As a primary-care physician with more than 25 years of experience, one of the most frequent concerns people mention during their appointments with me involves memory. The age of the patient doesn’t matter much. I’ve had people in their 30s ask me, just like I’ve heard it from people in their 60s and beyond. “Doc,” I’ll hear. “I can’t keep track of my car keys and often forget people’s names. Could I be losing it? Is this the start of the end?”
Usually it isn’t, of course. But it makes sense to be thinking about the loss of cognitive impairment over time. As someone who is getting older myself, I worry about it, too. I find that it eases people’s anxiety to know that preventive measures for mild cognitive impairment exist. It’s better to put these actions into practice in midlife, rather than later, when symptoms have already started to show up.
If you do have a close family member with the disease, Dr. Sharon Cohen of the Toronto Memory Program suggests making an appointment yourself to establish a cognitive baseline — basically, an assessment of your current memory. The baseline provides a point of comparison to assess your memory later on. If problematic changes do occur, the baseline provides greater opportunity to participate in clinical trials for drugs designed to keep memory from deteriorating. A cognitive baseline involves a 20-minute assessment with a qualified health care professional. “Better to keep on top of your memory than bury your head in the sand,” says Dr. Cohen.
Happily, there’s a tonne of academic research being conducted into prolonging lifespan and healthspan. One of the most intriguing is happening at the Scripps Translational Science Institute in San Diego, where researchers like Dr. Eric Topol are analyzing the DNA of 1,400 people who live free of chronic disease long past the age of 80 — a group that Topol and his fellow researchers call the “wellderly.” The research revealed that the group is more likely to have a set of genes that protect the brain from cognitive decline over time.
So winning the genetic lottery helps. But there’s good news for the rest of us, too. Three years ago, the G8 countries created the World Dementia Council, which led an effort to comb through the scientific evidence to determine the sort of preventive strategies people should follow to ensure long-term cognitive health. The resultant review was published in the medical journal, Alzheimer’s & Dementia.
Some of the biggest risk factors for cognitive decline include mid-life obesity, hypertension and smoking. Excessively low blood pressure in later life may also be a risk factor.