Scientist, yogi and author Lisa Genova, who wrote Still Alice, shares some encouraging words for brain health. While we can’t change our genes or prevent aging (yet!), restorative sleep is “like a power cleanse for the brain,” as is regular exercise and good nutrition.

These are basics we’ve heard for years, of course. But putting them into practice is something many people may not take seriously until they’re old enough for a reverse mortgage. A witty 93-year-old TEDx presenter suggests bodybuilding in old age is a great idea for precisely this reason. And if you start in your youth, you might be as limber as this incredible gymnast at 91!

Before It’s Clinical

However, the amyloid plaque that leads to Alzheimer’s disease begins accumulating in our brains 15-20 years before clinical symptoms appear. So keeping our brains healthy needs to begin in early middle age, if not sooner.

Here are some of the myriad posts in which we’ve discussed dementia, memory care, and brain health:

Medication — Or Meditation? Om-ing our way to mental health.

50th Birthday Reset: When medications block new brain cell formation, depression and pain remain.

I Knew You Looked Familiar: Traumatic brain injuries (TBI) can mimic Alzheimer’s.

Thanks for the Memories: Creative ways to keep our brains bright.

Women in their sixties are more than twice as likely to develop Alzheimer’s over the course of their lives as they are to develop breast cancer. And with the onset of mild cognitive impairment, women’s cognitive decline is twice as fast men’s. Alzheimer’s activist Maria Shriver asks, “Why aren’t more people interested in this? This is the biggest health crisis in the world… It bankrupts families faster than any other disease.”

All of which is good reason to make every effort to protect our aging brains. But there’s a larger issue that is often overlooked: misdiagnosis.

Dementia Masquerade

How easy is it to assume an older person has dementia, when it might actually be a vitamin or mineral deficiency? Absorption of nutrients declines with age. An elder exhibiting cognitive impairment may need B12 injections, more sun exposure (Vitamin D) or other nutrients. In such cases, “dementia” is reversible once the problem is properly diagnosed and remedied.

A serious health issue could also compromise a senior’s mental acuity: in her final months, my mother was not the woman I knew, although strangers (even the doctors unfamiliar with who and how she had been) did not detect it. Congestive heart failure, a series of falls, and a medication cocktail combined to alter her brain chemistry and function. She wasn’t as mentally sharp as she had been. But it was not dementia.

Similarly, in an elderly person the symptoms of a urinary tract infection can express as brain fog/confusion, which can lead to an erroneous dementia diagnosis — and a painful, untreated bladder infection.

Medication (such as chemotherapy) that blocks the formation of new brain cells can keep a person depressed and in pain, which can seem like a slide into dementia. This can become a causal circle: loss and loneliness tend to increase with age. Loneliness, and the lack of mental stimulation and emotional connection, increases the risk of heart disease and other physical and mental health problems. The result can be depression, and later dementia, if family members or caregivers are not paying close attention.

Finally, Parkinson’s disease, a long-term degenerative disorder of the central nervous system, can cause dementia symptoms. While dementia only becomes widespread in advanced stages of Parkinson’s, depression and anxiety are more common complications, and can escalate mental decline.

Inquiry Can Save An Elder’s Sanity

At the library recently, an older gentleman seated in the new book browsing area smiled at me as I turned from the shelves. He was beaming, so I stopped to ask, “What is it?” He replied, “I’m an artist, and I was sketching your form in my mind as you browsed the books.” He tapped his head, “It’s all up here.” Deeply moved, I took his hand and told him, “That’s one of the sweetest compliments anyone’s ever given me. What’s your name?” He told me his name, and just as we were getting into a conversation, a young woman rushed over and said, “Don’t tell her your Social Security number!”

Nonplussed, I thanked him again and turned to leave. After checking out my books, I saw the woman (out of his line of vision), beckoned her over and asked, “Are you his caregiver? When she said yes, her concern suddenly made sense. I asked, “Does he have dementia”? She said, “Yes, it’s in the early stages.” I told her our conversation had seemed perfectly normal, and that the only reason he was talking to me at all was because I initiated it. She said, “Well, a week ago he met another veteran and invited him over to the house; he told him his address!” Which struck me as reasonable behavior for someone — especially an older man — who was excited to make a new friend.

I cautioned her about being too quick to assume it’s dementia, and said I hoped his daughter, with whom he lives, had consulted a geriatrician (a physician who specializes in elder care). The 37-year-old caregiver no doubt saw this 86-year-old as elderly and infirm. But at my present life stage (and having had a lifelong friend live to 101), he didn’t strike me as particularly “old” — and certainly not addled.

Whenever possible, make sure your HECM clients’ family members are cognizant of the dementia impersonators that could be lurking in an older loved one’s life. By educating themselves, they may be able to restore a senior’s mental health — and maintain everyone’s sanity.

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