Alzheimer's Archive

Many cases of memory loss aren't related to dementia, but stem from other, treatable conditions.

You've been forgetting things lately — your keys, or maybe names. Sometimes you struggle to find the right word in conversations or repeat yourself to others. You may worry: are these signs of dementia?

If this sounds like you, you're not alone. Many people find their way into Dr. Tammy Hshieh's office wondering the same thing. But most of the time, it's not dementia causing their problems, says Dr. Hshieh, a geriatrician at Harvard-affiliated Brigham and Women's Hospital and Dana-Farber Cancer Institute and assistant professor of medicine at Harvard Medical School.

The shift from this condition to dementia is not necessarily inevitable.

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Will I get dementia? That common question takes on urgency if you have mild cognitive impairment (MCI), a slight but noticeable change in memory and thinking skills. But the progression from MCI to dementia is not automatic. In fact, MCI is not always permanent. "It depends on the underlying cause," says Dr. Joel Salinas, a neurologist at Harvard-affiliated Massachusetts General Hospital.

What are the causes of MCI?

MCI is not dementia (see "What is dementia?"), but it's not normal thinking, either. It often stems from disease or treatments for disease, including

So how do you keep your brain healthy, stay cognitively fit, and build your cognitive reserve? It's easier for some people than for others. And though genetics set the stage for your brain health, you can do something to improve your brain health and cognitive fitness.

First it is important to remember that you need a healthy body to have a healthy brain. Therefore, ensuring your brain health depends upon regularly seeing your doctor, following her or his recommendations, and managing any health conditions you have.

Stress management may reduce health problems linked to stress, which include cognitive problems and a higher risk for Alzheimer's disease and dementia.

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It's not uncommon to feel disorganized and forgetful when you're under a lot of stress. But over the long term, stress may actually change your brain in ways that affect your memory.

Studies in both animals and people show pretty clearly that stress can affect how the brain functions, says Dr. Kerry Ressler, chief scientific officer at McLean Hospital and professor of psychiatry at Harvard Medical School. Scientists have seen changes in how the brain processes information when people experience either real-life stress or stress manufactured in a research setting. (For the latter, researchers might challenge subjects to perform a difficult task, such as counting backward from the number 1,073 by 13s while being graded.) Either type of stress seems to interfere with cognition, attention, and memory, he says.

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.

In the journals

Because older adults often experience temporary changes in memory and thinking after having general anesthesia, they may worry that it increases their risk of dementia. A recent study should help put their minds at ease. Researchers found no association between the type of anesthesia and dementia risk, according to findings published online Oct. 6, 2020, by the Journal of the American Geriatrics Society.

The study looked at almost 7,500 people ages 66 or older without diagnosed dementia who underwent surgery requiring either general anesthesia (where you are unconscious) or regional anesthesia (where you are awake and the surgical area is numbed). The researchers included only people who had not had any previous surgery and stopped assessing those who had a second surgery later.

In the journals

Many commonly used drugs have anticholinergic effects, meaning the drugs block the action of acetylcholine. Nerve cells release acetylcholine to transmit impulses to other nerves in the brain and throughout the body. Previous research has shown a link between these drugs and dementia. Now a study has found a similar link with mild cognitive impairment (MCI), especially if you take larger doses. The findings were published online Sept. 2, 2020, by Neurology.

Some medications are designed purposefully to block acetylcholine, such as those used for urinary incontinence. But more often the anticholinergic action is a side effect of drugs taken to treat conditions like allergies, colds, and depression.

Research we're watching

According to a study published in the Aug. 4, 2020, issue of Neurology, the number of new cases of dementia in Europe and North America has dropped 13% every 10 years over the past 30 years. Researchers looked at data collected by the Alzheimer's Research Consortium, which included people over age 65 in Europe and the United States.

The actual number of adults with dementia has increased dramatically in recent years as life expectancy increases. The condition currently affects some 47 million people worldwide, and that number is expected to increase in coming decades.

Listening to music or playing an instrument engages multiple parts of your brain — and can help your mood and memory.

Music has the ability to soothe, energize, and even to improve your memory. And tapping into its power is as simple as turning on your radio.

Whether your choice is jazz, classical, rock 'n' roll, or hip-hop, music has unique effects on the brain, says Dr. Andrew Budson, a lecturer in neurology at Harvard Medical School and chief of cognitive and behavioral neurology at the VA Boston Healthcare System. And you can reap benefits whether you are playing a musical instrument or just kicking back and listening to some tunes.

High blood pressure can damage the brain in several ways. Treating this common problem can protect your mind as well as your heart.

High blood pressure seldom causes any symptoms. But over time, the excessive force and friction of blood pushing against the inner walls of the arteries can damage blood vessels throughout the body. And while the biggest threat may be to your heart, your brain can also suffer.

Even slightly elevated blood pressure in middle age has been linked to a 30% higher risk of dementia two decades later. But taking blood pressure drugs may help people avoid that risk, according to a study in the May 19, 2020, issue of JAMA.