Caitlin Whyte (Host): This is Celebrate Health, a podcast from San Juan Regional Medical Center. I'm Caitlin Whyte, and with me is neurology nurse practitioner, Taffeta Trautner. Join us as we discuss memory and cognition.

To start us off, can you tell us what's the difference between normal everyday forgetfulness and a memory problem that could signal something more serious?

Taffeta Troutner: So, normal everyday memory changes as we get older are expected. What we will often see is difficulty with remembering a name, but then you'll recall it a little while longer. it takes a little longer to remember a name, or it takes a little longer to find the right word. It takes a little longer to learn something unfamiliar or to process complicated information. It also is normal that it should take longer for you to switch between several tasks or things like you walk into the kitchen and you're like, "Oh, I don't remember why I came in here."

When it becomes more of a concern for memory loss disease is when you can't recall names, you're having more difficulty with remembering conversations, so people are saying things to you like, "We already talked about this. We talked about this this morning." You're having a harder time remembering things like taking medications, remembering appointments, or you can't recall names at all, and it's people's names that you should know.

Host: And is it true that our memory naturally changes as we get older? What changes are considered a normal part of aging?

Taffeta Troutner: So, yes, our memory will change. It is normal as we get older for normal age-related stuff. And so, examples would be forgetting someone's name but remembering it later, walking into a room and forgetting why you went there, occasionally misplacing your keys or glasses, forgetting appointments but remembering it later, or needing to write things down more often.

And even though these experiences can be frustrating, they do not automatically mean that there's something wrong. Slower recall does not mean memory loss. It means that sometimes the information is stored in your brain, it just takes a little while longer to retrieve it. And this is normal part of aging.

That tip of the tongue experience where you know exactly what you want to say but you can't think of the word until later is normal. You may pause longer during conversations, because you have to kind of go back into your brain and find the information. That's normal. And your thinking speed will slow down a little bit as we age, because it takes our brains a little longer to process information.

Other things that can be affected are multitasking with normal age-related stuff where people have to focus on one thing at a time instead of jumping between tasks.

Host: Well, how do things like stress, multitasking, poor sleep, and just feeling overwhelmed affect our ability to remember things?

Taffeta Troutner: It absolutely affects it. If you're not getting adequate sleep or you're stressed, your focus and attention gets diverted to the stressful part, or you're having being overly tired. It takes our brains a little while longer to process even when we're stressed. We're not getting enough sleep when we're young.

As we get older, sleep and stress, grief, depression, anxiety affects our memory even more. And those are considered reversible causes of memory problems, because it's something that if you remove that stress or if you improve somebody's sleep, designated a consistent bedtime or you're treating disorders like sleep apnea, their memory will actually improve.

Host: You know, we often use words like memory and cognition interchangeably, but can you explain what cognition means and how it relates to memory?

Taffeta Troutner: Cognition is the mental action or process of acquiring, storing, retrieving, and applying knowledge and understanding thoughts and senses. Whereas memory is the part of the brain that stores and retrieves information over time. And so, cognition is kind of how you process things, whereas memory is things that you store and can retrieve later.

Host: And what are some other cognitive skills beyond remembering things that people might not realize are important?

Taffeta Troutner: So, executive functioning is one of those cognitive things, so complex problem-solving. So, things that we do every single day like paying our bills, normal conversation, trying to make our everyday decisions as part of cognitive functioning. And certainly, when people have true memory loss disorder like dementia, not only is their memory affected, but their cognitive functioning is also affected. So, they have a harder time with things like paying bills. They have a harder time organizing things. They have a harder time deciding where things go in the house, like they're putting milk in the cupboards instead of milk in the refrigerator, and they're putting canned goods in the refrigerator instead of in the cupboard. Those are all cognitive functioning that can be affected by memory loss disease or dementia.

Host: At what point should someone stop brushing off forgetfulness as just getting older and talk to a healthcare provider?

