forgetfulness & old age

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06/06/22 06/06/22 1 Senior Citizens & Senior Citizens & forgetfulness forgetfulness Dr. Dhananjay D. Dr. Dhananjay D. Gambhire Gambhire MD (Psychiatry) DPM MD (Psychiatry) DPM Consultant Psychiatrist Consultant Psychiatrist

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This is a presentation by Dr.Dhanamjay Gambhire on Forgetfulness & Old Age.

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Page 1: Forgetfulness & Old Age

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Senior Citizens & forgetfulnessSenior Citizens & forgetfulness

Dr. Dhananjay D. GambhireDr. Dhananjay D. Gambhire MD (Psychiatry) DPMMD (Psychiatry) DPM

Consultant PsychiatristConsultant Psychiatrist

Page 2: Forgetfulness & Old Age

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Phase of life cycle Phase of life cycle characterized by characterized by developmental developmental issues, loss of issues, loss of physical agility, physical agility, mental acuity, friends mental acuity, friends and loved ones, and loved ones, status and power.status and power.

Old age is not a Old age is not a diseasedisease

Old age not numbers-Old age not numbers-mind setmind set

>65>65

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MemoryMemory

Immediate-e.g.. Repeating wordsImmediate-e.g.. Repeating words

Recent-e.g.FoodRecent-e.g.Food

Remote-Declarative-Semantic e.g. NameRemote-Declarative-Semantic e.g. Name

Episodic e.g. life eventEpisodic e.g. life event

Nondeclarative-ProcedureNondeclarative-Procedure

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In the past, doctors dismissed memory In the past, doctors dismissed memory loss, confusion, or similar behaviors as a loss, confusion, or similar behaviors as a normal part of aging. normal part of aging.

However, scientists now know that most However, scientists now know that most people remain alert and capable as they people remain alert and capable as they age age

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Some longitudinal Some longitudinal studies have studies have demonstrated a rather demonstrated a rather high stability of high stability of intelligence during intelligence during aging aging

World leaders are World leaders are usually 60+usually 60+

Most of the rich Most of the rich people & owners are people & owners are 60+60+

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Components of IntelligenceComponents of Intelligence Visuospatial skills. Visuospatial skills. Language.Language. Judgment or reasoning.Judgment or reasoning. Sequence.Sequence. Community affairs.Community affairs. Home.Home. Hobbies.Hobbies. Personal care.Personal care. MemoryMemory

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Age associated forgetfullnessAge associated forgetfullness

Simple lapses in memorySimple lapses in memory Forgetting the name of a Forgetting the name of a

person just met.person just met. Not finding the right word Not finding the right word

or expression while or expression while communicatingcommunicating

Taking more time to learn Taking more time to learn a new thingsa new things

Taking longer time to react Taking longer time to react or respond or respond

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General General populationpopulation

Age >65 yrsAge >65 yrs

Psychiatric Psychiatric conditionsconditions

10 %10 % 25 %25 %

ForgetfulnessForgetfulness 5 %5 % 20 %20 %

DepressionDepression 12 %12 % 15 %15 %

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Mild cognitive impairmentMild cognitive impairment

impairment in one a more cognitive domain impairment in one a more cognitive domain (typically memory), or an overall mild decline (typically memory), or an overall mild decline across all cognitive abilities that is greater than across all cognitive abilities that is greater than would be expected for individual age or would be expected for individual age or education but insufficient to interfere with social education but insufficient to interfere with social and occupational functioning as is required for a and occupational functioning as is required for a dementia syndrome .dementia syndrome .

Rate of conversion to dementia Rate of conversion to dementia

1 to 2 % to 10 to 15 %1 to 2 % to 10 to 15 %

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DementiaDementia

The term dementia The term dementia describes a group of describes a group of symptoms that usually symptoms that usually are caused by changes in are caused by changes in the normal activity of very the normal activity of very sensitive brain cells. sensitive brain cells. Dementia seriously Dementia seriously interferes with a person's interferes with a person's ability to carry out daily ability to carry out daily activities.activities.

3% at 60 yrs 3% at 60 yrs 40% at 80 yrs 40% at 80 yrs

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Dementia is irreversible - it cannot be Dementia is irreversible - it cannot be cured. However, there are many cured. However, there are many conditions with symptoms that seem like conditions with symptoms that seem like dementia but aren't. dementia but aren't.

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These reversible conditionsThese reversible conditions

Anxiety or Depression.Anxiety or Depression. High fever.High fever. Poor nutrition.Poor nutrition. Bad reaction to a medicine Bad reaction to a medicine Minor head injury. Minor head injury. Medical problems.Medical problems. Medication.Medication.

