Study highlights exercise for memory.

Combination therapy no advantage in Alzheimer's treatment

Forgetting things? Memory problems are more common than you think

It's normal to forget things from time to time, and it's normal to become somewhat more forgetful as you age. But how much forgetfulness is too much? How can you tell whether your memory lapses are normal forgetfulness and within the scope of normal aging or are a symptom of something more serious?

Healthy people can experience memory loss or memory distortion at any age. Some of these memory flaws become more pronounced with age, but — unless they are extreme and persistent — they are not considered indicators of Alzheimer's or other memory-impairing illnesses.

Some difficulty with remembering things (like names) and forgetting where you put things (like keys) is so typical that it's considered a normal part of aging.

But some people experience a middle ground of cognitive impairment that's worse than normal age-related problems but not as bad as dementia from Alzheimer's disease or other brain diseases. Researchers labeled this intermediate state "mild cognitive impairment" in the 1980s, and the name stuck.

Results have been discouraging for Alzheimer's disease, but they may help stroke patients in a variety of ways.

Alzheimer's disease and the depression that often affects people starting at about age 65 can easily be mistaken for one another. Depression can cause dementia-like deficits in memory and other mental functions, and Alzheimer's disease can cause depressive-like apathy and withdrawal.

More than half of adults ages 65 and over have sleep apnea, a disorder characterized by abnormal pauses in breathing during sleep. Chronic sleep apnea is associated with many health risks, including high blood pressure, heart disease, and stroke. It's also been linked to deficiencies in memory and attention in children and middle-aged adults, but studies of older adults have produced conflicting results. Now, a well-designed study has concluded that older women with sleep apnea are more likely to develop cognitive problems and dementia. The findings were published in The Journal of the American Medical Association (Aug. 10, 2011).

The study. At the start of the study, 298 healthy women, average age 82, completed tests of cognitive function and underwent overnight sleep testing that monitored changes in respiration, heart rate, blood oxygen levels, brain activity, and other measures. Sleep apnea was defined as 15 or more "sleep-disordered breathing events" — pauses in breathing or shallow breathing — per hour. Five years later, the women were given further cognitive tests.

A study provides one more reason to carve out time every day for a brisk walk or similar exercise, especially if you have vascular disease or are at risk for developing it. Vascular disease, including heart disease and other conditions that affect blood vessels, increases the risk of age-related problems with memory and thinking, known as cognitive decline. Many studies indicate that exercise has a protective effect on cognitive function, but most have focused on generally healthy populations. The study suggests that a 72-year-old woman with vascular problems (or vascular risk factors) who exercises at least 30 minutes a day may be, on average, as cognitively sharp as a 65-year-old woman. Results were published in the Archives of Internal Medicine (July 25, 2011).

The study. The investigation involved 2,809 women ages 65 years and over who were part of a larger study, the Women's Antioxidant Cardiovascular Study. All of them had vascular disease or at least three risk factors for heart disease, such as diabetes, high blood pressure, or a body mass index (BMI) of 30 or higher. Researchers periodically asked the women about their exercise habits, including activities such as swimming, biking, and aerobic dance, as well as walking and stair climbing. They also conducted telephone interviews to assess participants' cognitive function using five tests, including memory tests of 10 words and a "category fluency" test that asked participants to name as many animals as possible in one minute. Most of the women (81%) completed at least three assessments at two-year intervals. The researchers classified the women into five groups, or quintiles, based on their reported activity levels an average of 3.5 years before their initial cognitive assessment.

Diagnosing Alzheimer's disease

Doctors take a two-pronged approach to diagnosing Alzheimer's disease. First, they ask patients questions and perhaps have them fill out one of the standardized questionnaires used to assess memory and other parts of thinking. The purpose is to evaluate people's cognitive problems to see if what they're experiencing is consistent with Alzheimer's.

Second, doctors will order various tests to rule out other conditions that can affect mental functioning. Any CT or MRI brain scans or blood tests that might be done are part of this process of elimination.

New criteria divide the disease into three stages.

Doctors take a two-pronged approach to diagnosing Alzheimer's disease. First, they ask patients questions and perhaps have them fill out one of the standardized questionnaires used to assess memory and other parts of thinking. The purpose is to evaluate people's cognitive problems to see if what they're experiencing is consistent with Alzheimer's. Forgetfulness coupled with abnormal social behavior, for example, might indicate a different brain disease. And mild problems with short-term memory could be ascribed to normal aging.

Second, doctors will order various tests to rule out other conditions that can affect mental functioning. Any CT or MRI brain scans or blood tests that might be done are part of this process of elimination.

Berries are healthful and delicious, even if some of the health claims may be a little bit exaggerated.

Summer is berry season. The prime time for strawberries is winding down here in the Northeast, but July is the month for raspberries and blueberries, and blackberries will be ready for picking in August.