1. Asking the same question over and over again.
2. Repeating the same story, word for word, again and again.
3. Forgetting how to cook, how to make repairs, how to play cards, or other activities that were previously done with ease.
4. Losing the ability to pay bills or balance a checkbook.
5. Getting lost in familiar surroundings or misplacing household objects.
6. Neglecting to bathe, or wearing the same clothes over and over again, while insisting that they have taken a bath or that their clothes are still clean.
7. Relying on a spouse or others to make decisions or answer questions they previously would have handled themselves.
Source: www.nia.nih.gov/Alzheimers/Publications/sevensigns.htm.
Can you teach an old human new tricks?
"If people aren't challenging themselves because they believe that they're past their prime at learning new skills, they're completely wrong," says Michael Marsiske, associate professor of clinical and health psychology at the University of Florida in Gainesville.
In a study co-authored by Marsiske called ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly), seniors who were assigned to 10 training sessions performed better than those who got no training. And they still did better five years after the training ended. (22)
"Even in areas like memory, reasoning, and speed--which decline with age--people can experience substantial and long-lasting gains with a pretty small investment," says Marsiske. Here's how he described the ACTIVE study training to WebMD:
* Reasoning: Seniors learned to analyze new material and reach a conclusion about it. For example, they had to look at a series of letters like A, L, B, A, M, B, A and predict the next letter. By regrouping the series into triplets--A, L, B and A, M, B--it becomes clear that the letter between A and B is advancing alphabetically. So the letter following the final A must be N.
* Processing: Seniors sat at computer screens that flashed an image at them. As training advanced, the image became more and more complex, so the viewer had to take in more and more information at a single glance--a skill necessary for driving.
* Memory: Participants learned four strategies to improve verbal memory:
1. Make it meaningful. Link each item on a list to something that's meaningful to you. For example, if one word is "dog," link it to a memory of your favorite dog.
2. Organize. Organize items on a list into categories. For example, if "hamburger" and "chair" are on a list, put them into categories like "food" and "furniture." Remembering the categories will cue you to remember the items themselves.
3. Visualize. Create a detailed image of a word in your mind. Example: If the word is "dog," think of what a dog feels, looks, and smells like.
4. Associate. Link items on a list in a story. If the words on the list are "dog" and "apple," think of a dog biting an apple and spitting it out because he doesn't like it.
Can Marsiske recommend specific programs for older people who want similar training? "We're a few years from that," he replies.
Would ACTIVE training help younger people? It may not, says Marsiske, because "younger people don't have as much room to improve, especially in areas like memory."
However, there is something younger people can do to protect their future brainpower. "We know that people who have more education or more challenging and complex jobs enter late life at higher levels of mental functioning and may decline at a slower rate," says Marsiske. "Scientists call that building cognitive reserve."
It's not just school and jobs that make a difference. "The more you read widely, study heavily, and do challenging hobbies--everything from learning Web design to learning how to use a digital camera," he explains, "the more you challenge yourself mentally throughout adulthood." Then, once you start to decline, you've got more in the brain bank, just like someone who enters retirement with a bigger nest egg.
"If you've had an intellectually challenging lifestyle," says Marsiske, "you're declining from a higher level, so it takes longer to reach a threshold of functional loss." By Bonnie Liebman
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