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Memory Loss: Is It Just Aging or Something More?
Forgetting where you left your keys may have you concerned about memory loss. Dr. Lynn Kakos, Clinical Neuropsychologist, explains when it may be more than just aging.
Featured Speaker:
Lynn Kakos, PhD
Clinical Neuropsychologist Dr. Lynn Kakos joined WakeMed Neuropsychology in 2015. She received her doctorate in clinical psychology from Kent State University and completed a post-doctoral fellowship in neuropsychology at the Baltimore VA Medical Center before joining WakeMed. Dr. Kakos provides neuropsychological assessment to adult patients with a variety of neurological diagnoses. Transcription:
Memory Loss: Is It Just Aging or Something More?
Bill Klaproth (Host): So I've often heard when it comes to memory loss, forgetting where you park the car is normal. Forgetting that you even have a car means something more serious. So let’s find out when it comes to memory loss when is it normal and when does it mean something more serious? So here to talk with us is Dr. Lynn Kakos, a clinical neuropsychologist at WakeMed Health and Hospitals. This is WakeMed Voices, a podcast from WakeMed Health and Hospitals. I'm Bill Klaproth. Dr. Kakos, thank you so much for your time. So let’s start here. What is normal cognitive aging?
Lynn Kakos, PhD (Guest): Well normal, healthy cognitive aging has been described as a fadeout of memory and intellect that medical science really considers to gentle or benign for treatment. This definition acknowledges that cognition—or our thinking skills—can really decline with normal aging. In fact, aspects of our thinking skills may even begin to decline in our 30s if you can believe that.
Host: Uh-oh.
Dr. Kakos: Oh yeah. It’s true. I know. No. We’re all in the same boat here. So, for example, skills such as processing speed or your ability to think quickly, reasoning and thinking flexibility, complex attention, and even aspects of our memory decline in a healthy adult overtime.
Host: Okay. So that’s good to know because a lot of people get scared when they start forgetting little things. Gosh, I can't remember that as quickly as I used to. So that can be normal then?
Dr. Kakos: Right.
Host: So then what symptoms may suggest unhealthy cognitive aging?
Dr. Kakos: So concerning symptoms and symptoms that we often look for may include things like making errors with previously mastered tasks, like managing your medications or paying your bills, having limited or even no insight into your own difficulties. So you’ve having a hard time managing medications or paying bills, but you're not even able to recognize that. Getting lost or even disoriented, particularly if that’s occurring within familiar locations. Maybe experiencing word finding difficulties or that tip of the tongue type phenomenon to the point that it’s interfering with your communication or your ability to really carry on a conversation. Or it may even include demonstrating poor judgement and difficulty making decisions.
Host: So when it really starts to effect your day to day life, that’s what may suggest, “Mm, something may be more seriously wrong with me?”
Dr. Kakos: Mm-hmm. Yeah.
Host: Okay. So then what might such symptoms suggest?
Dr. Kakos: So when we start to observe cognitive difficulties that are to the extent that it’s above and beyond just normal aging alone, particularly as you were saying when these difficulties negatively impact your daily functioning—such as driving or preparing meals or managing medications—we consider a diagnosis of dementia.
Host: Okay. So then what is a dementia? I hear dementia and Alzheimer’s. It seems like they're used interchangeably. What is dementia?
Dr. Kakos: Yeah. That’s a common misconception. Actually dementia is an umbrella term and it’s described—It’s a term that describes a variety of processes that can change the brain and, in term, change the way that we think. So Alzheimer’s disease is a type of dementia. It’s the most common type of dementia, which is why we hear about it so much, but there’re actually quite a few other types of dementia as well. Basically when someone is diagnosed with dementia, it means that individual is having problems with their thinking skills above and beyond just normal aging alone. Now it’s impacting their ability to function.
Host: So that’s a really good clarification. So then what is recommended should someone experience these types of difficulties in their thinking and functioning?
Dr. Kakos: Well, first and foremost I would recommend that you speak with your doctor to discuss these concerns. That would be my first recommendation. Your physician then may suggest a neuropsychological evaluation. That’s a process that involves a clinical interview and administration of cognitive tests—paper and pencil type tests—to look at your thinking skills. Then your scores on those tests will be compared to your healthy peers, including individuals of the same age, educational background, gender, and ethnicity. So basically getting a sense of how you're performing in comparison to your healthy peers. This process can really assist in diagnosis, particularly if results are far outside of expectations for one’s age. They can help your doctor develop a treatment plan to address your new diagnosis.
Host: Okay. That’s really good to know to. So a treatment plan then obviously would follow if something seems to be abnormal. So is there anything we can do to help prevent dementia?
