Dementia is often portrayed as an inevitable consequence of ageing in our community. The media continues to emphasise abnormal and negative aspects of ageing, which has a powerful influence on society attitudes. We are regularly exposed to portrayals of public figures experiencing memory loss and dementia, and because more people than ever before are living into their eighties and nineties, we are now more likely to have first-hand experience of someone with dementia.
For many of us, the possibility of developing dementia is one of the greatest fears of growing old. After all, memory is self. Fortunately, dementia is not a part of normal ageing: less than 1 per cent of people under 65 have Alzheimer’s disease, and in the 65–75 age range the figure is still less than 5 per cent. The percentage does rise with increasing age—to around 11 per cent for those aged 80–84, and 18 per cent for those aged 85–89—but still, the vast majority of older adults do not develop dementia.1
The current outlook on memory and ageing
In the previous chapter, different memory processes were outlined. Only some of these have been shown to change as people get older. Some memory processes are found not to be affected at all, and some can improve, so the picture is certainly not one of dramatic, inevitable and accelerating decline.
For many people, changes in particular memory processes happen so gradually that they are not thought of as a problem. For others, the changes are only obvious in situations where they are required to push their memory abilities to the limit.
The bulk of past memory research involved stretching people’s memory to the utmost, and has resulted in an unnecessarily pessimistic view of the effect of old age on memory. Typical research compared the performance of young and old people on the same memory tests. Older people may have performed worse on testing, not because of their age, but due to comparative differences in their health, senses such as hearing, or level of education. Younger people could have been advantaged by familiarity with the type of tests used and the environment in which they were conducted. Moreover, many of the tests used measured speed of response, rather than actual memory ability. It is well known that younger people process information more rapidly than older people.2 They get new information into their storage files faster. We have all had the experience of observing how quickly five-year-olds learn how to use new technology! Finally, we should not forget that motivated older people can use life skills and adapt their learning by being very strategic (see Chapter 6), using their developed wisdom to manage effective learning.
Memory abilities at any age will be different for one person compared to another. At your book club you might notice that one person is able to remember all the details from a book they have just read, whereas another person might have difficulty recalling such details. There are many factors found to enhance this variability between people of the same age, and even in the same individual from day to day. These health, attitude and lifestyle factors will be discussed in Chapter 3.
Which memory processes change as we get older?
Research has described the effect of getting older on attention processes, the ability to get new information into storage, the time that it takes to learn new things, and the ‘tip of the tongue’ experience. It is often a combination of these changes, together with aspects of our health and the way we live our lives, that can make our memory more unreliable as we get older.
Attention
Research has shown that as we get older we can experience change in our ability to pay attention, and our ability to ignore distractions. These aspects of paying attention are part of ‘working memory’ as outlined in Chapter 1.
Some studies have shown that older people cannot focus attention on as much information at the same time as younger people. Furthermore, older people can find it difficult to shift their attention back and forth between two tasks.3 This may mean that it is harder to follow two conversations at the same time, or it may be more difficult to do several things at once—for instance, reading a book with music playing in the background and at the same time remembering not to let the casserole in the oven overcook.
Where did I put my phone? I may have three things on my mind—put the washing on, reply to that email and where is my phone? When I multi-task now I’m not as good as I was 10 years ago. I worry that my memory is going.
Jillian, 62
Older people have also been shown to have more difficulty resisting distraction.4 Distraction can be internal or external. A common internal distraction is when we are thinking about something else or registering pain, and find that we have let our mind wander. A common external distraction is the phone. You are busy doing something when your phone rings. You answer your phone, and later find it hard to remember what you were doing before the phone interrupted you.
I can’t remember what my friends tell me on the phone because they ring me when I’m at work and I’m distracted and feel interrupted.
Leona, 59
In these situations we have trouble getting new information into our storage files, because we are finding it harder to pay attention to it. Many ‘memory’ lapses are not so much memory, but attentional lapses.
Of course, changes in our senses with ageing can have an additional impact on our ability to focus attention.5 For example, if we have hearing or visual impairment, we allocate more attention to trying to hear or see incoming information. This means we have less attentional resources to dedicate to forming a memory of what is around us.6
My wife says I forget what she has told me. She might mention something once and if I don’t write it down, or she doesn’t remind me again, it might get lost. I wonder if my hearing problem has something to do with this. I sometimes find it hard to hear what she is saying, especially if there is background noise from the TV or radio.
Eric, 86
The ability to remember new things
As we have discussed in the previous chapter, remembering something new involves the processes of acquiring, storing and recalling. Research has shown that our acquiring and recalling processes can be affected as we get older.7
As we age, we have more difficulty on tests that involve remembering things that we have just seen or heard. Older people have been found to be less likely than younger people to use memory strategies, such as the way they organise their thinking, what they associate with information, or how they ‘see’ things in their mind, to help them to acquire or recall new information. The information may be stored, but unless it is well filed, it is hard to get at when needed. When you put a library book back on the wrong shelf, or the balsamic vinegar bottle in with the wine bottles, it is as good as missing.
