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.

Clocks and calendars may help patients stay oriented.

Being a hospital patient can be a disorienting and somewhat frightening experience. Being a hospital patient in the throes of delirium is a lot worse.

Delirium, which usually comes on suddenly, is a confused and scrambled state of mind. Memory and other types of thinking become disorganized. Hallucinations may occur. Symptoms fluctuate unpredictably, and the uneven course can make the experience even more bewildering. Classically, delirium has been associated with agitation and restlessness, but there's growing recognition that it can also put people into a hypoactive state that makes them withdrawn and seemingly drowsy.

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.

Mild cognitive impairment often stays mild, but it can "progress" to Alzheimer's disease.

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. Just as hair thins and joints become less flexible, the brain processes information more slowly in our later years.

With age come changes in the structure and quality of our sleep. After about age 60, we have less deep (slow-wave) sleep and more rapid sleep cycles, we awaken more often, and we sleep an average of two hours less at night than we did as young adults. It was once thought that older people didn’t need as much sleep as younger ones, but experts now agree that’s not the case. Regardless of age, we typically need seven-and-a-half to eight hours of sleep to function at our best. So if you’re not getting enough sleep at night, what about daytime naps? Or does napping disrupt the sleep cycle, ultimately yielding less sleep and more daytime drowsiness?

These questions were addressed in a study by researchers at the Weill Cornell Medical College in White Plains, N.Y., and published in the Journal of the American Geriatrics Society (February 2011). The authors concluded that napping not only increases older individuals’ total sleep time — without producing daytime drowsiness — but also provides measurable cognitive benefits.

It's never too late to benefit from talk therapy.

By midlife, you've probably spent years thinking of yourself as a certain kind of person — outgoing or introverted, high-strung or easygoing, optimistic or pessimistic. You may have become accustomed to certain roles and styles of communication in your relationships and certain ways of coping with stress. Even if you're dissatisfied with those roles and your patterns of coping aren't working so well anymore, you may think it's too late or too bothersome to question your perceptions or seek changes in important relationships.

Which type of psychotherapy works best? There’s no simple answer. Just as people respond differently to different drugs, you might do better with one type of therapy than with another. Many people find that a blended approach — one that draws on elements of different schools of psychotherapy — suits them best. There are many forms of psychotherapy, but the two most popular forms are psychodynamic therapy and cognitive behavioral therapy.

Psychodynamic therapy

Psychodynamic therapy focuses on how life events, desires, and past and current relationships affect your feelings and the choices you make. In this type of therapy, you and your therapist identify the compromises you’ve made to defend yourself against painful thoughts or emotions, sometimes without even knowing it. For example, someone with an overbearing parent may unconsciously find it difficult to risk developing intimate relationships, out of fear that all close relationships will involve a domineering partner. By becoming aware of links like this, you may find it easier to overcome such obstacles.

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.