Healthy Aging & Dementia
We provide neuropsychological and psychological assessment, cognitive remediation, and psychotherapy to adults into the golden years.
At Toronto Brain Health we provide neuropsychological and psychological assessment, cognitive remediation, and psychotherapy to adults into the golden years. They are supposed to be golden right? But beginning in mid-life, many people start to wonder whether the changes they are experiencing with memory or other thinking abilities are normal or cause for concern.
By mid-life many of us are dealing with cumulative stress related to parenting, caring for aging parents who are not as spry or independent as they once were, career advancements, and lack of sleep due to counting to-dos or mortgage payments rather than sheep. Could your increasing inattention and forgetfulness be due to burnout, out-of-control worrying, or something worse? For others, things have wound down since mid-life, the kids have moved out, retirement is approaching, or you have recently retired, the house is paid off, and you might be contemplating your bucket list or that new vacation property. Why aren’t you picking up the routines in step class or how to use that new app as quickly as you should? You lose your words and occasionally names. But now, you forgot your grocery bags in the trunk of the car. Is this normal?
For those with older parents, you may be worried that your parent forgot the conversation over the weekend about picking up the kids from school today. You have noticed increased irritability and withdrawal during the conversation, and when you think about it, those word-finding difficulties you chalked up to being normal started 2 years ago. For others, it may be that your parent was recently diagnosed with dementia, or you have suspected dementia for some time. This comes with many changes, which can feel overwhelming. You may be experiencing changes in your identity, to your roles and responsibilities, or relationships with family and friends, all of which make you wish dementia came with an instruction manual. For others, you have been at this for a while and are experiencing caregiver burnout, which makes it difficult to find the strength to cope and keep it together. Hearing things like “you really should take better care of yourself” makes you want to cry at the grocery store checkout line, no less.
At Toronto Brain Health, we strive to help you understand whether the cognitive changes you or your family member are experiencing are part of normal aging, so you can relax and enjoy the years ahead or are something you need to be concerned about and plan for. In some cases, a consultation with a knowledgeable neuropsychologist is enough to set your mind at ease. In other cases, it might take a more detailed neuropsychological assessment to gain clarity. Some cognitive changes are reversible depending on their cause, while others could be due to a progressive neurological process or other medical condition. For those with a parent with dementia, we offer resources, guidance, and tools to cope. It’s a difficult road to travel, and you don’t have to do it alone.
FAQs about Healthy Aging and Dementia
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How do I improve my brain health and reduce my risk of dementia?
There are many things we can do to reduce our risk of developing dementia, even starting in mid-life or later. In fact, there is a large and growing body of research on this topic. Through research, we have learned that staying physically active is important to slowing down decline and even improving cognition. The mechanisms by which exercise can be beneficial to brain health are many but can include improving cardiovascular disease and stimulating brain protein production important for growth of nerve/ brain cells and in sustaining them. Advanced education, being a lifelong learner and having an intellectually stimulating career are protective agents against developing dementia as is social engagement. The Mediterranean diet, rich in fruit, vegetables, legumes, whole grains and fish, has been associated with lower incidence of cognitive decline and dementia. Numerous well-designed studies have shown positive effects of diets low in saturated fats on cognition, even showing improvement in as little as 4 weeks.
READ: Dr. Carson’s article for a list of tips on maintaining brain health.
What are normal age-related memory changes?
It is well established that memory changes as we age. While memory is commonly understood as a single ability; you either have a good memory or you don’t; we now know that there are several memory systems or processes in the brain. These memory systems are supported by partially independent brain networks which, here is the good news, are not equally affected by age.
Age-related memory changes:
It is well established that episodic memory and working memory decline with age. Age-related changes are most pronounced in episodic memory.
Episodic memory
- Memory for events or details specific to a time and place.
- Episodic memory supports efficient learning of new information (such as one-trial learning), recalling who told you something (source memory), and remembering details of a specific event (episodic autobiographical memory).
- Episodic memory also supports prospective memory or remembering future intentions. Prospective memory involves recalling what you intended to do (episodic memory component) and retrieving the intention at the right moment (the prospective component).
Normal age-related changes in episodic memory can include recalling fewer details about a recent event, reduced learning efficiency for new material (taking more repetitions to learn) or forgetting intentions.
Working memory
- Working memory involves retaining and manipulating or working through information in mind for the purpose of completing a task or while working toward completing a goal.
- Examples of working memory include holding directions in mind until you reach your destination or keeping the name of someone you just met in mind during your conversation with them.
Normal age-related changes in working memory can include reduced efficiency in holding information in mind while thinking through a problem or while planning a task. Or forgetting the name of someone you were just introduced to while speaking with them.
Memory abilities preserved with age include:
There are also several memory systems or processes that are relatively well preserved with age or at least until very advanced years.
Procedural memory
- Memory for well-learned physical or cognitive sequences, routines or tasks.
- Examples include swimming, playing golf, cooking routine dishes or making an espresso, assuming you are well-practiced in these skills.
Semantic memory
- Memory for knowledge about the world or oneself, often used facts and vocabulary.
- The proverb, “with age comes wisdom”, turns out to be true.
Primary memory
- Basic attention span, such as holding a phone number in mind or a list of items.
If you have any concerns about whether your memory changes are normal or not, contact us to set up a consultation.
Assessment
- Initial consultation for memory or other cognitive concerns.
- Initial consultation and treatment plan for psychological concerns about low mood, anxiety, work or life stress, life transitions, loss, trauma, chronic pain, or a desire to pursue personal growth.
- Neuropsychological assessment to clarify normal age-related cognitive changes or assist you or your medical team in the diagnosis or ruling out of a potential neurodegenerative process.
- Psychological assessment in cases where a comprehensive evaluation is needed beyond that which we provide during initial consultation and psychological therapy.
Psychotherapy and cognitive interventions
- Psychotherapy for depression, anxiety, insomnia, trauma, life transitions, work stress, grief, post-retirement stress, chronic pain, and other personal challenges.
- Cognitive remediation and support for older workers who want to up their game or maintain their edge.
- Cognitive remediation and psychotherapy for people living with dementia.
- Psychotherapy and support for partners and adult children of someone living with dementia.