Forgetfulness & Old Age

This is a presentation by Dr.Dhanamjay Gambhire on Forgetfulness & Old Age.

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Senior Citizens & forgetfulnessSenior Citizens & forgetfulness
Dr. Dhananjay D. GambhireDr. Dhananjay D. Gambhire
MD (Psychiatry) DPMMD (Psychiatry) DPM
Consultant PsychiatristConsultant Psychiatrist

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Phase of life cycle Phase of life cycle
characterized by characterized by
developmental developmental
issues, loss of issues, loss of
physical agility, physical agility,
mental acuity, friends mental acuity, friends
and loved ones, and loved ones,
status and power.status and power.
 Old age is not a Old age is not a
diseasedisease
Old age not numbers-Old age not numbers-
mind setmind set
>65>65

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MemoryMemory
Immediate-e.g.. Repeating wordsImmediate-e.g.. Repeating words
Recent-e.g.FoodRecent-e.g.Food
Remote-Declarative-Semantic e.g. NameRemote-Declarative-Semantic e.g. Name
Episodic e.g. life eventEpisodic e.g. life event
Nondeclarative-ProcedureNondeclarative-Procedure

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In the past, doctors dismissed memory In the past, doctors dismissed memory
loss, confusion, or similar behaviors as a loss, confusion, or similar behaviors as a
normal part of aging. normal part of aging.
However, scientists now know that most However, scientists now know that most
people remain alert and capable as they people remain alert and capable as they
age age

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 Some longitudinal Some longitudinal
studies have studies have
demonstrated a rather demonstrated a rather
high stability of high stability of
intelligence during intelligence during
aging aging
World leaders are World leaders are
usually 60+usually 60+
Most of the rich Most of the rich
people & owners are people & owners are
60+60+

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Components of IntelligenceComponents of Intelligence
Visuospatial skills. Visuospatial skills.
Language.Language.
Judgment or reasoning.Judgment or reasoning.
Sequence.Sequence.
Community affairs.Community affairs.
Home.Home.
Hobbies.Hobbies.
Personal care.Personal care.
MemoryMemory

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Age associated forgetfullnessAge associated forgetfullness
Simple lapses in memorySimple lapses in memory
Forgetting the name of a Forgetting the name of a
person just met.person just met.
Not finding the right word Not finding the right word
or expression while or expression while
communicatingcommunicating
Taking more time to learn Taking more time to learn
a new thingsa new things
Taking longer time to react Taking longer time to react
or respond or respond

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15 %12 %Depression
20 %5 %Forgetfulness
25 %10 %Psychiatric
conditions
Age >65 yrsGeneral
population

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Mild cognitive impairmentMild cognitive impairment
 impairment in one a more cognitive domain impairment in one a more cognitive domain
(typically memory), or an overall mild decline (typically memory), or an overall mild decline
across all cognitive abilities that is greater than across all cognitive abilities that is greater than
would be expected for individual age or would be expected for individual age or
education but insufficient to interfere with social education but insufficient to interfere with social
and occupational functioning as is required for a and occupational functioning as is required for a
dementia syndrome .dementia syndrome .
Rate of conversion to dementia Rate of conversion to dementia
1 to 2 % to 10 to 15 %1 to 2 % to 10 to 15 %

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DementiaDementia
The term dementia The term dementia
describes a group of describes a group of
symptoms that usually symptoms that usually
are caused by changes in are caused by changes in
the normal activity of very the normal activity of very
sensitive brain cells. sensitive brain cells.
Dementia seriously Dementia seriously
interferes with a person's interferes with a person's
ability to carry out daily ability to carry out daily
activities.activities.
3% at 60 yrs 3% at 60 yrs
40% at 80 yrs 40% at 80 yrs

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Dementia is irreversible - it cannot be Dementia is irreversible - it cannot be
cured. However, there are many cured. However, there are many
conditions with symptoms that seem like conditions with symptoms that seem like
dementia but aren't. dementia but aren't.

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These reversible conditionsThese reversible conditions
Anxiety or Depression.Anxiety or Depression.
High fever.High fever.
Poor nutrition.Poor nutrition.
Bad reaction to a medicine Bad reaction to a medicine
Minor head injury. Minor head injury.
Medical problems.Medical problems.
Medication.Medication.

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Medications that can induce Medications that can induce
depression &forgetfulnessdepression &forgetfulness
Steroids Steroids
Painkillers Painkillers
Hormones Hormones
Arthritis medication Arthritis medication
High blood pressure drugs High blood pressure drugs
Heart disease medication Heart disease medication
Tranquilizers Tranquilizers
Cancer drugs Cancer drugs

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Tests for memoryTests for memory
Mini mental status evaluationMini mental status evaluation
Consortium to establish registry in Consortium to establish registry in
dementiadementia
Global deterioration scaleGlobal deterioration scale
LanguageLanguage
Learning and memoryLearning and memory
Executive functioningExecutive functioning

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Causes of depressionCauses of depression
Loneliness and Loneliness and
isolation – Living isolation – Living
alone; a dwindling alone; a dwindling
social circle due to social circle due to
deaths or relocation; deaths or relocation;
decreased mobility decreased mobility
due to illness or loss due to illness or loss
of driving privileges. of driving privileges.

