Magdalena Bednarczyk, MD
Magdalena Bednarczyk, MD, Division Chief of Geriatric Medicine and Palliative Medicine and associate professor in the department of internal medicine at RUSH University Medical Center in Chicago.
Steps you take today can help keep your mind sharp.
Even though forgetfulness is not a normal consequence of getting older, sometimes it’s hard for people of any age to keep dozens of details straight in their mind. Steps you take today can help keep your mind sharp.
1. Free up your brain. Use technology to set reminders and keep track of everyday tasks, stay more organized, and make handling chores as simplified and streamlined as possible, like keeping a running shopping list on your cell phone so it’s sure to be with you when you get to the store. Whether you ask Siri (a feature on iPhone and Apple computers) or Alexa (an artificial intelligence device available through Amazon.com) to ping you at certain times of the day or set alarms on your phone, these are strategies used by highly functional individuals with no short-term memory issues, so you can tap into them without feeling any stigma. It’s no different than setting up bill payment alerts or getting reminders about doctor appointments.
2. Pick one place to store things. Who doesn’t on occasion forget where they left their keys or put down their glasses? Yet these are precisely the kinds of memory blips that make people very nervous about their brain health. Develop a simple routine: Pick one place to drop off your things when you come home, and make it the same place you leave your glasses after reading the morning paper. A handy innovation is using Apple air tags or Tile devices on your keychain or in your purse to locate them easily. Also consider this old-school tip: Thumbtack a checklist to the door you use when going out. It should detail all your must-haves, such as keys, cell phone, umbrella, water bottle, sunglasses, and medication if needed, and review it before you leave the house.
3. Protect your microbiome. The gut-brain connection is a complex pathway that relays messages from your digestive system to your brain.We know from research that it’s important to have a healthy microbiome for a healthy brain. Boost the bacterial diversity in your GI tract by increasing the amount of fiber and fermented foods (think pickles and kefir) in your diet. Aim for a wide variety of fruits, vegetables, legumes, and whole grains.
4. Stop attempting to multitask. Studies have found that multitasking is not possible because the brain really can’t do two things well at once. Focus on and finish your most important task, then move on to the next one.
5. Exercise your body to indirectly exercise your brain. There are data showing that physically active people enjoy cognitive- and heart-health protection. Physical and mental fitness are linked. Throughout the day, break up sedentary behavior with little chunks of movement. Take regular five-minute breaks to walk if you’re at a desk for long stretches. Walking outside, especially in nature, brings extra brain boosts. If you’re watching a movie or series on TV at home, pause it periodically and move around. Your body benefits from a variety of activities, from cardio to balance work. Think of movement as medicine: It improves overall health and mobility. Mobility is linked to being able to do all the things that can improve cognitive health.
6. Challenge your brain. Cognitively challenge your brain by introducing a variety of new activities. Learning new skills, taking up a new hobby or game, and being social are all activities that get your brain out of its comfort zone and prompt it to work differently. There are countries in Europe that have universities just for seniors, where they can enroll and learn a language or take drama classes, to name only two options.
The best part is that there’s no one app or activity that’s better than another. Doing puzzles, for instance, doesn’t have a lock on helping you maintain memory. It’s the variety of the experiences that exercises the brain’s cognitive plasticity, the ability of its networks to change through growth at any age.
7. Boost focus with quality sleep. Many people find it hard to get a good night’s sleep as they get older—the very time of life when it’s extra important. Be sure you’re practicing all the good sleep hygiene habits you’ve read about in these pages, like turning off gadgets at least an hour before bed and keeping your bedroom cool and dark.
Also keep in mind that the rebound effects of alcohol tend to worsen as you get older, interfering with restorative sleep even more than in your youth. Even a glass of wine in the evening can alter your sleep-wake cycle.
If there’s a possibility that you could have undiagnosed or untreated sleep apnea, get it attended to. Apart from the other consequences of sleep apnea, losing sleep at night affects your ability to function during the day, including your level of concentration, clarity of thought, and recall of recent information.
Ask your doctor or pharmacist to evaluate all your meds—not only prescription drugs, but also over-the-counter products. Advancing age can cause you to become sensitive to medications that didn’t bother you before. Having your meds reviewed and eliminating any that you may not need can be helpful. In particular, drugs that are anticholinergic can interfere with memory because they block acetylcholine, a chemical that transmits messages in the nervous system and is involved with memory. Some antidepressants, overactive bladder drugs, and Parkinson’s medications are in this class. So is Benadryl and its generic diphenhydramine. Many people use it to help them sleep because it causes drowsiness, but it can also cause confusion, so it’s not a practical solution for better sleep.
8. Beware of supplements. Commercials are filled with real-person testimonials about their results, but the truth is that there’s no hard evidence that they’re helpful. Put that money toward that new hobby.
9. Plan post-hospital recovery. Being in the hospital is essential to correct a serious health problem, but your older body isn’t as resilient as it used to be. It takes more time than it used to just to get back to your baseline, so allow yourself as long of a healing period as you need. If you become as cognitively fit as you can before an illness lands you in the hospital, the smoother your recovery will be.
10. Ask about a cognitive test. Even a cognitively sharp person may, in a moment of absentmindedness, misplace things. If it happens to you once or twice, there’s probably no need to panic, but if it becomes a pattern, consider discussing your cognitive health with your physician. Don’t write off repeated forgetfulness as normal aging. That denies you the opportunity for an early evaluation, potential interventions, and starting conversations about planning for the future before there’s a crisis, when your options may be more limited.
There are multiple screening tests that aim to capture cognitive changes that signal mild cognitive impairment (MCI) or early-stage dementia, which is now being called major neurocognitive disorder. If the test is normal, you can feel reassured. If not, more thorough screening may be warranted. With MCI, you may have some short-term memory changes, but you still have overall functionality and the ability to live independently. A major neurocognitive disorder not only affects memory, but also has an impact on functionality.
Having MCI doesn’t mean that you’re automatically going to progress to a major neurocognitive disorder. Some people improve, some stay in the MCI stage indefinitely, and some will worsen over time.