Dr. Kakos: Yes, actually. A recent study just determined that about 50% of cognitive aging is directly related to the lifestyle choices that we make on a daily basis. So that’s pretty empowering. The other 50% is likely due to genetic factors. So you have your family to blame for that. The other 50% is lifestyle choices that you can make on a daily basis. Lifestyle choices we want to focus on include eating a healthy diet. The current recommendation is really attempting to increase your intake of leafy vegetables and greens and things like that. Also getting exercise to the extent that you can. Current recommendations include getting about 30 minutes of aerobic and resistance training at least five days a week. Then we want to make sure that we’re engaging in mentally stimulating activities, like doing crossword puzzles, reading, learning a new skill. All of that can be helpful to kind of keep the connections strong within your brain and keep yourself sharp.
Believe it or not, maintaining and engaging in social activity is also really good for your brain too. Some people find it that joining a club or taking a class, volunteering or even having a pet can kind of help maintain that social activity throughout the life span.
Host: I love it. I'm writing everything down. I'm taking notes diligently Dr. Kakos.
Dr. Kakos: That’s right. Then lastly I just want to make sure that I stress the importance of getting sufficient sleep. Research shows that about 50% of older adults endures some type of sleep problem. So if you are one of those individuals who’s experiencing some type of sleep problem I would first recommend that you go to your physician and rule out an actual sleep disorder. If that’s been ruled out, then trying to really ensure that you’re utilizing what we call sleep hygiene techniques is going to be really important. So that includes not exercising before bed, making sure that you're avoiding heavy meals late in the day, reducing the use of bright and stimulating devices while you're in bed, avoiding intake of caffeine in the afternoon and evening hours, and most importantly maintaining a set sleep and wake time because our bodies work really well with routine.
Host: That is a great road map Dr. Kakos. I've been furiously taking notes here. So let me review with you.
Dr. Kakos: Sure.
Host: So one, healthy diet. Pay attention to that. Make sure that you exercise 30 minutes, five times a week either aerobic or resistance training. Engaging mental stimulation, which is always good. Social activities. I've heard that. Very important to keep up a healthy, active social life. Pay attention to your sleep as well and use good sleep hygiene. So did I do okay on my note taking?
Dr. Kakos: I give you an A plus.
Host: I love it. Alright. Well this has been very informative Dr. Kakos. Thank you so much for your time today.
Dr. Kakos: My please. Yeah, thank you.
Host: I'm Bill Klaproth with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. To learn more about WakeMed’s memory assessment services and to get connected with Dr. Kakos or another provider, please visit wakemed.org/memory-assessment. If you’ve found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.
Memory Loss: Is It Just Aging or Something More?
Bill Klaproth (Host): So I've often heard when it comes to memory loss, forgetting where you park the car is normal. Forgetting that you even have a car means something more serious. So let’s find out when it comes to memory loss when is it normal and when does it mean something more serious? So here to talk with us is Dr. Lynn Kakos, a clinical neuropsychologist at WakeMed Health and Hospitals. This is WakeMed Voices, a podcast from WakeMed Health and Hospitals. I'm Bill Klaproth. Dr. Kakos, thank you so much for your time. So let’s start here. What is normal cognitive aging?
Lynn Kakos, PhD (Guest): Well normal, healthy cognitive aging has been described as a fadeout of memory and intellect that medical science really considers to gentle or benign for treatment. This definition acknowledges that cognition—or our thinking skills—can really decline with normal aging. In fact, aspects of our thinking skills may even begin to decline in our 30s if you can believe that.
Host: Uh-oh.
Dr. Kakos: Oh yeah. It’s true. I know. No. We’re all in the same boat here. So, for example, skills such as processing speed or your ability to think quickly, reasoning and thinking flexibility, complex attention, and even aspects of our memory decline in a healthy adult overtime.
Host: Okay. So that’s good to know because a lot of people get scared when they start forgetting little things. Gosh, I can't remember that as quickly as I used to. So that can be normal then?
Dr. Kakos: Right.
Host: So then what symptoms may suggest unhealthy cognitive aging?
Dr. Kakos: So concerning symptoms and symptoms that we often look for may include things like making errors with previously mastered tasks, like managing your medications or paying your bills, having limited or even no insight into your own difficulties. So you’ve having a hard time managing medications or paying bills, but you're not even able to recognize that. Getting lost or even disoriented, particularly if that’s occurring within familiar locations. Maybe experiencing word finding difficulties or that tip of the tongue type phenomenon to the point that it’s interfering with your communication or your ability to really carry on a conversation. Or it may even include demonstrating poor judgement and difficulty making decisions.
