Remember the jump-to-conclusions mat in the movie “Office Space?” Maybe there should be a square for concluding: “My parent’s signs of normal aging must mean dementia is around the corner.” In truth, for most adults 65 years or older, that just isn’t the case.
In 2012, about 9 percent of U.S. seniors had dementia, according to a study published January 2017 in JAMA Internal Medicine, with the prevalence of dementia declining from 11.6% in 2000. The vast majority of seniors will not develop dementia.
However, well-meaning family members are sometimes anxious about any changes they see in an older loved one. Adult children can conflate medical conditions, physical disabilities or memory slips with impending mental impairment.
Read why two experts — a caregiving authority and an anti-ageism advocate — caution against making assumptions on cognitive ability based on someone’s frailty, disability or simply older age.
[See: 13 Ways to Improve Your Memory.]
Anxious About Dementia
Carol Bradley Bursack was a bit frustrated when she wrote the insightful column, “Aging Bodies Can House Strong, Agile Minds” in 2016. As a columnist, blogger and author of “Minding Our Elders: Caregivers Share Their Personal Stories,” Bradley Bursack receives a lot of mail and hears from many family caregivers.
Having spent 20 years as a caregiver for multiple elders, Bradley Bursack could relate to adult children’s concerns. However, from her perspective, many well-meaning children seemed to be overreacting to an aging parent’s increasing weakness or occasional memory lapses. Changes like these prompted some caring children to speculate about a parent’s possible dementia, making them feel they should immediately leap into a protective mode.
Online messaging and increased awareness of dementia — Alzheimer’s awareness in particular — can contribute to family members’ anxiety and overreaction, Bradley Bursack believes. They’re bombarded with advice like: “When your parents are 65, you have to check their refrigerator for old food,” she says. “And if they forget a word, you better get them in to a doctor.”
Although she doesn’t hear this from everyone, Bradley Bursack notes, some family members “want to kind of dive in and take over their parent’s lives once a birthday happens. They mean well — they’re worried about what they read.”
Alzheimer’s awareness is important, Bradley Bursack says. Yet, awareness of what older adults can accomplish and their value in society is equally important, she emphasizes.
“We all know that in this day and age, somebody 65 or 70 could still be working on the internet,” Bradley Bursack says. “They’re starting their own businesses. People are running; they’re going to the gym. They’re out there volunteering. Senior volunteers keep this country running. It’s amazing what people do.”
Aging is normal and acceptance is golden. “Just because we might walk slower or take longer to climb the subway stairs — well, you know, that’s life,” says Alice Fisher, founder of the Radical Age Movement, a national group based in New York City. Some people may deal with severe disabilities, she notes: “We’re not saying that getting old is this Pollyanna thing.”
Fisher is not a fan of phrases such as “aging well” or “healthy aging” and what they seem to imply. “‘Successful aging’ is the worst,” she says. “What does that mean: If I am just unfortunate and get sick, I failed? I didn’t succeed? I didn’t age successfully? That’s another way of looking at it.”
When older adults show outward signs of physical disabilities, like using a wheelchair, people around them may make assumptions that wouldn’t occur to them with younger adults, Fisher says. Complications from certain health conditions are often misconstrued.
Physical effects of stroke — from which many people recover — may cause family caregivers, friends or co-workers to assume the survivor’s mental capacity must also be affected. Not so, Fisher says. She describes an 80-year-old college professor, a fellow group member, who has had two strokes. Although these caused a speech impediment, Fisher says, “We could understand her just fine.”
Others around the professor were inspired as she moved ahead with her life, exercising daily, returning to teaching and writing books simultaneously. As for her stroke history, Fisher says, “It obviously had no effect on her brain.”
Hearing loss can occur with age, but difficulty hearing is not the same as difficulty with comprehension. Consider whether somebody may have trouble hearing — not cognitive issues — if he or she doesn’t seem to understand you right away, Fisher advises.
Whether it’s a family member or health professional, determining how to account for memory loss and other cognitive changes in an older adult is challenging: Is it due to normal aging or potential dementia? Many factors are considered, such as specific language deficits or new behavioral patterns like increasing apathy.
Geriatricians use paper-and-pencil exercises and verbal testing of short-term recall to screen for cognitive problems as part of routine wellness visits. If Alzheimer’s or other dementia is suspected, more intensive testing could include brain imaging and possibly a spinal tap to reach a diagnosis.
Most of the time, however, gradual memory changes occur as part of the normal aging process, and people develop workarounds and continue to go about their lives. Certain types of memory may actually improve with age.
Researchers explored subtle differences in memory, intelligence and executive function related to age in the September 2013 issue of the journal Psychology and Aging. A study of age and economic decision-making found that younger adults had more “fluid intelligence,” whereas older adults had greater “crystallized intelligence” that influenced traits such as financial literacy, debt literacy and temporal discounting — a concept related to immediate reward-seeking versus self-control and delayed gratification.
Another study compared older and younger adults’ ability to use sentence context to memorize words. “Older and wiser” was the conclusion of researchers who found superior memory performance in seniors. Experience and earned wisdom matter.
Before making assumptions about mental capabilities, look around at what seniors are accomplishing. You’ll find older adults learning, adapting and contributing in myriad ways — even if they’re not in perfect health. It could be seniors earning a living in today’s gig economy, returning to college or volunteering their time and skill to help others in the community.
Changing Your Mindset
You’re never too young to reset your attitude on aging. Keep these points in mind when you think about what aging means:
— Your future self-image is at stake. In a youth-oriented culture, Bradley Bursack says, some 40-year-old adults say they feel old and “washed up,” when they’re actually just entering middle age. Start training yourself now to think about age in a more positive light.
— ‘Othering’ elders discounts their humanity. “People look at old people as the ‘other,'” Fisher says. “They don’t realize: Hey, excuse me, but I’m you. You just haven’t gotten here yet. We’re not another species. We are human beings, the same as you are.” Recognize the humanity of people at every stage of life and in every state of health, she urges.
— Age-based stereotyping is a two-way street. Bradley Bursack is dismayed by social media stereotyping of all older adults being technology-averse. However, she adds, “The reverse is true and I also don’t like to see it: when older people have a stereotypical view of Gen Xers or millennials, where they just think they’re all about themselves, which is not true at all.” Workplaces where people of all ages work and interact with one another can help eliminate these outworn ideas, she says.
It’s natural to worry when a parent has health issues, Bradley Bursack says. It could be your father who’s had a stroke and some physical disabilities but no cognitive effects. Or it might be something gradual, like, “Mom’s getting so frail — her arthritis is making it difficult for her to take jar lids off,” she says. “Well, that isn’t Mom’s brain.”
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