Researchers have begun to ask why is it that many older people don’t spontaneously make use of strategies to help them remember new things. Could it be that older people were never taught to use these strategies? Many older people of today were taught to rely on rote learning, while school education has more recently focused on using meaning and association to remember. Or could it be that using such strategies is more difficult for older people because they are slower to process information or have more difficulty with ‘working memory’ processes? Information is often presented rapidly, and older people may need more time than when they were younger to organise it into the proper files in their filing system.
The time that it takes to remember things
Mastering something new takes more time as we age. Extra time may be required for practice and review in order to acquire new skills, such as speaking a new language, cooking a new recipe, or managing the intricacies of new technologies.
As a 56-year-old mature-age university student, I am noticing that I need to go over information many more times when preparing for exams than I did when I studied in my twenties.
Chan, 56
I am learning Japanese. I can learn the information, but it takes a lot longer than it would have taken me when I was younger. I have to put in more effort. I write organised notes and read over them several times. I can’t rely on memory; I ha
ve to rely on methodology. When I’m learning new words, I need to build bridges. Once the bridges are there, I can recall the information. For example, I spent hours trying to learn the word ‘kudasai’ in Japanese. It just wouldn’t come, every time I tried to recall it. So I associated it with the word ‘cuckoo’, and this gave me the first sound of the word. Now I can easily remember it.
Patrick, 71
When we get older it can take longer to get information out of the storage files, as well as into them.8 This is most evident when an immediate response to something is required. You might have difficulty recalling someone’s name when you meet them in the street, or you might draw a blank when someone asks you what you did last weekend, but you can often remember the information later. The impact of this slowing is not so obvious in responding to familiar or more routine requests for quick memory recall. If an activity is second nature, it can be performed without a great deal of mental effort and the ‘normal’ slowing associated with older age doesn’t affect it so much.
The ‘tip of the tongue’ experience
‘Memory is often not so much lost as hard to find.’9
Most of us have had the ‘tip of the tongue’ experience. We say, ‘What is that word … I know it, but I can’t recall it’, or, ‘What is that person’s name—I know it so well, but it won’t come to me.’ Whenever we want to remember something, we review the contents of the files in our filing cabinet. People of all ages can experience ‘blocking’—when a search for particular information is not successful.
I’m having a brain-freeze: I know it’s there, but it won’t come up!
Yanina, 54
A ‘tip of the tongue’ experience occurs when our search process gets close to the word or name, but we cannot ‘locate’ the file for it. The word that we want to say is typically a word we don’t use frequently. Difficulty finding a word is different to recalling something that we have just learned. It involves sorting through old storage files for a memory that has been there for a long time, and that we know very well is in there for us to find.
When I went to buy my meat at the butcher’s yesterday, I had a blank for the word ‘skewers’. I covered it up by asking for ‘the chicken on sticks’, and thankfully the butcher knew what I was talking about.
Steve, 73
Research has shown that we experience the ‘tip of the tongue’ problem more often as we get older.10 Some researchers suggest that this is because our storage files get larger as we get older and we have more information to search through. Names of people are a common example. Perhaps, after a lifetime of meeting people, it becomes more difficult to pluck out one particular name, especially if it is similar to many other names that we have stored in our files.
I wish my brain was as fast as my computer. I find that my brain’s ‘search engine’ is much slower now that I’m older.
Rico, 57
Another theory relates to the context that we are in when we are doing a memory search of our files. It is much easier to identify and name someone when we always see them in the same place or at predictable times. But we all know how difficult it can be to remember someone’s name when we meet up with them unexpectedly in a new context. As we get older, it seems we become more dependent on contextual cues.
I was at my local shopping centre last week and I walked past a woman who smiled at me and looked familiar but I couldn’t work out where I knew her from. Later I sifted through in my mind all the places where I meet people. Was it through work, through the kids? The next day it suddenly came to me: I had met her when my daughter was at primary school 15 years ago—her daughter’s name is Francesca and she is Fay!
Naya, 56
So as we get older our memory is influenced by our ability to attend, the context (the where and when), needing more time to process our files, and the ever increasing amount of information stored in our files (some of which we may not have organised very well!).
Which areas of memory will not be affected by age?
