Is it normal aging or dementia?

 Do you ever wonder if your forgetfulness is normal or an early sign of dementia? Could losing your keys be something more sinister? While memory lapses are just part of getting older, knowing the difference between normal aging and early dementia could change everything. Today, we'll uncover the subtle warning signs that should not be ignored

 I'm Dr.Vickie Petz Kasper. I practiced obstetrics and gynecology for 20 years until I landed on the other side of the sheets   as a very sick patient. When my own body betrayed me, I took a handful of pills to manage my disease and another handful to counteract the side effects. My health was out of control.

Through surgery, medications, and lots of prayers, I  regained my strength only to face another  diagnosis.  My doctor challenged me to make radical changes through lifestyle medicine. Now I feel great and I want to help you make changes that make a difference. Healthy Looks Great On You podcast takes you to many medical schools so you can learn the power of lifestyle medicine.

If you're ready to take control of your health, you're in the right  place. Whether you're focused on prevention or you're trying to manage a condition. I'll give you practical steps to start your own journey toward better health because healthy looks great on you.  

 This is episode 154, Is it Normal Aging or Early Signs of Dementia?   Today we resume our month long series on dementia. If you've ever worried about your own cognitive function, or that of a friend or a family member You're going to learn what's normal and what's an indication of something more ominous.

And we're going to start by taking a look into the complexities and wonders inside our skulls. The brain.

It's the most complex organ in the body. When I was a medical student, over the course of gross anatomy, we dissected a cadaver. All the organs. It was a long and tedious process, separating tendons and blood vessels in the hand, examining the stomach, pancreas and liver as we removed layer after layer from the abdominal cavity.

We inspected the lungs inside and out.  But you want to know what we did not do in gross anatomy? brain.  Now, before you think we skipped something, just the opposite is true. At the end of the semester, we had to remove the brain because there was an entire course that followed on neuroanatomy.  But don't worry, I don't call this mini medical school for nothing, so I'll be quick, but we are going to do a very surface overview of the anatomy of the brain.

Your brain weighs about three pounds and it contains lots of nerve cells. and an intricate network of communication.  This may surprise you, but about 40 percent of it is water, protein, carbohydrates, and salts. And guess what comprises the other 60%?  If you said fat, you get to graduate early, but I'm guessing that you didn't.

There are three main parts of the brain and two main layers. Now, of course, this is a huge oversimplification, and there's so much more, but we're going to stick to the very basics. The biggest part of the brain is the cerebrum, and it takes up about 80 percent of the brain. This is your thinking, feeling, reasoning, learning, problem solving memory part of the brain.

It's the part that makes you uniquely you. It allows you to speak, and exercise judgment, and feel, and see, and hear, and touch. It also helps regulate temperature and controls the movement of your body. But it's the cerebellum in the back part of the head that keeps your body balanced and coordinated. And it's about the size of your fist.

It may also play a role in thought, emotions, and social behavior, even addiction.  The third part is at the bottom of the other two parts. It's called the brainstem, and it connects the brain to the spinal cord, and it controls basic functions, like your heart rate and breathing. 

The outer layer of the brain is called gray matter because it's literally a darker shade. The interior of the brain is made up of white matter.  And speaking of matter, why does any of this matter? Well, you see, different parts of the brain control different functions. And wherever there is pathology, There is loss of function and like real estate, location, location, location is everything. 

The surface of the brain is convoluted with these deep folds and this creates more surface area for more connections between neurons or nerve cells.  But as we age, the brain starts to shrink and it actually starts in your 30s and 40s. Then, like crow's feet and gray hairs, it starts to ramp up at age 60 along with saggy skin.

and accelerates even more after age 70. Hmm, aging is not for the faint at heart, but a lot of people are doing it. In fact, one in six American adults is over the age of 65. According to U. S. Census data, this age group grew nearly five times faster in the total population over the last 100 years to reach nearly 17 percent of the entire population in this country.

to To the tune of 55 million gray headed, pickleball playing, Medicare receiving, joint creaking, golden agers. And yeah, we're concerned about living independently, driving,

retaining our mental acuity, and remaining productive members of society.  Full disclosure, I'm not quite there, but I'm also not far away.  The brain's characteristics can actually be seen on imaging. MRI is the most sensitive, and with aging, the radiologist can see that the surface of the brain is less wrinkled and occupies less space inside the cranium or skull.  I mean, when your belt's a little loose, that's not a bad thing, but who wants a smaller brain? And unfortunately, this is not like Honey, I Shrunk the Kids, where you can just aim a contraption and zap it back to normal.  It's more like the sweater you accidentally put in the dryer.

It's not going to be the same.  And although it's normal for the brain to lose volume as we age, it's When it exceeds what's expected for age, that's not normal. When the brain no longer fits snugly inside the skull, we call that atrophy. And there are varying degrees from mild to severe, and symptoms typically match depending on which areas of the brain are affected. 

 In this episode, we're going to focus on 10 signs that you should not ignore. And you can find this information on the AA website. Oh, not that AA, but if you need it, I'll put a link to that in the show notes too. I'm talking about the Alzheimer's Association website.

We're going to discuss each one as well as when to worry and when not to, but here's the list from their website.  Memory loss, challenges in planning or problem solving.  Difficulty completing familiar tasks. Confusion with time or place. Trouble understanding visual, imaging, and spatial relationships. New problems with words and speaking and writing.

Misplacing things and losing the ability to retrace steps. Decreased or poor judgment. Withdrawal from work or social activities. And finally, changes in mood or personality. Now let's dive into each one. When you think of Alzheimer's or dementia, what do you think of?  I'm not sure I heard you, but I think you said trouble remembering things.

