Issues and Approaches to Declining Memory
It’s a common refrain and a subject of frequent casual references: the ‘senior moment’.
Those are the episodes when we’re unable to recall a fact, a name, and the title of that book (or the plot).
We seem less organized in our thinking and can’t multitask as well as we used to.
We can’t remember where we put something or why we walked into that room.
Our spouses or friends may comment about our being dizzy or spacey. We joke about it but we also wonder is it ‘normal aging’ or the early sign of something more serious.
Of course we’re all aware that increased life expectancy has brought with it an epidemic of cognitive decline, and that the projections for Alzheimer’s are sobering. But there is a good deal of cognitive dysfunction that is not due to Alzheimer’s, yet should be evaluated and treated if possible. In addition, there may be nonpharmacologic approaches to preventing or stabilizing Alzheimer’s as well.
Diagnosing Alzheimer’s is usually the purview of neurologists and there are brain scans and other tests that are being developed to help with early diagnosis. There are also screening tests of cognitive function and formal neuropsychological testing to fully document mental capacity and dysfunction.
Measuring and diagnosing dysfunction is important, but in those who are shown to have cognitive issues, the real question becomes why? This is the question that preoccupies physicians who practice integrative/nutritional medicine, whether the problem is memory, fatigue, pain or anything else.
There are a host of metabolic issues that can negatively affect cognitive function and these will be discussed in subsequent posts. But there are also some psychosocial factors that can clearly compromise cognitive function and two of those will be mentioned here.
The first is obvious, but often overlooked: Sleep
Sleep quality and duration often declines with age for a variety of reasons:
- Melatonin levels may be reduced which can cause difficulty falling asleep as well as maintaining sleep.
- Obstructive sleep apnea clearly increases with age, and cognitive dysfunction is a hallmark of that condition.
- Hormonal imbalances in menopause as well as adrenal dysfunction can also negatively affect sleep quality.
- Increased likelihood of prostate and/or bladder dysfunction.
Other factors that may negatively impact quality sleep include:
- Poor sleep “hygiene” — the practices and habits leading to sleep.
- Gastroesophageal reflux.
Many of these problems can be treated without drugs.
Sleep can of course be helped by taking melatonin at bedtime, and herbs such as valerian, passion flower and hops can improve sleep. 5-Hydroxytryptophan can help with both sleep and depression. For menopausal insomnia, herbs such as wild yam, black cohosh, dong quai and others may be helpful, and bioidentical progesterone can often be used. Saw palmettos pygeum and nettles can reduce nocturnal prostate symptoms and there are a variety of agents such as licorice, aloe vera and enzymes that may improve reflux.
Another common cause of cognitive decline: Depression or Mood Disorders.
This dementia syndrome of depression is often called Pseudodementia. We usually associate depression with feelings of sadness, social isolation or lack of motivation, but in some instances cognitive decline is the most obvious symptom, and only by probing further does one reveal the underlying mood disorder. There are a variety of nonpharmacologic approaches to depression. Nutritional agents such as fish oil, SAMe, St. John’s Wort, B12, inositol and 5-Hydroxytryptophan treat depression. Sex hormone deficiency can also cause depression and can be treated with the appropriate bioidentical hormones. It should be noted that depression is often accompanied by insomnia.
For supplements that promote Sleep, click here.
For supplements that promote Emotional and Mood Support, click here.