Research suggests our lifetime memories are less sensitive to the ageing process.11 The various forms of lifetime memories were described in the previous chapter: personal memories; information about your area of expertise at work or at home; memories of familiar places; memories of procedures such as riding a bike or playing a musical instrument; general knowledge and conceptual knowledge. We might not be able to recall some specific details, such as the exact dates of past memories, but in general our lifetime memories are very enduring. They also keep accumulating throughout our lives. We continue to broaden our knowledge through reading, socialising, listening to the radio, watching television or participating in education programs.
Our strong lifetime memories help to give us a sense of self and are part of what is often referred to as the wisdom that comes with getting older. The memories and stories of older adults are often highly valued contributions to family and community memory. In some cultures certain older people are assigned elder status, and their memories are accorded great respect. With age and increasing experience, older adults are often called on to mentor younger people as their expertise deepens. Many leaders are older adults, who draw on past experiences and learnings to resolve conflicts by seeing problems from multiple perspectives.
Many older adults take the time to write down their lifetime memories to ensure that the memories will not be lost, and will be passed on to others over time. Older people who spend a lot of time recalling past life experiences can be negatively judged by family and friends as ‘living in the past’. Yet some people use such reminiscences to work on ‘unfinished business’, which may often be emotive or painful. Reminiscence can also be therapeutic in a group setting, where older people share enduring memories of life experiences and are valued for their diverse range of experience. When we reminisce and bring our older memories back, we promote our sense of self and, in turn, we strengthen our sense of family and community.
Memory-wise ageing
It’s important to be positive about the many continued strengths we have in our memory processes as we get older, but at the same time we need to acknowledge that it is likely that we will experience some age-related changes in our memory. Our brain is like any other part of our body: it can change as we get older, and it can be hard to accept this change when it occurs. Alterations in the efficiency of our memory processes can give us a sense of loss and make us feel frustrated and sad at times. Just like any other aspect of ageing, we can be proactive, and work on ways to enhance brain health and memory as we get older. The importance of nurturing our memory through addressing aspects of our health, lifestyle and attitude is addressed in the following chapter. The latest findings on optimising brain health are described in Chapter 5, and practical everyday memory strategies to get the most out of memory are suggested in Chapters 6 and 7.
Key points HOW MEMORY CHANGES AS WE GET OLDER
• As we get older, we often notice changes in our memory.
• Dementia, such as Alzheimer’s disease, is not a part of normal ageing, and the vast majority of older adults will not develop dementia.
• Knowledge about how memory changes as we get older is a lot more positive than in the past. Memory change with healthy ageing doesn’t interfere with everyday life in a dramatic way.
• Everyone is different, and the effect on memory of getting older is different for each person.
• Memory researchers have described age-related changes in attention processes, acquiring and recalling new information, the time that it takes to learn new things, and the ‘tip of the tongue’ experience.
• Lifetime memories continue to accumulate as we get older, and our community benefits from the experience and wisdom of older adults.
CHAPTER 3
What else affects memory? Health, attitude, lifestyle
At any age, our memory abilities will be sensitive to what is going on in our lives. In this chapter, people’s stories will be used to illustrate the often complex interact
ion of physical and emotional factors that can affect memory. Some factors are beyond our control—for example, a stroke can cause permanent changes to our ability to remember. However, there are choices we can make, to do with our health, lifestyle and attitude towards remembering, that will help us get more out of our memory.
How ‘healthy’ your memory is depends quite a bit on how healthy you are. Many of us notice fluctuations in our ability to remember when we experience changes in our physical wellbeing—when we are hospitalised, after a general anaesthetic, or even when experiencing a severe cold.
We can find that our ability to remember is worse when we are experiencing emotional stresses; during menopause; during bereavement; or when we’re leading a very active social life combined with a heavy workload and complex relationships. Taking steps to deal with stress or excessive busyness can improve our remembering.
Our attitudes towards our memory are important. Negative expectations can become a self-fulfilling prophecy. If we think we have no control over our memory abilities, we may never take action.
The following four stories show how aspects of our health, lifestyle and attitude towards remembering can influence memory. Each story is followed by an analysis and some suggestions for action to enhance memory.
STORY 1 Barbara, 72
‘I panic when I forget something—I’m scared that I’ve got early signs of Alzheimer’s.’
I ended up in tears yesterday. I had dashed up to the local shopping centre in the morning to buy a present for my little grandson’s birthday party that afternoon. Of course, I had left it to the last minute, and I only had half an hour to buy the gift. As I parked the car, I was running through possible gift ideas in my head. I found a present fairly quickly, rushed back out to the car park, and realised straight away that I couldn’t remember where I had parked my car. I felt my heart beating in my chest and my hands started to shake. ‘Oh no!’ I thought, ‘Mum did this—I’m sure she did this too, at about the same age as me, and she ended up with dementia.’ I had to get home. I told myself to stop thinking about Mum and I did everything I could to calm myself down. I walked to all the usual places that I park my car, and eventually I found it.
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