Cognitive Decline / Stages of Dementia

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When a person perceives his memory or other cognitive function as “not as good as before” but scores within “average range” in objective testing, he may be experiencing Subjective Cognitive Decline (SCD) – the initial sign of Dementia.

The next stage of the disease is normally symptoms of Mild Cognitive Impairment (MCI).

This is when mild signs of cognitive decline start to appear although person is still able to function in his work (employment) and in activities of daily living.

Mild signs of decline could include forgetfulness, decreased efficiency in performing familiar tasks, disorientation as to place and time, changes in mood and behavior.

MCI is usually the stage before conversion to Alzheimer’s Disease (AD).

Dementia is the final stage in the expression of this disorder.

SCD and MCI do not always follow this course. For instance, there have been cases where a person’s SCD progresses to MCI and then goes back to SCD. There are cases where a person goes directly from normal functioning to Dementia.

Source: Symposium speaker Wiesje M. Van Der Flier, UV University Medical Center Amsterdam, The Netherlands

 

 

Meaningful Life After Retirement

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In my practice, I have come across clients, particularly retirees, with complaints of deterioration of their memory. After a neuropsychological assessment, results showed that memory functioning was within average range compared to people in their age range. This meant that the memory”deterioration”was not really a deterioration but rather diminished memory capacity due to, in this case, depression. I have also noticed that some clients were less prone to depression and memory decline than others. These people:

1. Were engaged in an activity or hobby that they were passionate about.

2. Were engaged in some form of exercise on a regular basis (e.g. walking, swimming, gym/aerobic dancing).

3. Had friends or family with whom they spent time and shared activities with on apeople in sunset regular basis. These friends and family not only provided social interaction but emotional support as well.

4. Had a spiritual life.

5. Had enough hours of fitful sleep (6-8 hours).

6. Ate a healthy diet and had few medical/health issues.

7. Were optimistic and did not take themselves too seriously.

Actually, this list for a meaningful life after retirement can apply to anybody at any age! We would be happy campers indeed if we could incorporate most, if not all of the above, into our daily lives.

 

 

Know the 10 Warning Signs of Dementia/Alzheimer’s Disease

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glassesDementia is a general term for a decline in mental ability severe enough to interfere with daily life. The most common type of dementia is Alzheimer’s Disease (The Alzheimer’s Association, alz.org).

Alzheimer’s Disease International (ADI) estimates that in 2013 there were 44.4 million persons worldwide with the disease. This number is estimated to increase to 75.6 million in 2030 and to 135.5 million in 2050. Much of the increase will be in developing countries – the fastest growth seen to take place in China, India and South Asia.

The following are tell-tail signs of Alzheimer’s Disease:key w red tag

  1. Memory loss
  2. Difficulty performing familiar tasks
  3. Problems with language & communication
  4. Disorientation with regard to location or time
  5. Poor or decreased judgement
  6. Problems with keeping track of things
  7. Misplacing things
  8. Changes in mood and behavior
  9. Changes in personality
  10. Loss of interest in hobbies and personal activities

 

When a loved one is showing the above conditions, the Alzheimer’s Association recommends seeing a neurologist right away for a professional evaluation to determine the condition and to confirm if dementia is indeed the problem. Early diagnosis can give the person with dementia and his family the opportunity to explore available treatments, preserve quality of life and plan for the future.

 

Sources: Alzheimer’s Association (www.alz.org) and Alzheimer’s Disease Association (ADA), Singapore (www.alz.org.sg)

Why Exercise is Good for You

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The brain is the most important part of our body. One of the best ways we can take care of it is through exercise. Why is exercise good for you?

Exercise can take various forms depending on whatever a person is comfortable with.

Some people like to work out at the gym or play a sport, do yoga, take aerobics classes or do a combination of these.

Whatever the exercise is, a good cardio workout is essential. A good cardio workout will get the blood and oxygen circulating to your brain, nourishing and stimulating it. You will notice that your mind is clearer, more alert and sharper after exercising.

Exercise will not only give your brain a healthy dose of oxygen, but will give your body a chance to sweat and remove toxins as well.

You also get to stretch and move your body and keep it limber and coordinated.

Exercise will also cheer you up and improve your mood and outlook.

It is a great stress buster!

My top 5 neuropsychological Stress Busters:

1. Physical exercise in whatever form. Exercise increases blood flow (and oxygen) to the brain, stimulating and energizing it. Stretching, twisting and moving your body keeps away the aches and pains of stiff joints.

2. Breathing deeply. This not only puts more oxygen in your brain but also has a calming effect on it.

3. Taking breaks as often as needed & short naps if possible.

4. Eating well but only just enough so that you do not overeat and gain unnecessary weight.

5. Taking a few minutes each day to reflect and meditate. A good way to end each day is to go over three things or events that day for which you are grateful.

Memory Difficulties

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A number of my clients are people in their 50s, 60s and 70s referred to me by their neurologist to help find out why they are having memory difficulties.

Are the difficulties related to advancing age?

Or secondary to a neurological condition (such as Alzheimer’s Disease)? Or due to depression?

Neuropsychological assessment will help find out the reasons behind a person’s memory problems. Standardized, normed tests are used to assess cognitive, memory, adaptive and emotional functioning. The scores from the different tests will give a good picture of how the client is doing compared to other persons of the same age range.

I have had a number of clients complaining of memory difficulties who, upon neuropsychological assessment, exhibited normal or average memory functioning. Although they have noticed their capacity to retain information was no longer as good as they used to, they are not any worse off than their peers. I had one client who was so immensely relieved of such assessment finding because she had been afraid of the big “A” (Alzheimer’s Desease). Instead of a memory impairment, testing uncovered a mild depression, a condition that often looks much like memory impairment.

Memory difficulties could be due to any one or a combination of the following:

1. Age related memory decline— with advancing age, the brain is less able to retain as much information as it used to. Neuropsychological assessment will help determine if memory functioning is still “normal” compared to peers.

2. Memory decline secondary to a neurocognitive disorder— Memory decline also happens when the brain suffers an injury during a traumatic event (e.g. vehicular accident) or neurological insult (e.g. a stroke), or a degenerative disease (Alzheimer’s Disease). In this case, neuropsychological testing will assess and document the nature and depth of the memory difficulty.

3. Depression— Memory difficulties also happen during a depression. I have seen this in some of my clients. Retirees, formerly busy executives or entrepreneurs, who find themselves with nothing to do and with limited social contact. Neuropsychological assessment will help determine if the difficulties are due to depression and recommend strategies to help manage them.