Lost your keys? Can’t find your spectacles? Can’t remember where you left the car? Can’t remember names – that almost inevitable sign of ageing? So great is the anxiety about developing dementia that these symptoms cause consternation, although they are as much part of growing old as grey hair and wrinkles.

Be that as it may, it is no reason to ignore intellectual fitness. Brains, like muscles and joints, need exercise and care. In the absence of other medical problems that could account for memory loss, three conditions need to be separated.

The first of these is age-associated memory impairment. This is a long winded way of describing the benign memory loss that affects all older people. Everyone, including even the President of the Royal Society and the Archbishop of Canterbury, will become less good at learning new information in their sixties and beyond. In people with age associated memory impairment the decline is not fast, it doesn’t become progressively ever faster and there is no detectable corresponding change in personality. The loss of memory should be similar to that of their contemporaries. The only problem for those with age-associated memory impairment is that those who have it are slightly more forgetful than they were twenty years earlier and that their attention span is not so long. They may nod off when listening to a speech or after the pudding at a family dinner – but once awake, they are on the ball.

The next condition that needs separating out is mild cognitive impairment. This form of memory loss may have stemmed from a partial failure in the system that processes and stores recently acquired information and relates it to earlier memories. Impairment of the system that processes and stores memory may be the consequence of a shrinking hippocampus. Although short-term memory may be faulty. the person’s general cognitive function, his or her ability to think and reason, to plot and plan and to carry on with daily activities are unimpaired. Such people can drive safely and even if they can’t immediately recognise birdsong or their distant cousin, they are still professionally competent. Their memory, even if not as good as it was, is normal for their age group. These people are often suffering from mild cognitive impairment.

Tucked away around the middle of each of the temporal lobes side on each side of the brain are the two areas known as the hippocampus. As people grow older, so does the hippocampus and as a result the person may become less good at recalling recently acquired knowledge whether it is a name or where the car key is. The answers may come in time, but perhaps not for minutes, or even hours. The retrieval system from the memory storehouse is beginning to become as creaky as ageing joints. The hippocampus deals with what is learned and how it is stored: as someone’s shrinks, so is she or he less able to relate earlier experiences to the present. This applies not only to memory for words and names but to visual images and also olfactory and auditory impressions (of sights, smells and sounds). For example older people are not so good at remembering the taste of an individual wine when they sample it again and it may take them a few moments longer to distinguish the song of a nightingale from one of the other members of the thrush family.

The third possibility is that these otherwise well people with minor memory loss may be suffering from the first stage of Alzheimer’s disease, or one of the other forms of dementia. Mild cognitive impairment needs to be sorted out from early Alzheimer’s. Three or four years ago, medical authorities agreed that there is a difference between mild cognitive impairment and early Alzheimer’s. A review of family history, blood tests, scans, the analysis of the memory loss and the speed it deteriorates all give clues: sometimes the diagnosis is obvious only in retrospect. Whatever the cause of memory loss, everyone can help to keep it sharp and minds active by taking a few simple steps. Many of the reasons for memory loss in old age are related to inherited genes, early education and environment. The objective is to hold on to what there is: this includes protecting the brain by taking every precaution to save it from even minor injuries or damage. Heavy blood loss, damage from strokes or even from high blood pressure or furred-up arteries can also adversely affect the brain and later intellect. The brain is a delicate, sensitive organ that, despite a thick skull, needs protection and nourishment.

The role of oily fish containing omega 3 fatty acids in preserving brain function can’t be overestimated. The minimum should be fish twice a week. Folic acid is also so important that those rich in folates, including yeast extracts, chicken livers, black-eyed beans, soya, wheat germ, breakfast cereals, liver, broccoli and asparagus, should be taken in abundance. I always recommend folic acid and vitamin B supplements as well. There are conflicting reports on the value of vitamin E but it and other antioxidants would be expected to help. Gingko biloba is a well established treatment for early memory loss and other swears by co-enzyme Q10.

“The role of oily fish containing omega 3 fatty acids in preserving brain function cannot be overestimated. Folic acid is also very important.”

Everything that keeps the circulation flowing and the heart strong also maintains a regular supply to the brain of nutrients and oxygen. Regular, steady, daily exercise, a well chosen low-fat diet, a waist under 40 inches for men and 35 for women help to keep arteries free of atheroma and healthy.

Recent research showed that the most important single measure for keeping the brain in good order was an active social life. It is even better if this involves activities using the intellect, whether bridge, chess, or crosswords. I am a member of the Dinosaur’s Club, an organisation for former politicians. It seems that those who aged most quickly are those who hadn’t found other interests and activities after retirement.

back to the top »