That senior moment

IT'S a quaint term used to describe that moment when you're eloquently explaining a point to an audience of about a thousand people and then suddenly, you can't remember what you wanted to say next. It happens to all of us, even when we're in our 20s and 30s, but in midlife, we can now excuse ourselves by saying, "I'm sorry but I'm having a senior moment." Sometimes we're able to move on, and sometimes, the senior moment turns into eternity, and we panic.

The terms we use to refer to forgetfulness can be quite cruel. In Filipino, "ulyanin" has negative connotations, almost equivalent to saying "old fool." In Minnan (Hokkien), spoken by local ethnic Chinese, people will use the term "lao gong" -- lao meaning "old" and gong meaning "stupid."

It hasn't helped as mass media pick up on the findings around Alzheimer's disease, which seem to create even more anxiety for older people. Pinoy-style, we've turned the disease into a verb. Instead of saying "I have a senior moment," we go, "Ay, parang nag-a-Alzheimer's ako (I think I'm getting Alzheimer's)."

Actually, my choice of today's topic was sparked by a health feature I heard last week on radio, which attempted to explain forgetfulness, dementia and Alzheimer's disease -- all in three minutes. The result was a rather confusing and alarming discussion. (There was a mildly amusing ending though, when a radio commentator butted in and asked if perhaps the President was suffering from one of those disorders, what with all her flip-flops.)

We need to distinguish the various problems we have with memory. All of us get memory lapses even in our youth, as changes in our brain bring about a decline in our cognitive functions. It's not just the memory that's affected but our ability to learn new tasks, as well as our thinking and judgment processes.

If you want to be fancy about those senior moments, you can explain you're suffering from "benign senescent forgetfulness" or "age-associated memory impairment." As the terms imply, these are not serious problems.

Forgetfulness becomes serious when we can't recall entire events, and when our daily activities are affected. The medical people refer to this more serious disorder as dementia, a term I hope will be changed eventually because it has such negative connotations.

People tend to think dementia is a sign of Alzheimer's. This is only partly correct. Dementia can result from other problems, including a stroke and Parkinson's disease. An older person's dementia may also be caused by depression. Treat the depression and the dementia will be resolved, although note that if certain tranquillizers are used, these pills can themselves be a cause of dementia.

Dementia and Alzheimer's are not inevitable problems that come with old age. The chances of getting these conditions depend on a combination of genes, lifestyles and environment. The latest edition of Merck's Medical Manual says that dementia affects about 6 to 8 percent of people aged 65 or older. Among those who are 85 or older, the prevalence increases to about 30 percent. Merck states categorically, "dementia is never a normal part of aging," noting that even among centenarians, "more than 50 percent" will not have dementia.

Those figures are for the United States. I recently talked with Prof. Grace Cruz of the UP Population Institute, who is coordinating a survey of older people, and she assures me they've included some tests in the survey to look at how our senior citizens are functioning, physically and mentally.

While we're waiting for those figures though, we should draw consolation from the fact that all around us, in our families and communities, there are senior citizens who function very well, sometimes even with serious memory problems.

It's important to be reassuring when older people have their senior moments, whether from simple forgetfulness or from more serious dementia. Give them time as they fumble in their bags for their keys. It never helps to nag, "Look at you. Your memory is so bad."

But it does help, I feel, to find the correct "moment" to sit with them and point out that we're all getting older and that as our memory begins to fail, we need to take measures to avoid potential problems. With older women, for example, this might mean something as simple as sticking to one large wallet to keep credit cards, cash and keys.

Go through the house with the elderly and help to clear the clutter. Older people can get really worked up when they can't find something they need. This is especially the case with glasses, because they can't get on with the day's activities. Quite often, it turns out the glasses were on the bed, but "disappeared" because it blended into the dark-colored bedcover. Solution? Change the bedcovers to ones with light colors.

There are two keys to creating a "cognitive-friendly" environment. First is familiarity--memory problems are often amplified simply because the older person is in a new environment, whether because they're on vacation in a new place, or because the furniture at home has been rearranged.

The second key is safety. Again, walk through the house with older relatives to figure out where to post reminders, for example, a sheet of paper next to a phone with the most important numbers in large bold letters, or a sign next to a stove: "Turn off the gas after using." Since older people often have several medicines to take, it's always useful getting them a pill case with seven separate divisions, each to carry all the medicines to be taken in one day.

Are there "drugs" to reduce memory impairment? The jury's still out with gingko biloba; many studies say it helps, but there are also some researchers who say gingko's a placebo.

But even while the debates continue over gingko, we should note that many studies do show that keeping mentally active can delay or slow down dementia. That can be reading and writing, as well as simply interacting with friends and relatives. Love, care and companionship can make the senior moments a minor annoyance in the golden years.

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