Taffeta Troutner: So when people should start considering it's something more than just normal age-related changes, and usually the patient doesn't identify it, it's usually family members. So, family members are like, "Okay, there's something more than just normal age-related changes here. I'm concerned, because I've had the same conversation with my mom three times today. I gave her this information. And two hours later, she does not remember the conversation." Or, "I've given my mom the information a couple of days ago, and when I went to pick her up for her appointment, she doesn't remember that we had this appointment, and we've had this discussion several times." That's what family members will typically start to notice.

Other things that family members will notice is that patients are forgetting to take their medications, they're forgetting appointments, they're forgetting how to drive, they're getting lost when they're driving, they're forgetting how to do things like pay their bills, or they're forgetting to pay bills, or they're overdrawing their accounts because they're paying their bills multiple times. That's when family members really start to get concerned. And usually, the family member is the one who says, "Okay, we have a problem. I need you to get checked." A lot of times, the patient doesn't recognize that there's an issue.

Host: Talking about memory and cognition, you know, when people hear the word dementia, they often think immediately of Alzheimer's disease. But what are some other possible causes of memory and cognitive changes?

Taffeta Troutner: So, dementia is not a specific disease. It's kind of a general term to describe changes in memory, thinking, reasoning, or behavior. And then, under that big umbrella, there's very specific types of dementia. And the most common ones that we see are Alzheimer's disease. We see vascular dementia, Lewy body dementia, and frontotemporal dementia.

Many times, patients can have more than one type at a time. Like, we will see patients who have what's called a mixed dementia, and the most common type of mixed dementia that we see is a combination of Alzheimer's disease and vascular dementia. And those are very specific types of dementia that we kind of put our fingers on once we get them in the clinic and we do an evaluation, and we deem that there is a memory problem. Then, we try to further drill it down to what type of dementia so we can treat it adequately.

Host: So, what can we do in our everyday lives to help maintain memory and cognitive function as we age?

Taffeta Troutner: So, our brain is like any other muscle in our body. If we don't use it, it becomes very sluggish and lazy. And what we know about normal age-related changes is those normal age-related changes will improve with things like being physically active, eating healthy, staying cognitively active, staying socially active will help to slow down some of the normal age-related changes.

We also know that dementia is also something that is affected by what we do in our everyday lives. So, what we do to our brains 20 years ago affects our brains now and increases our risk for Alzheimer's and vascular type dementias, which are the two most common types of dementias that we see. And so, again, like really being very protective of our brain because anything that we do to our body that is not healthy also affects our brain.

So, eating healthy, avoiding alcohol, avoiding tobacco, not using illicit drugs, avoiding medications that increase risk for memory loss, like the anticholinergic medications, which are like some of the bladder control medications. And Benadryl have anticholinergic properties. Avoiding things like processed foods, eating healthy, exercising, staying cognitively and mentally active, and staying socially active will also help to decrease the progression of dementia should a patient develop the disease.

Host: Well, on that note, we talked about sleep and activity and how other things can affect our brain health, but how does social connection affect it?

Taffeta Troutner: As humans, our brains really thrive in social interactions. You know, that's how we kind of identify with what we do. So whether our social interactions be related to work, that's how we identify, or our social interactions is encompassed around our family or our friends, our brains thrive in social interaction because it allows us to engage with people, it allows us to have conversations with people, it allows us to just enjoy being around people, and it allows our brain to make memories, and those things are super important for our brains as we age.

Host: Well, what advice would you give someone who is maybe becoming anxious about every time they forget a name, misplace an item, or miss an appointment?

Taffeta Troutner: Again, those are normal age-related changes after a certain point. But if you're concerned, you can always go to your primary care and start getting evaluated for memory loss to make sure that it's not an early sign of dementia. And if you are concerned, getting evaluated will help maybe set their mind at ease, or it will confirm what they're worried about so that we can treat it appropriately.

Host: That was neurology nurse practitioner, Taffeta Troutner. For more information, go to sanjuanregional.com. I'm Caitlin Whyte, and this is Celebrate Health. Thank you for listening.