Host: So when it really starts to effect your day to day life, that’s what may suggest, “Mm, something may be more seriously wrong with me?”
Dr. Kakos: Mm-hmm. Yeah.
Host: Okay. So then what might such symptoms suggest?
Dr. Kakos: So when we start to observe cognitive difficulties that are to the extent that it’s above and beyond just normal aging alone, particularly as you were saying when these difficulties negatively impact your daily functioning—such as driving or preparing meals or managing medications—we consider a diagnosis of dementia.
Host: Okay. So then what is a dementia? I hear dementia and Alzheimer’s. It seems like they're used interchangeably. What is dementia?
Dr. Kakos: Yeah. That’s a common misconception. Actually dementia is an umbrella term and it’s described—It’s a term that describes a variety of processes that can change the brain and, in term, change the way that we think. So Alzheimer’s disease is a type of dementia. It’s the most common type of dementia, which is why we hear about it so much, but there’re actually quite a few other types of dementia as well. Basically when someone is diagnosed with dementia, it means that individual is having problems with their thinking skills above and beyond just normal aging alone. Now it’s impacting their ability to function.
Host: So that’s a really good clarification. So then what is recommended should someone experience these types of difficulties in their thinking and functioning?
Dr. Kakos: Well, first and foremost I would recommend that you speak with your doctor to discuss these concerns. That would be my first recommendation. Your physician then may suggest a neuropsychological evaluation. That’s a process that involves a clinical interview and administration of cognitive tests—paper and pencil type tests—to look at your thinking skills. Then your scores on those tests will be compared to your healthy peers, including individuals of the same age, educational background, gender, and ethnicity. So basically getting a sense of how you're performing in comparison to your healthy peers. This process can really assist in diagnosis, particularly if results are far outside of expectations for one’s age. They can help your doctor develop a treatment plan to address your new diagnosis.
Host: Okay. That’s really good to know to. So a treatment plan then obviously would follow if something seems to be abnormal. So is there anything we can do to help prevent dementia?
Dr. Kakos: Yes, actually. A recent study just determined that about 50% of cognitive aging is directly related to the lifestyle choices that we make on a daily basis. So that’s pretty empowering. The other 50% is likely due to genetic factors. So you have your family to blame for that. The other 50% is lifestyle choices that you can make on a daily basis. Lifestyle choices we want to focus on include eating a healthy diet. The current recommendation is really attempting to increase your intake of leafy vegetables and greens and things like that. Also getting exercise to the extent that you can. Current recommendations include getting about 30 minutes of aerobic and resistance training at least five days a week. Then we want to make sure that we’re engaging in mentally stimulating activities, like doing crossword puzzles, reading, learning a new skill. All of that can be helpful to kind of keep the connections strong within your brain and keep yourself sharp.
Believe it or not, maintaining and engaging in social activity is also really good for your brain too. Some people find it that joining a club or taking a class, volunteering or even having a pet can kind of help maintain that social activity throughout the life span.
Host: I love it. I'm writing everything down. I'm taking notes diligently Dr. Kakos.
Dr. Kakos: That’s right. Then lastly I just want to make sure that I stress the importance of getting sufficient sleep. Research shows that about 50% of older adults endures some type of sleep problem. So if you are one of those individuals who’s experiencing some type of sleep problem I would first recommend that you go to your physician and rule out an actual sleep disorder. If that’s been ruled out, then trying to really ensure that you’re utilizing what we call sleep hygiene techniques is going to be really important. So that includes not exercising before bed, making sure that you're avoiding heavy meals late in the day, reducing the use of bright and stimulating devices while you're in bed, avoiding intake of caffeine in the afternoon and evening hours, and most importantly maintaining a set sleep and wake time because our bodies work really well with routine.
Host: That is a great road map Dr. Kakos. I've been furiously taking notes here. So let me review with you.
Dr. Kakos: Sure.
Host: So one, healthy diet. Pay attention to that. Make sure that you exercise 30 minutes, five times a week either aerobic or resistance training. Engaging mental stimulation, which is always good. Social activities. I've heard that. Very important to keep up a healthy, active social life. Pay attention to your sleep as well and use good sleep hygiene. So did I do okay on my note taking?
Dr. Kakos: I give you an A plus.
Host: I love it. Alright. Well this has been very informative Dr. Kakos. Thank you so much for your time today.
Dr. Kakos: My please. Yeah, thank you.
Host: I'm Bill Klaproth with WakeMed Voices brought to you by WakeMed Health and Hospitals in Raleigh, North Carolina. To learn more about WakeMed’s memory assessment services and to get connected with Dr. Kakos or another provider, please visit wakemed.org/memory-assessment. If you’ve found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you.