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Pursuit of memory

Telling normal forgetfulness and mild cognitive impairment apart can be tricky

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Some seniors are remembered forever for their acts of forgetfulness. One of my ex-colleagues, a 60-something man, would pick up the phone the moment it rang. One day the phone rang while he was having coffee. He rushed to the table, picked up the receiver, and then put the paper coffee mug which he was holding in his other hand against his ear.

As the managing director of CovaiCare, one of the pioneer retirement communities in India, Achal Sridharan often deals with such forgetful people. Many seniors have 'intentional amnesia,' says Sridharan. “Sometimes they say 'I don't remember when I had gulab jamun last'. You tell them it was just the other day. They say 'No, it was too long ago'. Then you tell them they are not supposed to have gulab jamun, and they will disarm you with a smile and ask 'Can I have it again with some ice cream?'”

Once, a 90-year-old lady living in CovaiCare told Sridharan that she had forgotten how to dance. “I took her to the dance floor at our retirement home, while there was some karaoke performance. She danced like crazy. The next day, I asked her whether she enjoyed dancing. She said the last time she danced was 20 years ago,” says Sridharan who is fondly called 'Colonel'. The “70-year-young” now plans to have memory care centres set up at CovaiCare facilities in Coimbatore and Bengaluru.

Forgetfulness is common among the elderly. Nirupma Raina, 70, from Gurgaon has no qualms in admitting that she is forgetful. “Sometimes I go to the kitchen and wonder what I had wanted to do. Then, when I look around , I remember that I had to pick up a recipe book or make coffee,” she says. “Of late, I forget to switch off the gas. I'll go back to the kitchen after five minutes, and find a slightly overdone dish. However, I can easily memorise the phone numbers of my friends even at this age. I have never had any severe memory lapses like getting lost while walking. Touchwood!” Raina is a consultant and is often complimented for handling her professional responsibilities efficiently.

Why do we turn forgetful as we age? “As age advances our brain cells die and the brain shrinks in volume,” explains Dr Mathew Varghese, professor of psychiatry at the National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru. “The higher your brain reserve, the less forgetful you tend to be. A person who uses her brain faculties, and is mentally active, will be able to deal with forgetfulness better.”

S. Ramakrishnan, of Bengaluru would agree with that. An alumnus of IIT Kanpur, Ramakrishnan has downloaded the Sudoku app on his phone. “Sometimes I play Sudoku for a few days in succession,” says the 71-year-old, who keeps himself active by playing golf.

Thanks to all these activities, Ramakrishnan has not yet had any senior moments that bothered him. “Having said that, sometimes while going out, I worry whether I locked my door or switched off the gas. That has been with me for the last two decades,” he says.

Unlike Ramakrishnan, Prof Manish Bhandari from Madhya Pradesh worries a lot when something slips his mind. Bhandari who used to take pride in his language skills and vocabulary is now a shadow of his former self. He struggles to find the right words, which according to him is the worst part of getting old. “It is very embarrassing,” says the 73-year-old. “But there are certain things you never forget,” says Bhandari. He has vivid memories of the moment he held his grandson the first time. He cleaned, dusted and decorated the baby room and even learned to sing lullabies.

Bhandari was visibly upset the day his daughter Swathi had to go to her in-laws' house. His eyes welled up as he put the baby to sleep. When the cab came, Bhandari put the luggage in the boot and asked Swathi to get in. As Swathi reached her arms out, inviting a hug, Bhandari suddenly realised he had left the baby behind on the sofa. “I have never pardoned myself for that forgetfulness,” he says.

Older adults with such symptoms should get themselves screened, says Varghese. “They must be screened preferably by a neurologist, psychiatrist or geriatrician, especially if they have diabetes, hypertension or heart disease,” he says. “It is important to see what the memory problem is caused by, whether it is progressing, and if it is a treatable condition. ”

It is tricky even for a physician to distinguish between normal forgetfulness and Mild Cognitive Impairment (MCI). MCI could meddle with one's everyday activities involving memory. “People with MCI tend to compensate for their memory deficit by keeping lists or reminders,” says Varghese. “MCI may be caused by certain physical conditions like thyroid or vitamin deficiency or by mild strokes in the brain. It may reverse, and the person may become better, or in some cases they progress to dementia.”

A little forgetfulness is a boon for some. It is good to be able to let go of some things, says Bhandari, who has been through a lot in his life.

Some names have been changed.

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