• Home
  • Geriatrics Blog
    • Helping Older Parents Posts
  • Helping Older Parents
  • Podcast
  • Testimonials
  • About
    • About Better Health While Aging
    • About Leslie Kernisan, MD MPH
  • Courses & More

Better Health While Aging

Practical information for aging health & family caregivers

  • Getting Started
    • Why Geriatrics
    • Are you a caregiver?
    • How to use this site
  • Popular Topics
    • Preventing Falls in Aging Adults
    • Medication Safety
    • Dementia, including Alzheimer’s
    • Advance Care Planning & End-of-Life

Cognitive Impairment in Aging: 10 Common Causes & 10 Things the Doctor Should Check

by Leslie Kernisan, MD MPH 74 Comments

Have you been worried about an older person’s memory or thinking abilities?

Maybe your parent has seemed more confused recently. Or you may have noticed that your aging spouse is repeating herself, or struggling to do things that didn’t use to pose much of a problem.

These are very common concerns, and they often lead to questions such as:

  • Is this normal aging or something more significant?
  • What is wrong?
  • Could this be Alzheimer’s? Or some other form of dementia?
  • Can this be treated or reversed?
  • What should we do about this??

The answer to the last question is this: if you are worried about memory or thinking, then you should seek out some kind of medical evaluation.

That’s because when families worry about an older person’s cognitive abilities, there often are some underlying health issues affecting the mind’s function.

Those need to be detected, and treated if at all possible. So, you’ll need to request help from a health professional, and in this article, I’ll explain what that initial help should consist of. This way you’ll know what to expect, and what the doctor might ask you about.

Technically, these kinds of problems are called “cognitive impairment.” This is a broad term that means some kind of problem or difficulty with one’s memory, thinking, concentration, and other functions of the conscious brain, beyond what might be expected due to normal “cognitive aging.”

(For more on “cognitive aging” and what types of changes are considered normal aging, see this article: 6 Ways that Memory & Thinking Change with Normal Aging, & What to Do About This.)

Cognitive impairment — which is also called “cognitive decline” — can come on suddenly or gradually, and can be temporary or more permanent. It may or may not keep getting slowly worse; it all depends on the underlying cause or causes.

In this article, I’ll share with you the more common causes of cognitive impairment in older adults.

I’ll then share a list of 10 things that should generally be done, during a preliminary medical evaluation for cognitive decline in an older adult.

Common causes of cognitive impairment in older adults

[Read more…]

Filed Under: Aging health, Featured, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: dementia diagnosis, memory, mild cognitive impairment

6 Ways that Memory & Thinking Change with Normal Aging (& What to Do About This)

by Leslie Kernisan, MD MPH 71 Comments

brain changes with agingIt’s annoying but unfortunately true: most parts of the body work less well as one gets older and older.

This is even true of the brain, which is part of why it becomes more common to experience a “tip of the tongue” moment as one gets older.

Such age-related changes in how the brain manages memory, thinking, and other mental processes are called “cognitive aging.”

Understanding how aging changes cognition is important. It can help you understand what to anticipate when it comes to your own aging. It can also help families better understand the changes they’re noticing in an older person, and whether those are out of the ordinary or not.

Since I’ve often written about changes in thinking that are abnormal and concerning in older adults, I thought it might be helpful for me to write an article outlining what is normal and to be expected.

Specifically, I’ll cover:

  • How cognitive aging differs from other diseases and conditions that affect memory and thinking
  • 6 ways that memory and thinking change with aging
  • The difference between crystallized and fluid intelligence
  • How to tell cognitive aging apart from more worrisome changes
  • Practical takeaways and what you can do

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: brain health, memory

Financial Exploitation in Aging: What to Know & What to Do

by Leslie Kernisan, MD MPH 19 Comments

Here’s an upsetting situation that comes up a lot, and may have come up for you: is someone financially taking advantage of Mom or Dad?

It’s a pretty legitimate concern to have. To begin with, most people know that there are plenty of “scammers” out there, phoning or mailing older adults with deceptive information designed to hoodwink them out of some of their savings.

But there’s actually another form of exploitation that may be more common, and is often harder for families to address.

That would be exploitation perpetrated by a someone the older person knows and has a personal relationship with.

Sometimes the person suspected of exploitation is relatively new to the older person’s life, such as a new romantic interest, friend, or paid caregiver.

In other cases, family members become concerned that someone in the family – such as one of the older person’s children – is beginning to take financial advantage of things.

Exploitation in the context of personal relationships is often especially tricky for families to address. The older person may be quite attached to – or otherwise feel dependent on – the person that others perceive as suspicious or problematic. Or there may be concerns about stirring up family dramas and conflicts, by voicing concerns about a sibling or another relative.

People are often unsure of what exactly constitutes illegal activity, and what can be done if they are concerned about financial exploitation.

So in this article, I’ll cover the key things you should know, so that you can better evaluate and address a worrisome situation, should one arise.

