Forgetful or dementia? Neuroscientist reveals the five signs you should never ignore
- Forgetfulness and sudden mood changes are among six key causes for concern
- The Alzheimer’s Society estimate 900,000 people live with dementia in the UK
Losing our memory, our sense of self and identity sounds like a living nightmare.
And for many people suffering with Alzheimer’s and other forms of dementia, it is.
But how can you tell if you or a loved one are experiencing the early stages of Alzheimers?
Forgetfulness is common, particularly as we get older. Who hasn’t struggled to remember someone’s name?
And walking into a room with no memory of what you walked in for is another all-too common experience. Although disorientating, and sometimes worrying, these lapses in memory aren’t usually anything to worry about.
Professor Hana Burianova, a scientist and advisor for British supplement brand Healthspan, says: ‘When the brain is pathologically ageing, the neurons – which transmit messages to other parts of the brain – are dying. This neuron death is what happens with Alzheimers’
‘Our brains start ageing from our early 20s,’ says Professor Hana Burianova, a scientist and advisor for British supplement brand Healthspan.
‘Once they stop developing, they begin to age, which means it’s losing connections between different parts.
However, the brain is plastic and if we’re active and social, if we exercise and eat a healthy diet we can make new connections right up until old age.
‘But when the brain is pathologically ageing, the neurons – which transmit messages to other parts of the brain – are dying. This neuron death is what happens with Alzheimers.’
So what are the memory and behaviour changes that are cause for concern? Professor Burianova reveals the tell-tale signs you should never ignore.
What is dementia?
A global concern
Dementia is an umbrella term used to describe a range of progressive neurological disorders (those affecting the brain) which impact memory, thinking and behaviour.
There are many types of dementia, of which Alzheimer’s disease is the most common.
Some people may have a combination of different types of dementia.
Regardless of which type is diagnosed, each person will experience dementia in their own unique way.
Dementia is a global concern but it is most often seen in wealthier countries, where people are likely to live into very old age.
How many people are affected?
The Alzheimer’s Society reports there are more than 900,000 people living with dementia in the UK today. This is projected to rise to 1.6 million by 2040.
Alzheimer’s disease is the most common type of dementia, affecting between 50 and 75 per cent of those diagnosed.
In the US, it’s estimated there are 5.5 million Alzheimer’s sufferers. A similar percentage rise is expected in the coming years.
As a person’s age increases, so does the risk of them developing dementia.
Rates of diagnosis are improving but many people with dementia are thought to still be undiagnosed.
Is there a cure?
Currently there is no cure for dementia.
But new drugs can slow down its progression and the earlier it is spotted, the more effective treatments can be.
Source: Alzheimer’s Society
One of the hallmarks of early Alzheimer’s is loss of memory. But how can you tell if an older loved one is being scatty or there’s something more concerning at work?
‘We know from research that older adults, aged 65-plus, will lose some detail in autobiographical memory, but their memory for facts and words is better than younger people,’ says Professor Burianova.
And often much of the typical ‘forgetfulness’ of otherwise healthy older people might be because they’re not paying attention in the first place.
‘They may not be “encoding” the information, for instance perhaps they were told a story at a party but they were distracted,’ she says.
‘The difference between a brain that’s ageing healthily, and pathological degeneration is the progressive dying of neurons. The changes will occur gradually.’
The death of these neurons typically takes place in the parts of the brain involved in memory such as the entorhinal cortex and hippocampus.
Someone will forget conversations they just had, or they may get lost somewhere they know well, or forget the route home, despite doing it countless times before.
‘Anyone can forget to turn off the stove, but with someone with Alzheimer’s, it keeps happening,’ she says.
Most of us are all too familiar with loved ones who’ve been telling the same stories for years.
However, unlike Aunt Mary relating the tale about the nice neighbour who came to trim her hedges whenever you visit, someone with Alzheimer’s will repeat the same information over and over again often in a short space of time.
‘We all tell stories several times, especially to our partners. There might be a cue that reminds us, and that’s the trigger for our retrieval,’ says Professor Burianova.
‘But someone with Alzheimer’s will repeat something three times in a row. It’s a symptom of their short term memory loss.’
Sudden changes in mood
If your otherwise level loved one suddenly becomes anxious or depressed, it could be more than a mid-life crisis.
‘Early signs of frontotemporal dementia (FTD), which Bruce Willis has, include changes in personality. It’s very hard as people get depressed and anxious,’ says Professor Burianova.
‘Someone will try to find out why their beloved is suffering from mental health issues, but it’s more than that – it’s because part of the brain is deteriorating.
‘Picture the brain as a big net and part of the net starts being broken, then the rest of the net starts to rip. Depending on where that process starts, it will govern the symptoms.
‘FTD has secondary symptoms like memory loss and physiological issues such as bowel problems.’
Last month Bruce Willis was given a second diagnosis of frontotemporal dementia, less than year after it emerged he had an untreatable brain disorder. Pictured above, in 2019 at the European premier of Glass in 2021
They can’t speak
If a previously fluent speaker suddenly starts tripping over their words, take heed.
They might have aphasia, where a person has difficulty with speech and understanding language, which can be caused by FTD.
