As I grow older, I tend to worry more about losing my mental abilities. In contrast, it seems easier to accept my normal decline in physical abilities. Though I used to be a college wrestler, I now have an excuse for avoiding competition with younger men. Even when exercising, I feel comfortable working at a lower rate for cardiovascular conditioning rather than pushing myself to the limit. Although my senses are also fading, I am able to compensate for much of this loss. My glasses are now bifocals, and I am adjusting to a hearing aid. However, if I decline mentally, there are no such aids for me.
Like almost all people, I notice that I have the normal tendency to "block" – not remember a specific name or term when I want it – seems to be occurring more frequently. It seems to take more effort to remember the names of new students each semester. Does this mean that my mental abilities are declining? Will this become so severe that I might be classified as having "dementia"?
Two common forms of dementia are Alzheimer's disease and vascular dementia. Vascular dementia occurs when the blood supply to the brain is reduced significantly. In both, symptoms may include declining memory, impaired speech and diminished ability to perform physical tasks. However, to be classified as dementia, these symptoms must greatly effect everyday activities, including your interpersonal relationships.
Although minor problems with memory take place at all ages, it is difficult to estimate how often these symptoms occur at a significant level. We can estimate how many people have dementia at any one time. However, it is more challenging to determine the rate of occurrence – how many new cases occur in a population. This difficulty is caused by a lower survival rate, because the population is older, and that the dementia itself leads to increased mortality.
In 1994, a study was completed on an older group of people – 1,195 subjects aged 75 or over – in England. At the beginning of the study, none of the subjects had signs of dementia. After initial exams and tests, subjects were retested 30 months later. The retested group was smaller. Although some had died, others were unable or unwilling to be tested. Since women typically live longer than men, two-thirds of the remaining subjects were women.
In this group, the rate of dementia increased consistently with age, doubling about every five years. However, even at this age level, the rates were surprisingly low. At 75-79 years, the annual rate of new cases was about 2%. At 85-89, it was still only 8.5%. The frequency was not related to gender, social class or educational level.
However, others suffered from minimal dementia. Minimal dementia leads to a greater likelihood of losing or misplacing possessions, mild problems in learning new information and recalling recent events, and occasional errors in work tasks. Subjects developed these less severe problems at a slightly faster rate. At 75-79 years the rate was about 3%, but it jumped to 30% for those over 90.
If we take a positive view, our future is more encouraging. Data from this study indicate that the great majority of older people – even into their late 80s – do not show signs of dementia.
Knowing this, I think I will be more optimistic. None of us have perfect memories. We all forget at times. So when I do forget something, I'm not going to berate myself (much) or constantly worry about having dementia.
Rather than spending our later years rocking in front of the television, it is much better to remain active and involved in life. The repeated use of mental abilities seems to avoid dementia. Volunteer groups always need more help, even if it only involves socializing over the phone. If you want to become active in some volunteer work, you can call RSVP (Retired Seniors Volunteer Program) in your area. (I forgot the number, but you can look it up in your phone directory.)
* Adapted from "Mental decline with age affects relatively few people," The Menninger Letter, November, 1994, page 6.
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