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Reduced sense of Reduced sense of
purpose - Feelings of purpose - Feelings of
purposelessness or loss purposelessness or loss
of identity due to of identity due to
retirement or physical retirement or physical
limitations on activities. limitations on activities.
Health problems – Illness Health problems – Illness
and disability; chronic or and disability; chronic or
severe pain; cognitive severe pain; cognitive
decline; damage to body decline; damage to body
image due to surgery or image due to surgery or
disease. disease.

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Fears – Fear of death Fears – Fear of death
or dying; anxiety over or dying; anxiety over
financial problems or financial problems or
health issues. health issues.
Recent bereavement Recent bereavement
- The death of friends, - The death of friends,
family members, and family members, and
pets; the loss of a pets; the loss of a
spouse or partner spouse or partner

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Symptoms of depressionSymptoms of depression
Unexplained or aggravated aches and pains Unexplained or aggravated aches and pains
Hopelessness Hopelessness
Helplessness Helplessness
Anxiety and worries Anxiety and worries
Memory problems Memory problems
Loss of feeling of pleasure Loss of feeling of pleasure
Slowed movement Slowed movement
Irritability Irritability
Lack of interest in personal care (skipping meals, Lack of interest in personal care (skipping meals,
forgetting medications, neglecting personal hygiene) forgetting medications, neglecting personal hygiene)

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Investigations in depressionInvestigations in depression
Routine blood investigationsRoutine blood investigations
Hormonal imbalances Hormonal imbalances
Thyroid problems Thyroid problems
Vitamin B12 deficiency Vitamin B12 deficiency
Other nutritional deficiencies Other nutritional deficiencies
Electrolyte imbalances or dehydration Electrolyte imbalances or dehydration
CT ScanCT Scan

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TreatmentTreatment
Getting out in to the Getting out in to the
world – Try not to stay world – Try not to stay
cooped up at home all cooped up at home all
day. Go to the park, day. Go to the park,
take a trip to the take a trip to the
hairdresser, or have hairdresser, or have
lunch with a friend. lunch with a friend.

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Connecting to others – Connecting to others –
Limit the time you’re Limit the time you’re
alone. If you can’t get out alone. If you can’t get out
to socialize, invite loved to socialize, invite loved
ones to visit you, or keep ones to visit you, or keep
in touch over the phone in touch over the phone
or email. or email.
Volunteering your time – Volunteering your time –
Helping others is one of Helping others is one of
the best ways to feel the best ways to feel
better about yourself and better about yourself and
regain perspective. regain perspective.

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Taking care of a pet – Taking care of a pet –
Get a pet to keep you Get a pet to keep you
company. company.
Participating in Participating in
activities you enjoy - activities you enjoy -
Pursue whatever Pursue whatever
hobbies or pastimes hobbies or pastimes
bring or used to bring bring or used to bring
you joyyou joy

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Learning a new skill – Learning a new skill –
Pick something that Pick something that
you’ve always wanted you’ve always wanted
to learn, or that to learn, or that
sparks your sparks your
imagination and imagination and
creativity.creativity.
Write an Write an
autobiography autobiography

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Enjoying jokes and Enjoying jokes and
stories – Laughter stories – Laughter
provides a mood provides a mood
boost, so swap boost, so swap
humorous stories and humorous stories and
jokes with your loved jokes with your loved
ones, watch a ones, watch a
comedy, or read a comedy, or read a
funny book.funny book.

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Maintaining a healthy diet – Avoid eating Maintaining a healthy diet – Avoid eating
too much sugar and junk food. Choose too much sugar and junk food. Choose
healthy foods that provide nourishment healthy foods that provide nourishment
and energy. and energy.

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Exercising - Even if Exercising - Even if
you’re ill, frail, or you’re ill, frail, or
disabled, there are disabled, there are
many safe exercises many safe exercises
you can do to build you can do to build
your strength and your strength and
boost your mood—boost your mood—
even from a chair or even from a chair or
wheelchairwheelchair

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maintain daily routines.maintain daily routines.
Diary writing.Diary writing.
Hourly writingHourly writing
RevisingRevising
High mental activity.High mental activity.
CardsCards
SodokuSodoku
AntakshariAntakshari

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 Always make a point to remember Always make a point to remember
things.things.
 Even if it is something you do not have to Even if it is something you do not have to
memorize.memorize.
 Read-Write-Repeat do it anyways. Read-Write-Repeat do it anyways.

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