Memory and aging – The Washington Post


Survey It shows that half of middle-aged adults are worried about getting dementia. People who feel isolated, have less sleep, or take care of someone with memory loss tend to be particularly worried. The fear of cognitive impairment is widespread.Scientists are people Dementia is more scary Than others Major cause Deaths such as heart disease and stroke.

Decades of research have shown that age-related changes in cognition are completely normal.Most adults Face recognition gets worse When Remember new information It starts in the thirties and continues to decline for the rest of its life. This means that a typical retiree can remember less items from a long grocery list than a 20-year-old grandson, even if both are cognitively normal. Memories for well-learned facts It lasts a long time, but these skills have diminished over time. So the question of whether something is wrong with the brain is not “Did I decline?” Rather, “Did you refuse too much?”

Inaccurate cognitive assessment

We are notorious for being inaccurate in assessing our cognition. Studies show that insights into quantification are particularly inadequate. processing speed And dexterity. In the presence of Alzheimer’s disease and other distress, the ability to self-determine cognitive ability, starting from the early stages of the disease, is even less reliable. Loss of self-awareness is so common in these conditions that it may be included in the diagnostic criteria for illness.

So how do we need to understand if someone is experiencing normal aging-related memory processes or something more important?

Instead of trying to evaluate yourself, ask your close friends and family to see if there are any problems. Studies show that Spouse description It is more reliable than your opinion about your memory and thinking ability. The most useful questionnaires for measuring cognitive dysfunction are filled out by someone who is familiar with them, not by the patient. At my own memory clinic, I am compensating for incomplete self-awareness by having patients come to the clinic with friends and family who can speak individually.

As cognitive experts, we assess brain health in two ways.

First, think of it as macroscopic. How well do people work in the real world? Ask if the patient has forgotten to pay the invoice, lost his way on a familiar driving route, or removed the ingredients from the recipe. Discuss difficult words and behavioral changes.

Next, I try to predict what is happening in my head on a microscopic scale. Do you suspect that molecules that damage the patient’s brain are accumulating? Our brain is made up of hundreds of billions of molecules, each formed by connected atoms, similar to Lego blocks clicked together. Most of these molecules help us prosper, but some can turn us on and cause havoc to the organs they were intended to serve. We don’t always know the exact molecules that cause Alzheimer’s disease or similar conditions, but we often know which abnormal molecules tend to be associated with distress.

To assess whether dangerous molecules are accumulating in the patient’s brain, we use thinking tests that can quantify memory, multitasking skills, language skills, and spatial judgment, similar to brain games.

Look at a picture of the patient’s brain (usually an MRI) to look for small or damaged areas. From time to time, it incorporates additional results from blood and spinal fluid. Summarize the information and, if there are abnormal molecules, assume what kind of molecules are gathered in the person’s brain. “If I look at a part of your brain under a microscope, I can tell the patient,” I think I’ll find this. “

Alzheimer’s disease, Lewy body dementia, Frontotemporal dementia Because each of the other types of dementia is associated with specific molecular changes, it is possible to predict what will happen to the patient in the future by associating human symptoms with the roots of the microscope. The three who start a conversation can face completely different fate. One whose symptoms are caused by Alzheimer’s disease continues to experience progressive amnesia. Others may be significantly disinhibited because the repetition is due to frontotemporal dementia. Yet another, if the problematic molecule is not accumulating in the brain at all, it may eventually stop repetitive behavior and return to normal after tackling mood symptoms and sleep problems.

Predicting which molecule is associated with a patient’s disease is important not only for prognosis but also for drug discovery. The idea of ​​a single cure for dementia (magic pills or universal flu vaccine) has long been obsolete. Drugs that treat Alzheimer’s disease are unlikely to help patients with frontotemporal dementia. Because the disease is thought to be caused by various molecular disasters.The same applies to treatment Lewy body dementia Also Huntington’s disease.. Therefore, scientists are looking for multiple medicines at the same time. Each drug acts on certain malicious molecules.

Ultimately, dementia treatments will be a weapon of medicine that doctors can tailor to each patient based on the unique molecular signature in the individual’s brain.

As the quest for cure continues, the most valuable action you can take if you are worried about your memory is to talk to friends and family. You may ask, “Will you keep an eye on my memory and thoughts?” “And if I think I’m worse than others of my age, be honest.” If that person is worried, talk to your doctor.

If everything seems normal to your age group, set your anxiety aside and ask again after 6 months. Statistically, rest assured that your family and friends probably know better than you.

In the meantime, don’t worry about forgetting your acquaintance’s name and leaving the key on the kitchen counter. Most often, these are just signs of normal cognitive aging.

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