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Age brings emotional changes: Know when to act

By JIM GILLIS Special to The Day

Publication: Age Of Choice:MAIN

Published September 30. 2012 4:00AM

As we age, the physical effects are apparent - a receding hairline and an expanding waistline, not to mention the aches and pains associated with rising each morning.

But there are other factors less obvious, at least at a glance. The psychological effects may be more hidden but can be just as serious as physical decline.

"The factors you tend to see are a shift in mood, which can lead to depression and the early onset of dementia," said Dr. Luisa Skoble, a Westerly psychiatrist. "Those conditions aren't exclusively within the elderly population but that tends to be the population that is greatly
affected."

Skoble works mostly with the Veterans Administration and has worked at Butler Hospital, spending most of 20-year medical career working with the elderly.

Depression among the elderly is common but treatable. It can stem from isolation with those who live alone, sometimes cut off from day-to-day social activities. And signs of physical decline - the inability to perform once-easy tasks - can work in tandem on the emotional state.

Only Jack Benny got away with claiming to be 39 forever. As we advance upward from middle age, lifting things or walking a good
distance become more of a challenge. But adjusting and living a full life is possible even if it takes more effort.

"One of the problems we see is a lack of public transportation," Skoble said. "If you live in a place, for example, like Pawcatuck, your options are somewhat limited. If you've reached the age and condition where you can no longer drive that can prove to be isolating. I suppose in some ways the best place to live if you're elderly is New York City, because there's so much public transportation."

On the plus side, some communities offer senior citizen ride programs. Most communities have senior centers, with activities and support groups. And assisted living centers and elderly housing sites often bring in instructors for exercise groups, dance classes and other activities.

Depression is treatable with therapy and medication, but dementia is tougher to tackle. Signs include forgetfulness, confusion and, in particular, short-term memory struggles.

Loved ones should look for slippage, mood changes and a decreasing interest in once enjoyed activities. Skoble said it's a fine line when family members should intervene, when a phase becomes a lingering trend. Contacting an older person's physician is one route.

Exercises such as walking and word games such as Scrabble and crossword puzzles help keep the mind sharp and may stave off dementia, which can lead to full-blown Alzheimer's disease.

Those who follow a nutritional diet tend to be more successful. "There are still difficult problems that many older people face," Skoble said. "But there have been improvements. And there are many who have a wonderful quality of life."

MORE

STEPS TO KEEP YOUR MEMORY SHARP

By Elena Schjavland

With the tremendous stress sustained from family caregiving, it is important that the caregiver takes care of themselves. Make changes now while you are in your 40s, 50s, and 60's to be on the right track for cognitive health as you age.

1. Be a motivated patient. If you have health issues such as heart disease (especially hypertension), diabetes, thyroid disease, obesity or low vitamin levels, do your best to keep them in control. Untreated, they contribute to types of memory disease, cognitive impairment and dementia.

2. Get enough sleep. Have a sleep apnea study done if you snore or have risk factors (obesity, falling asleep during the day, large neck circumference, smoking, etc.). Inadequate restorative sleep can cause memory problems.

3. Exercise your body. Research shows that balanced daily workouts are key to aging well. Balance routines such as Tai Chi and yoga have been shown to mitigate risk factors for dementia. Sharpen your visual-spatial skills with ring toss, horse shoes, bean-bag games, or any hobbies that hone your precision skills. Do activities that emphasize eye-hand coordination.

4. Exercise your mind with puzzles, crosswords, sudoku, books and competitive board games. Play computer mind games for skills to flex and improve memory, sequences and basic knowledge. (Nintendo: Big Brain Academy and Brain Age; DVDs: "Mindfit" and "Brain Fitness Program" and online, www.lumosity.com and www.mybraintrainer.com.)

5. Adopt a healthy diet rich in fruits, vegetables and omega-3 fatty acids. The same diet that is strongly
recommended for those with heart disease has been shown to limit the Alzheimer's risk factor. Add legumes (beans and nuts), salads with tomatoes, vegetables (dark and green leafy, broccoli, cauliflower, radish, cabbage and bok choy), fruits, and proteins (fish, poultry and lesser quantities of red or organ meat). Finally, limit butter and high-fat dairy products.

6. Get out and socialize with family, friends and community. Take up a new hobby, class or activity. Having larger social networks keeps your communication and social skills sharp and decreases the risk of depression. If you have sadness, blue moods or depression, talk to someone (your health care provider, your minister, your family, or others), but get help. This risk factor contributes to cognitive impairment, social isolation and potential for suicide.

Elena Schjavland is a board-certified adult and geriatric nurse practictioner, and the founder of Keys2Memory, LLC, a Mystic-based private practice that provides memory and dementia evaluations and behavioral and depression management. For more information, call 860.245.4144 or visit www.Keys2Memory.com.

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