Up to 20 percent of Americans over the age of 65 experience memory and thinking problems that, while noticeable, don’t interfere with their daily life or ability to live independently. These changes to the brain are known as mild cognitive impairment (MCI) and are not severe enough to be diagnosed as dementia. Still, people with MCI are more likely to develop Alzheimer’s disease or another type of dementia later on compared to those without any loss of mental function.
These types of milder memory and thinking problems, however, are far from a straight path to dementia. Up to 70 percent of people with MCI never develop dementia even after 10 years. Some improve after just one or two years.
More research is needed to understand which people are most at risk. A review of recent research was published Dec. 17 in JAMA. The review identifies strategies to help people maintain their mental health as they age.
Multiple Medications May Cause Memory Problems
Many prescription drugs can interfere with thinking and memory and produce so-called “brain fog.” The list includes narcotic painkillers, benzodiazepines (such as those used as sedatives or anticonvulsants), and sleep medications. For older adults, the sheer number of drugs found in their medicine cabinets can create even more problems.
“It is quite common for older adults to be on up to 10 medications, which increases the risk for side-effects and interactions,” said the study’s co-author Dr. Kenneth M. Langa, a professor of medicine at the University of Michigan. “The problem is compounded if older adults have multiple doctors who may not be aware of the other medicines being prescribed.”
Langa suggests that seniors keep an updated list of medications they are taking to reduce drug-related memory and thinking problems. He also recommends that seniors track the over-the-counter drugs and supplements they take. These can also interact with prescription drugs. They should review this list at every doctor’s visit to look for ways to decrease drug interactions. Seniors can ask their doctors about possible alternatives with fewer side-effects if they are already taking a medication that causes “brain fog.”
Overtreatment Is Not Healthy for the Brain
Taking steps to reduce the risk of stroke may head off mild memory and thinking problems. These precautions are recommended even for people who don’t show signs of damage to the blood vessels in the brain. Damaged blood vessels are the hallmark of stroke. Stroke prevention includes controlling high blood pressure and diabetes, not smoking, managing cholesterol levels, and taking aspirin or other anti-clotting medications if prescribed.
However, people should be cautious when it comes to treating diabetes and high blood pressure. More is not always better.
“There is a growing recognition, based on both observational studies and clinical trials,” said Langa, “that aggressive treatment of cardiovascular risk factors in older adults may have fewer benefits than previously thought, and may actually cause harm, such as falls and possibly progression of cognitive impairment.”
Social Engagement Is Good for the Mind
Keeping the brain healthy means using it for what it is designed to do: being active and creative in as many ways as possible. This can include reading, playing a board game, or doing an art project.
“Learning musical instruments, being part of a choir — music has a unique way of using many different aspects of the brain at once,” said Dr. Jon Lieff, a psychiatrist who specializes in geriatric psychiatry and shares information about brain health on his website Searching for the Mind.
Another way to activate your brain is through regular social engagement. Observational studies suggest that older adults who are married, volunteer regularly in the community, or stay in touch with their family and neighbors experience less memory loss.
It’s Never too Early to Focus on Brain Health
Tests used to screen for Alzheimer’s and other types of dementia may not work to identify MCI because MCI doesn’t fall into the same category as these more serious conditions. Instead, Langa suggests that older adults and their partners or family members keep an eye out for potential memory and thinking problems. Red flags include new difficulties finding one’s way around familiar places or using everyday appliances at home. Another indicator is forgetting the names of familiar people.
All of these tips for reducing the risk of dementia in older adults are just as useful for improving brain health in younger people.
“It is also important for middle-age adults to address any cardiovascular risks that can increase the long-term risks for heart and cognitive problems,” said Langa. This includes maintaining a healthy weight and exercising regularly. Both reduce the risk of stroke and give the brain a boost.
“It may be even more important for long-term cognitive health,” said Langa, “to have these risks treated well and aggressively in middle-age than at older ages.”