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16 October 2003
That senior moment
IT'S a quaint term used
to describe that moment when you're eloquently explaining a point to an
audience of about a thousand people and then suddenly, you can't
remember what you wanted to say next. It happens to all of us, even when
we're in our 20s and 30s, but in midlife, we can now excuse ourselves by
saying, "I'm sorry but I'm having a senior moment." Sometimes
we're able to move on, and sometimes, the senior moment turns into
eternity, and we panic.
The terms we use to refer to forgetfulness can be quite cruel. In
Filipino, "ulyanin" has negative connotations, almost
equivalent to saying "old fool." In Minnan (Hokkien), spoken
by local ethnic Chinese, people will use the term "lao gong"--lao
meaning "old" and gong meaning "stupid."
It hasn't helped as mass media pick up on the findings around
Alzheimer's disease, which seem to create even more anxiety for older
people. Pinoy-style, we've turned the disease into a verb. Instead of
saying "I have a senior moment," we go, "Ay, parang
nag-a-Alzheimer's ako (I think I'm getting Alzheimer's)."
Actually, my choice of today's topic was sparked by a health feature I
heard last week on radio, which attempted to explain forgetfulness,
dementia and Alzheimer's disease--all in three minutes. The result was a
rather confusing and alarming discussion. (There was a mildly amusing
ending though, when a radio commentator butted in and asked if perhaps
the President was suffering from one of those disorders, what with all
her flip-flops.)
We need to distinguish the various problems we have with memory. All of
us get memory lapses even in our youth, as changes in our brain bring
about a decline in our cognitive functions. It's not just the memory
that's affected but our ability to learn new tasks, as well as our
thinking and judgment processes.
If you want to be fancy about those senior moments, you can explain
you're suffering from "benign senescent forgetfulness" or
"age-associated memory impairment." As the terms imply, these
are not serious problems.
Forgetfulness becomes serious when we can't recall entire events, and
when our daily activities are affected. The medical people refer to this
more serious disorder as dementia, a term I hope will be changed
eventually because it has such negative connotations.
People tend to think dementia is a sign of Alzheimer's. This is only
partly correct. Dementia can result from other problems, including a
stroke and Parkinson's disease. An older person's dementia may also be
caused by depression. Treat the depression and the dementia will be
resolved, although note that if certain tranquillizers are used, these
pills can themselves be a cause of dementia.
Dementia and Alzheimer's are not inevitable problems that come with old
age. The chances of getting these conditions depend on a combination of
genes, lifestyles and environment. The latest edition of Merck's Medical
Manual says that dementia affects about 6 to 8 percent of people aged 65
or older. Among those who are 85 or older, the prevalence increases to
about 30 percent. Merck states categorically, "dementia is never a
normal part of aging," noting that even among centenarians,
"more than 50 percent" will not have dementia.
Those figures are for the United States. I recently talked with Prof.
Grace Cruz of the UP Population Institute, who is coordinating a survey
of older people, and she assures me they've included some tests in the
survey to look at how our senior citizens are functioning, physically
and mentally.
While we're waiting for those figures though, we should draw consolation
from the fact that all around us, in our families and communities, there
are senior citizens who function very well, sometimes even with serious
memory problems.
It's important to be reassuring when older people have their senior
moments, whether from simple forgetfulness or from more serious
dementia. Give them time as they fumble in their bags for their keys. It
never helps to nag, "Look at you. Your memory is so bad."
But it does help, I feel, to find the correct "moment" to sit
with them and point out that we're all getting older and that as our
memory begins to fail, we need to take measures to avoid potential
problems. With older women, for example, this might mean something as
simple as sticking to one large wallet to keep credit cards, cash and
keys.
Go through the house with the elderly and help to clear the clutter.
Older people can get really worked up when they can't find something
they need. This is especially the case with glasses, because they can't
get on with the day's activities. Quite often, it turns out the glasses
were on the bed, but "disappeared" because it blended into the
dark-colored bedcover. Solution? Change the bedcovers to ones with light
colors.
There are two keys to creating a "cognitive-friendly"
environment. First is familiarity--memory problems are often amplified
simply because the older person is in a new environment, whether because
they're on vacation in a new place, or because the furniture at home has
been rearranged.
The second key is safety. Again, walk through the house with older
relatives to figure out where to post reminders, for example, a sheet of
paper next to a phone with the most important numbers in large bold
letters, or a sign next to a stove: "Turn off the gas after
using." Since older people often have several medicines to take,
it's always useful getting them a pill case with seven separate
divisions, each to carry all the medicines to be taken in one day.
Are there "drugs" to reduce memory impairment? The jury's
still out with gingko biloba; many studies say it helps, but there are
also some researchers who say gingko's a placebo.
But even while the debates continue over gingko, we should note that
many studies do show that keeping mentally active can delay or slow down
dementia. That can be reading and writing, as well as simply interacting
with friends and relatives. Love, care and companionship can make the
senior moments a minor annoyance in the golden years.
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