John Gale introduced his daughter Reagan Gale whose topic was about changes in thinking as we age.
Reagan received her PhD from the University of Windsor with a focus in Clinical Neuropsychology. She is the founding president of the Psychological Society of the Yukon and President-Elect of the College of Alberta Psychologists. Reagan is the Director of Clinical Psychology for the Yukon Department of Health and Social Services, where she has been formally recognized as one of the emerging leaders within the public service. She has practiced privately providing neuropsychological, psychological, and psycho-vocational assessment in Whitehorse. Reagan’s practice focuses largely on the areas of aging, cognition, and brain injury.
Reagan was a Rotary Exchange student to the Philippines, hosted by the Rotary Club of Kingston and the Islands, and is a current member of the Rotary Club of Whitehorse. She has two young sons, a highly neurotic dog, and enjoys running (slowly) in her spare time.
“Forget About It”
As we age, some things slow down and some things become stronger, and it’s normal for thinking to change as we get older. Cognitive processing slows and reaction time slows. Speech is harder to hear and understand. Novel problems are harder to solve, and there are small changes in working, or short-term memory. Most older adults believe that memory will decline with age, so are primed for it and look for it. The use of memory strategies can improve our ability to learn and remember new information. Examples of strategies are writing lists, and using phone reminders about things to do.
Some things improve with age, like memory for words and concepts. Emotion and logic are integrated in our reasoning. Older adults have an increased acceptance of ambiguity and uncertainty. Unexpected and challenging changes would be in thinking, social behaviour, personality and self care. Some changes do merit attention. It’s normal to forget names of people, but forgetting names of close family and friends or recent events, and asking for the same information over and over is not. It’s normal to misplace items but putting objects in unusual places, such as putting keys in the microwave are concerning.
It can be normal to pick up a pill bottle and wonder, “Did I already take this?” Unfortunately, although this is normal, some older adults worry that this is a sign of dementia. Everyone has memory lapses and it’s usually unnecessary to worry about it.
It would be abnormal if one is very confused and not just slower. It is normal to find multitasking more difficult but it’s not normal if it is really hard to concentrate and pay attention. It’s normal to make a bad decision sometimes, but not normal to frequently show poor judgment in dealing with money or assessing risk. Everyone makes occasional mistakes in dealing with their own finances, but not normal if a person can’t keep track of monthly bills.
Regarding language, it’s normal to have difficulty finding a word, but not normal if this is frequent or if someone begins to refer to really common objects as “that thing”. It’s normal to lose the thread of a conversation especially if distracted or if many are speaking at the same time. To regularly lose the thread of what someone is saying is not.
Stress can increase these challenges. We tend to remember things that we pay attention to. You can’t remember what you didn’t learn, or in other words put into your memory, if your attention is elsewhere at the time. Low mood and high anxiety both impair memory and if that is the case, these should be addressed.
Usually people don’t have a problem with orientation (that is knowing who, where and when you are). It is not normal to lose track of the date, the season or the passage of time. Getting lost or not knowing where you are in a familiar place is troubling.
Most adults do not get dementia, but many people worry about it, and this can lead to thinking that normal lapses are a symptom. Depression related cognitive dysfunction leads to a quicker onset of dementia, whereas it could otherwise take as much as fifteen years. Vagueness, memory loss and slowed speech can be a sign of dementia and these can go into remission with effective treatments.
Adults today are under pressure to age perfectly. You are told that if you just do enough to keep fit, eat a healthy diet, and do things to stimulate cognition, you can do this. There is an industry in selling products to look young and this is especially aimed at women. You cannot prevent normal changes, but you can learn to be gentle with yourself and have fun.
Q&A:
There is some truth in crosswords and similar pursuits being helpful. What can be more protective is doing NEW things that are both cognitive and physical, such as learning to play a new musical instrument. It is important to maintain social relationships. This can be a challenge in retirement, and you need to be intentional. Rotary can play an important role.
Is a decline as the day progresses a sign of impending dementia? No. It could just be normal fatigue. In dementia there is a term “sundowning”. Many people with dementia evidence increased agitation and confusion as the day progresses.
If anyone would like to ask Reagan a question, she would be available by email at reagan.gale@gmail.com.
Heather Nogrady offered our thanks, and as a loaf of bread was out of the question, Reagan said she would go and make herself some toast and peanut butter for breakfast.
Reagan's presentation can be viewed at https://portal.clubrunner.ca/1091/Documents/en-us/1363f16e-bd43-4853-975b-66ad1cce1ac7/1/