Bruce Willis has recently shone a light on this kind of dementia, revealing that the giveaway that he had the condition was his struggle with language.
‘There is an area in the frontal lobe which has to do with the initiation of language,’ says Professor Burianova.
‘You might be telling them something and you realise they don’t understand. Or they start stuttering or stumble as they try to produce language.’
If your hitherto quiet and modest grandmother starts telling crude jokes, there may be more afoot than a new addiction to Mrs Brown’s Boys.
‘Depending on what kind of dementia you have, your personality can change once it starts affecting your prefrontal cortex,’ says Professor Burianova.
‘There can be a lot of fear or OCD (obsessive compulsive disorder), you can become super obsessive and some people become disinhibited.
‘Suddenly your grandma starts making lewd remarks to men on the street, or they start taking off their clothes.
‘There could be aggression too, but that could be because they’re afraid of their environment and feel extremely vulnerable.’
How to keep your brain sharp
From the right diet to staying active, a few lifestyle tweaks can give your grey matter a new lease of life
Get those omega-3s
Our brains love the omega-3 fatty acid DHA, which is found in oily fish such as salmon and mackerel.
One study of more than 2,000 adults found eating fish twice a week appeared to reduce the risk of dementia by 44 per cent.
What makes fish – particularly oily or fatty fish like salmon, mackerel and sardines – so beneficial for vascular or brain health is its omega 3 essential fatty acid content.
Omega 3 appears to support blood flow to the brain, which helps support memory and reduces the risk of cognitive decline.
For vegetarians and vegans, avocados, nuts, seeds and plants oils such as flaxseed and olive oil are rich in omega-3 fats.
Don’t stop moving
As if you needed any other reasons to exercise, working out is essential to your grey matter.
Getting hot and sweaty increases blood flow to the brain, which is thought to encourage enzymes to break down proteins that can build up into the damaging brain plaques, which are a hallmark of Alzheimer’s.
A 2017 review examining the effects of exercise on at-risk people found that aerobic exercise, such as brisk walking and swimming, was three times more beneficial than those who did a mixture of cardio and weights.
However, older people who do any sort of exercise at all demonstrated better cognitive ability than people who did nothing.
Nootropics are a new generation of drugs that are thought to help boost cognitive function.
The term is used to refer to any natural or synthetic substance that may have a positive impact on mental skills.
These can include known natural brain-boosting vitamins and minerals but also lesser-known herbs including ginkgo biloba (said to have neuroprotective effects and thought to help reduce the build-up of amyloid plaque linked to some forms of dementia) and Bacopa monnieri (one clinical trial found taking 300mg of it daily delayed word recall in the over 65s compared to placebo treatment).
Caffeine is also classed as a nootropic and having your usual coffee or tea pick-me-up – or even chewing caffeine gum – has been shown to help boost mental alertness, particularly if you are tired.
Learn new things
Our brain loves new things and when we are not exposed to anything new cognitive decline becomes more likely.
This doesn’t have to be ultra-challenging or daunting like learning a new language or signing up to an OU course – it can include something as simple as walking on the different side of the road on your usual route to work or brushing your teeth with your left hand when you are right-handed (or vice versa) to give your brain a mini work-out.
And it’s not all obviously ‘brainy’ stuff that is beneficial.
Eat your greens
According to a 2018 study from Rush University, just one serving of green vegetables a day for an average of 4.7 years is enough to help to slow cognitive decline, giving the study volunteers the brain of someone 11 years younger.
So load up on kale, spinach, broccoli which provide brain-friendly nutrients including vitamin K, lutein, nitrate and folate.
Boost your gut bugs
Understanding of the importance of our gut is growing by the day, particularly the relationship between our gut microbiome and the brain, called the brain-gut axis.
The theory goes that the healthier your gut is, teeming with trillions of bacteria, ideally a diverse mix of ‘friendly’ bugs, the better your brain health is.
Research shows that following the Mediterranean diet – primarily plant-based, filled with anti-inflammatory fruit and vegetables, omega 3 fatty acids, fish and extra virgin olive oil – can nurture the ‘good’ bacteria in your gut.
Loneliness can take a huge toll on our mental and physical health and it’s particularly stressful for our brains.
‘Social connectedness is important not only for our emotional health, but also for cognitive resilience’, says Professor Burianova.
‘Research has shown that feeling lonely more than doubles the risk of developing Alzheimer’s.’
She advises anyone feeling lonely not to feel bashful but to reach out to others.
A hot chocolate before bed may be doing more than helping you sleep.
A small Italian study involving healthy volunteers aged between 50 and 69 found that a specially prepared cocoa drink, containing large amounts of flavanols – powerful polyphenols – showed a decline in memory loss.
Researchers think the drink increased the blood flow to a specific region of the brain concerned with memory.
Get to bed
Unsurprisingly, a good night’s sleep has a huge impact on our cognitive health.
A 2017 Greek study showed that a lack of sleep, and poor quality sleep, were associated with poorer memory in men and women over 65.
The position you sleep in could also play a part. Researchers at Stony Brook University in New York found that sleeping on your side can more effectively contribute to a night time ‘power cleanse’ helping to remove brain waste, like beta-amyloid proteins, implicated in the development of Alzheimer’s and other neurological diseases.
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