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Medications that can induce Medications that can induce depression &forgetfulnessdepression &forgetfulness

Steroids Steroids Painkillers Painkillers Hormones Hormones Arthritis medication Arthritis medication High blood pressure drugs High blood pressure drugs Heart disease medication Heart disease medication Tranquilizers Tranquilizers Cancer drugs  Cancer drugs 

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Tests for memoryTests for memory

Mini mental status evaluationMini mental status evaluation Consortium to establish registry in Consortium to establish registry in

dementiadementia Global deterioration scaleGlobal deterioration scale LanguageLanguage Learning and memoryLearning and memory Executive functioningExecutive functioning

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Causes of depressionCauses of depression

Loneliness and Loneliness and isolation – Living isolation – Living alone; a dwindling alone; a dwindling social circle due to social circle due to deaths or relocation; deaths or relocation; decreased mobility decreased mobility due to illness or loss due to illness or loss of driving privileges. of driving privileges.

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Reduced sense of Reduced sense of purpose - Feelings of purpose - Feelings of purposelessness or loss purposelessness or loss of identity due to of identity due to retirement or physical retirement or physical limitations on activities. limitations on activities.

Health problems – Illness Health problems – Illness and disability; chronic or and disability; chronic or severe pain; cognitive severe pain; cognitive decline; damage to body decline; damage to body image due to surgery or image due to surgery or disease. disease.

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Fears – Fear of death Fears – Fear of death or dying; anxiety over or dying; anxiety over financial problems or financial problems or health issues. health issues.

Recent bereavement Recent bereavement - The death of friends, - The death of friends, family members, and family members, and pets; the loss of a pets; the loss of a spouse or partner spouse or partner

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Symptoms of depressionSymptoms of depression

Unexplained or aggravated aches and pains Unexplained or aggravated aches and pains Hopelessness Hopelessness Helplessness Helplessness Anxiety and worries Anxiety and worries Memory problems Memory problems Loss of feeling of pleasure Loss of feeling of pleasure Slowed movement Slowed movement Irritability Irritability Lack of interest in personal care (skipping meals, Lack of interest in personal care (skipping meals,

forgetting medications, neglecting personal hygiene) forgetting medications, neglecting personal hygiene)

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Investigations in depressionInvestigations in depression

Routine blood investigationsRoutine blood investigations Hormonal imbalances Hormonal imbalances Thyroid problems Thyroid problems Vitamin B12 deficiency Vitamin B12 deficiency Other nutritional deficiencies Other nutritional deficiencies Electrolyte imbalances or dehydration Electrolyte imbalances or dehydration CT ScanCT Scan

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TreatmentTreatment

Getting out in to the Getting out in to the world – Try not to stay world – Try not to stay cooped up at home all cooped up at home all day. Go to the park, day. Go to the park, take a trip to the take a trip to the hairdresser, or have hairdresser, or have lunch with a friend. lunch with a friend.

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Connecting to others – Connecting to others – Limit the time you’re Limit the time you’re alone. If you can’t get out alone. If you can’t get out to socialize, invite loved to socialize, invite loved ones to visit you, or keep ones to visit you, or keep in touch over the phone in touch over the phone or email. or email.

Volunteering your time – Volunteering your time – Helping others is one of Helping others is one of the best ways to feel the best ways to feel better about yourself and better about yourself and regain perspective. regain perspective.

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Taking care of a pet – Taking care of a pet – Get a pet to keep you Get a pet to keep you company. company.

Participating in Participating in activities you enjoy - activities you enjoy - Pursue whatever Pursue whatever hobbies or pastimes hobbies or pastimes bring or used to bring bring or used to bring you joyyou joy

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Learning a new skill – Learning a new skill – Pick something that Pick something that you’ve always wanted you’ve always wanted to learn, or that to learn, or that sparks your sparks your imagination and imagination and creativity.creativity.

Write an Write an autobiography autobiography

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Enjoying jokes and Enjoying jokes and stories – Laughter stories – Laughter provides a mood provides a mood boost, so swap boost, so swap humorous stories and humorous stories and jokes with your loved jokes with your loved ones, watch a ones, watch a comedy, or read a comedy, or read a funny book.funny book.

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Maintaining a healthy diet – Avoid eating Maintaining a healthy diet – Avoid eating too much sugar and junk food. Choose too much sugar and junk food. Choose healthy foods that provide nourishment healthy foods that provide nourishment and energy. and energy.

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Exercising - Even if Exercising - Even if you’re ill, frail, or you’re ill, frail, or disabled, there are disabled, there are many safe exercises many safe exercises you can do to build you can do to build your strength and your strength and boost your mood—boost your mood—even from a chair or even from a chair or wheelchairwheelchair

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maintain daily routines.maintain daily routines. Diary writing.Diary writing. Hourly writingHourly writing RevisingRevising High mental activity.High mental activity. CardsCards SodokuSodoku AntakshariAntakshari

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Always make a point to remember Always make a point to remember things.things.

Even if it is something you do not have to Even if it is something you do not have to memorize.memorize.

Read-Write-Repeat do it anyways. Read-Write-Repeat do it anyways.

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