Could this be a precursor to dementia?

You are terrified. You are in the supermarket but suddenly you don’t know what you wanted to buy. You wander around the racks until you suddenly remember. Jam! Happy. You pick up a jar and don’t think about it at all. But at night you lie brooding. You recently lost your driver’s license and you were supposed to water your neighbor’s plants, but you had completely forgotten that. Could this be a precursor to dementia?

Elderly people in particular will sometimes have these kinds of thoughts, says Professor of Cognitive Neuroscience André Aleman of the University of Groningen. “With these kinds of complaints, young people simply think that they are very busy and therefore forget things. But older people are more likely to attribute this to old age or dementia.” Now memory does indeed decline a bit as we get older, but not as dramatically as we sometimes think. Aleman wrote about this in his book The senior brain and also in his latest book Who is confused here? he sheds light on misunderstandings about the brain.

shopping lists

“What is striking is that thinking in particular is slowing down and that we have a bit more trouble retrieving information quickly or following things,” says Aleman. “If someone explains something new and it all goes a bit fast, it is more difficult for an older person to keep up.” That mental delay can take its revenge in all sorts of ways: “Think of the subtitles on television, which go a bit fast. Or when you come into a new traffic situation and have to make decisions quickly.” In general, this is not so bad or disturbing, Aleman knows.

Most of the time, remembering works just fine. Even shopping lists don’t have to be a problem if all the groceries are logically related, because they are all ingredients for apple pie, for example. “As you get older, it is especially more difficult to remember a list of random messages,” Aleman explains. “In addition, old information is often still well stored, but it sometimes takes a little more time to dig up it. Do you suddenly have to think for a long time about the name of a colleague with whom you have worked for years.”

Worrying and stress

If you are suddenly able to remember much less, there can also be all kinds of other reasons why you are suddenly more forgetful. If you are very sad or worried, are going through the menopause or are taking certain medicines, this can affect your memory. This can pass and is not necessarily a cause for concern. “People who worry a lot about their memory complaints can actually suffer from less functioning due to the stress. It would be good for them to be reassured,” Aleman said. “Over the age of 85, the majority of people do have some form of cognitive decline. Memory problems are not uncommon. But the majority of these people are not demented.”

Some people are especially concerned because their parent, brother or sister also developed Alzheimer’s around age 70. But that is not right, according to the professor. “Alzheimer’s is not so strongly hereditary. There’s a pretty good chance you won’t get it and not necessarily that early.” And then of course there are people who have been a bit confused and forgetful all their lives. No wonder they still are at an older age.

rule of thumb

When is it wise to contact your doctor? Aleman has a handy rule of thumb for this: “When others, your partner or a close friend start to worry. When they say: you always forgot something, but now it becomes a lot.” In general, it appears that many people themselves do not really have insight into the seriousness of their complaints.

However, some people also notice the difference themselves. Aleman: “A cause for concern is when the memory problems are so strong that your daily functioning is hindered. Everyone has forgotten a name once, but all day long can be a concern. Even if you can’t find your way to the dentist, while you didn’t have any problems with it before, you can start scratching your head.”

Sometimes complaints are difficult to estimate, even as a relative. “I once spoke to a man who told me that his wife could no longer pay by card unless he was standing next to her. I’m not sure if there really is anything wrong. I am afraid that he will help Mrs. a little and that she can no longer do it herself.”

Memory test

Also, with superficial contact, there may not seem to be anything wrong. Aleman: “People with dementia can continue to have a good conversation well into the course of the illness. The problems are often much more in his ability to function independently. Are you still able to organize your life properly, do the shopping, and make an appointment on time? You often see people neglecting themselves or getting out of bed at night and wandering.”

If the complaints are mild, it can also be MCI: Mild Cognitive Impairment or a mild cognitive impairment. People with MCI forget a lot and sometimes have difficulty with actions such as making coffee or dressing themselves. Tricky, but you can live with it. There is a lot to be gained with smart notes and lists.

Half of people with MCI will develop dementia later in life. Nowadays people sometimes speak of SCI (Subjective Cognitive Impairmen), subjective memory complaints. This is the case when people indicate that they suffer from complaints in their memory and act daily, but that nothing comes up from a memory test. Some of them do indeed get MCI in the longer term.

If the doctor suspects that you have more than normal memory complaints, he can refer you to a memory clinic or a hospital department where they specialize in memory complaints.

To slow down

You don’t have to patiently wait for your fate; you can do things yourself that may help slow down the brain’s decline. “Actually, it is advice that is sensible for everyone and the sooner you intervene, the better,” Aleman explains. Staying active, both socially, mentally and physically helps. Think of volunteering or doing something with friends, reading books, taking a course or having a hobby. And of course every week a few vigorous movements, which make the heart beat faster.

Diet also plays an important role. Aleman: “A study is currently being conducted in which elderly people from the island of Okinawa in Japan are compared with elderly people in the Netherlands. On Okinawa people live very old and brain scans of older people are more suited to younger people. In part, this is due to their genes and movement. But also because of their diet.” Eat less calories, lots of vegetables and fruit, few saturated fats and a fish every now and then; These advices are not very new. “You could say that anything you can do to live a healthier life for longer is also good for your brain.”

wisdom of life

With all the doom and gloom, you’d almost forget that there are also benefits to having an older brain. Aleman says that older people may not be able to process information so quickly, but they have built up life wisdom. And a little sluggishness can help make better choices. “Some studies show that older people may have an advantage in terms of nuanced thinking or complex decisions. Young people answer faster, but older people ask more questions and are more gentle with others.” Good to hear, because negative expectations about aging make you score worse on memory tests. Those who have a positive view of aging have, on average, less stress and more healthy life years ahead.

This article previously appeared in Plus Magazine February 2022. Want to subscribe to the magazine? You can do that in an instant!