My Uncle Harry always told great jokes. But as he aged, he told the same joke over and over -- and to the same people. Eventually, he stopped telling jokes completely.
"Older adults are increasingly aware of memory changes," says Dr. Kelly Murphy, who runs an outpatient Memory Intervention Program at Baycrest Centre for Geriatric Care. "Many people wonder about memory slips and whether they should be concerned. It's sort of a free-floating worry."
Some of these memory changes are due to something called Mild Cognitive Impairment or MCI, a condition that does not have the name recognition that Alzheimer's has but still affects 500,000 Canadian seniors. It's a kind of border zone between the mild cognitive changes associated with getting older and the more substantial problems caused by a dementia such as Alzheimer's disease.
"The common denominator is that people with MCI are experiencing more frequent memory slips like repeating comments or questions, or forgetting the name of someone they really should know. They are able to plan things but it takes more effort -- and people begin to comment on the fact that their memory slips are increasing."
Because MCI is relatively new even to primary care physicians, Murphy, along with Baycrest colleagues Dr. Angela Troyer and Dr. Nicole Anderson, has written Living with Mild Cognitive Impairment, a guide to maximizing brain health and reducing the risk of dementia. The book, which is aimed at families and physicians and published by Oxford University Press, is available through amazon.ca.
Shining the spotlight on the border-zone condition means that early intervention can help to delay cognitive deterioration, says Murphy, who teaches patients what she calls "good memory habits."
"You can learn to compensate. It is really all about learning to take more time to do tasks, or recognizing you can't just leave your keys willy-nilly around the house."
Murphy believes in "a place for everything and everything in its place. When you have a memory problem that kind of support is really key - something should always be in its logical place."
Today's technology makes remembering easier, but Jane, a retired financial planner diagnosed with MCI, says she chooses pen and paper over smartphone prompts.
"I started making lists. I started organizing things differently because I was so uncomfortable about not being in control."
Whatever they choose, there's a concern that if they use memory helpers they are admitting that they have a problem, says Murphy. "Others feel that it will make their memories lazy. But I tell them it is the exact opposite. There is so much complex thinking that goes into managing our lives."
Though about 80% of patients with MCI will develop dementia within six years, not all people with MCI will get worse. Vitamin D and calcium, antioxidants, regular exercise and developing good memory habits can help to slow the process, says Murphy. "We always hope for that magic pill, but the reality is this is a complex condition that needs a multi-pronged approach."
Exercise for brain health
Research from Lindsay Nagamatsu, a PhD student at University of British Columbia, showed resistance and aerobics training in women 70 to 80 years of age improved their selective attention, conflict resolution and memory. She believes that twice-weekly resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.
Climbing for Alzheimer's
Vancouver's Martin and Esther Kafer, 85 and 84 years young, are about to climb Mount Kilimanjaro to raise money and awareness for Alzheimer's, and to honour Martin's sister Etta Kafer-Boothroyd, a former geneticist now struggling with dementia.
What's up doc?
Some family physicians can do a cognitive screen test to determine whether a patient's thinking abilities appear normal for his or her age. If your doctor cannot do this, ask for a referral to a neuropsychologist for further testing. If your family doctor has screened you and diagnosed MCI, ask your doctor how he or she manages patients with this condition.
A simple-to-make memory book contains all the important information you need to access readily -- names, phone numbers, addresses, a list of medications. It should include a go-to calendar with spots to note everything from birthdays to when you have theatre tickets or are due to pick up laundry; it can include a scratch-pad for shopping lists and a "to-do" section. Your book should be comprehensive, but try to keep it small enough so you can take it with you everywhere.
You're in charge
"People have a major role to play in their own destiny, in their health as they age. If you have MCI or dementia in your future, you can impact it in terms of delaying it or improving your ability to cope with it." -- Dr. Kelly Murphy, co-author Living with Mild Cognitive Impairment.
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