Specifically, in this article I’ll explain: [Read more…]

Filed Under: Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: elder abuse, financial concerns, memory

Cerebral Small Vessel Disease:
What to Know & What to Do

by Leslie Kernisan, MD MPH

MRI brain small vessel ischemic disease
Signs of cerebral small vessel disease. From Inzitari et al, BMJ. 2009 Jul 6;339:b2477. doi: 10.1136/bmj.b2477

This article is about the most common aging brain problem that you may have never heard of.

While leading a fall prevention workshop, I mentioned that an older person’s walking and balance problems might well be related to the presence of “small vessel ischemic changes” in the brain, which are very common in aging adults.

This led to an immediate flurry of follow-up questions. What exactly are these changes, people wanted to know. And do they happen to every older adult?

Well, they don’t happen to every older person, but they do happen to the vast majority of them.  In fact, one study of older adults aged 60-90 found that 95% of them showed signs of these changes on brain MRI.

In other words, if your older parent ever gets an MRI of the head, he or she will probably show some signs of these changes.

So this is a condition that older adults and families should know about. Furthermore, these changes have been associated with problems of consequence to older adults, including:

  • Cognitive decline,
  • Problems with walking or balance,
  • Strokes,
  • Vascular dementia.

Now, perhaps the best technical term for what I’m referring to is “cerebral small vessel disease.” But many other synonyms are used by the medical community — especially in radiology reports. They include:

  • Small vessel ischemic disease
  • White matter disease
  • Periventricular white matter changes
  • Perivascular chronic ischemic white matter disease of aging
  • Chronic microvascular changes, chronic microvascular ischemic changes
  • White matter hyperintensities
  • Age-related white matter changes
  • Leukoaraiosis

In this post, I will explain what all older adults and their families should know about this extremely common condition related to the brain health of older adults.

In particular, I’ll address the following frequently asked questions:

  • What is cerebral small vessel disease (SVD)?
  • What are the symptoms of cerebral SVD?
  • What causes cerebral SVD?
  • How can cerebral SVD be treated or prevented?
  • Should you request an MRI if you’re concerned about cerebral SVD?

I will also address what you can do, if you are concerned about cerebral SVD for yourself or an older loved one.

[Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles Tagged With: alzheimer's, brain health, dementia, memory

Incompetence & Losing Capacity:
Answers to 7 FAQs

by Leslie Kernisan, MD MPH 92 Comments

Depositphotos_9669220_m-2015-brain-cogs-leaving-compressorHave you ever been concerned about an older relative who seems to be making bad decisions?

Perhaps your elderly father insists he has no difficulties driving, even though he’s gotten into some fender benders and you find yourself a bit uncomfortable when you ride in the car with him.

Or you’ve worried about your aging aunt giving an alarming amount of money to people who call her on the phone.

Or maybe it’s your older spouse, who has started refusing to take his medication, claiming that it’s poisoned because the neighbor is out to get him.

These situations are certainly concerning, and they often prompt families to ask me if they should be worried about an older adult becoming “incompetent.”

In response, I usually answer that we need to do at least two things: [Read more…]

Filed Under: Aging health, Geriatrics For Caregivers Blog, Helping Older Parents Articles, Managing relationships, Q&A Tagged With: capacity, dementia, memory

Next Page »

Yours Free: The Quick Start Guide to Checking Older Parents for Health & Safety Problems

Action Plan - Pencil and Checklist

Enter your email to download this free Quick Start Guide

Get The Guide Now »

No spam ever! We collect, use and process your data according to our Privacy Policy.

Popular Posts

4 Types of Brain-Slowing Medication to Avoid if You’re Worried About Memory

5 Top Causes of Sleep Problems in Aging, & Proven Ways to Treat Insomnia

Anemia in the Older Adult: 10 Common Causes & What to Ask

8 Things to Have the Doctor Check After an Aging Person Falls

Vitamin D: the Healthy Aging Dose (Plus Answers to 7 FAQs)

Understanding Laboratory Tests: 10 Commonly Used Blood Tests for Older Adults

5 Types of Medication Used to Treat Difficult Dementia Behaviors

Find It Here

Follow Better Health While Aging

  • Facebook
  • Twitter

Disclaimer

The material on this site, including any exchanges in the comments section of the blog, is for informational and educational purposes only.

Any comments Dr. Kernisan may make regarding an individual’s story or comments should not be construed as establishing a physician-patient relationship between Dr. Kernisan and a caregiver, or care recipient.

None of Dr. Kernisan’s website or group information should be considered a substitute for individualized medical assessment, diagnosis, or treatment.

Please see the full Disclaimer for more information.

Please also carefully read our Terms & Conditions of Use, before using this site.

Creative Commons License
This work by Leslie Kernisan MD & Better Health While Aging LLC is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at BetterHealthWhileAging.net.

Privacy Policy & Disclosures

Your privacy is very important to us. Your information will never be sold to anyone, whether you browse the site, sign up for email updates, or register for an event.

Pleae read our complete Privacy Policy for more information and for Dr. Kernisan's financial disclosures.

© 2021 Better Health While Aging, LLC · Terms & Conditions · Disclaimer · Privacy Policy · Contact Us