head injury

Symptoms

• Forgetfulness or amnesia for recent events
• Need to write reminders to do things or else will forget
• Struggles but is able to perform daily chores and tasks
• Sometimes needs a reminder or prompt to remember

Dementia

Condition

• Alzheimer’s
• Vascular (stroke)
• Others: Pick’s, hydrocephalus, drugs/alcohol, etc.

Symptoms

• Unable to perform complex daily tasks (for example, paying bills, taking medications, shopping, driving)
• Loss of insight or awareness of memory loss
• Poor judgment
• Behavioral symptoms (for example, irritability worrying, anger, agitation, suspiciousness)

Can normal memory be preserved in aging?

Research has shown the following:

• Continued education (college) helps preserve "cognitive reserve" and delays the onset of dementia.
• A healthy diet--one high in antioxidants and olive oil--lowers the risk of dementia.
• Cognitive training (memory training, reasoning training, speed-of-process training) improves cognition.
• Playing board games (chess, checkers, cards) and musical instrument delays the onset of dementia.
• Engaging in social activities slows cognitive decline.
• Reducing cardiovascular risks (for example, treating hypertension) delays the onset of dementia.