And you know, we all have trouble remembering things, especially if we're distracted with a million thoughts running through our mind. And it's perfectly normal to have trouble remembering things like someone's name.  Not someone close, like your kid, but maybe someone you just met. And you know most people say, I'm just not good with names.

Well here's a little tip. Most people aren't good with names because they don't listen in the first place. When you're at an event and you're meeting lots of people and you're going to be introduced to people, you're thinking about what you're going to say, not what they're saying to you. So here's a little hint.

The best way to get good with names when you're meeting new people is repeat their name back to them. That's It forces you to listen and it helps you remember.  It's also normal to miss an appointment occasionally or forget a call you were supposed to make.

Or forget to pick something up that you were supposed to do. But what's not normal is forgetting information.  Also forgetting birthdays and anniversaries of people close to you, that's not normal.  People with early signs of dementia may start to rely more on putting everything on their calendar or taking notes or setting an alarm on their phone to remember things.

Now, some of these are just organizational skills, like set a reminder on your phone to take medication. But when people start forgetting routine things, That's way more concerning.  I'm not sure telling the same stories over and over is necessarily a bad thing. It's kind of part of our social fabric. But, certainly asking the same questions over and over is a red flag.

Like, when is my hair appointment? Then five minutes later, when is my hair appointment? Over and over.  

Next on the list is difficulty with what we call executive function. And this is the part of the brain that helps us follow a plan or solve a problem. It's necessary when dealing with numbers. And this can manifest itself as the inability to do something like follow a recipe. That's a warning sign.

But also more subtle things like just difficulty concentrating. Mentally tasking exercises just take a lot longer in people with early dementia. Now, it's normal to slip up occasionally and forget to pay a bill, or leave out the baking soda in a recipe.  But with early dementia, things that should come easy, get more and more difficult.

 Playing games becomes more of a challenge, or navigating directions. And getting lost is a big concern for people with dementia, both driving, as well as something we call wandering.  But, it's perfectly normal to have to ask your grandkids how to program your favorite shows on your streaming platform. 

But, it's perfectly normal to have to ask your grandkids how to program your favorite show on Netflix. You've probably even seen those commercials where the grandparents are just waiting on their grandkids to come and help them with their phones.  But, if someone loses the ability to do something simple like return a text message or read an email, That's more serious.

And back when everything was on paper, it seems like we often wrote the date. Now, sometimes I have to think about what day it is. You too? Well, that's normal, as long as you can remember quickly. Dementia, on the other hand, causes people to not know what day, month, year, or even season it is. And what about trouble seeing?  As we get older, our eyesight tends to go kaput due to normal aging as well as things like cataracts. Recently, uncorrected vision loss has been linked to dementia just like untreated hearing loss. Good grief, I have to get up and put in my hearing aids and put on my glasses in order to function.   While declining visual acuity is normal, difficulty interpreting what you see is not.

And people with dementia start losing the ability to read and comprehend. They also have difficulty with color contrast, and this can be very dangerous because they may fall because they don't realize there's a step or there's a rug and that can trip them up.  Have you ever lost your train of thought in the middle of a conversation? 

I remember a particularly stressful season of my life about 10 years ago, and I felt like I couldn't complete a thought or a conversation, but it's because my mind was a million miles away.  Turns out it's normal to occasionally have trouble finding the right word you're looking for. But in people with dementia, this is more pronounced.

They may start stories in the middle instead of a logical beginning, and they often repeat things in a loop.  But they come to a word and they can't recall it, so they kind of make a weird substitution like calling a watch a hand clock.

What about losing things? Well, it's okay if you have to ping your cell phone on your hand clock or search for your keys.  I'm kidding, I hope you know that. But when my kids would lose things, I always told them to look with their brain, not their eyes. And think back to when you last saw it, and then retrace your steps.

It usually works, but people with dementia can't do that. They also may put things in weird places, like put a can of vegetables in the refrigerator.  And when they can't find their car in the parking lot, They may jump to the conclusion that someone has stolen it.  Since the decision making part of the brain is affected by dementia, people make poor decisions.

And of course, we all have bad judgment occasionally, but in dementia, this can be a serious problem, and it can be really dangerous. Because they're more susceptible to scams, and that can have devastating financial consequences. But it's also physically dangerous, because they may forget to turn off the stove or the faucet, and as the disease progresses, their hygiene is affected, as well as their ability to dress appropriately. 

Now, after the holidays, you may just be ready for some peace, quiet, and solitude. Sometimes we all just want to stay home and veg out, but people with dementia struggle to participate in conversations, so they may withdraw from things that they used to enjoy. Especially if it requires more complex mental activity. 

And lastly, there can be mood swings and personality changes. In fact, and hear me on this one, Dementia can present as depression, anger, extreme irritability, and anxiousness.  Because here's the deal, when all of this is slipping, they know, and it's scary.  And even though it's frightening, I don't want you to ignore warning signs in yourself or in someone you love. 

Because if something's wrong, there is hope. Stay tuned for more about prevention, treatment, and even some evidence about reversal. And of course, it's all about a healthy lifestyle. And if you're ready in this new year to make healthy lifestyle habit changes, I have a great resource for you. You can go to my website, www. healthylooksgreatonyou.  com and find kickstart to healthy habits in just seven days.

Of course, I'll also put a link in the show notes, and there are lots of podcast episodes that will help. And when you're on my email list, I send out lots of goodies. Recipes, sources of fiber, foods that affect your mood. So this is not something you want to miss. 

Because your physical health affects your brain health, and healthy looks great on you.

     The information contained in this podcast is for educational purposes only and is not considered to be a substitute for medical advice. You should continue to follow up with your physician or health care provider and take medication as prescribed. Though the information in this podcast is evidence based, new research may develop and recommendations may change.

RESOURCES
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