Spotting Normal vs Abnormal Cognition During the Holidays, Recap for 2022

November is National Family Caregivers Month and it's an excellent time to recognize and honor caregivers in our families.   

It’s probably more than a coincidence that Caregivers Month is during the holiday season.  The holidays often mean we’ll be reuniting with family and friends we haven’t seen for quite some time. While we look forward to enjoying dinners, parties, and winter activities, this is also a unique time when we can spot cognitive changes in our loved ones. NeuroReserve founder Dr. Edward Park recently reconnected with family dementia coach Jessie Hillock in an Instagram Live to discuss what changes to look for during this holiday season – and if they are normal or abnormal.   

We originally worked with Jessie last year on this topic, which you can watch or read here. This time, Ed and Jessie caught up to discuss specific examples you can look for during family gatherings and advice on the right approach to take (click above to watch). 

Brain Aging: Normal or Not?

It can be difficult to determine what’s normal or not, and Jessie shares that families often express that they thought the early signs were normal, and didn’t take action until there was much more decline. Normal aging is characterized by slowing in the brain, but thinking and processing are still working fine. Some examples of normal aging include: 

• not being able to remember the name of someone you used to work with, but recognizing their face  
• misplacing your keys or cellphone 
• walking into a room and forgetting momentarily why you went in there  

A beginning phase of abnormal cognitive aging is mild cognitive impairment, or MCI. This includes some cognitive difficulties involving planning and organizing, often referred to as executive function. MCI is typically when others around you start to notice cognitive changes. Examples of this include: 

• being overwhelmed with planning or other complex tasks 
• difficulty following conversations 
• missing appointments or planned events 

A more advanced stage is much more noticeable to others and significantly impacts daily life. It could be a form of dementia, such as Alzheimer’s, Lewy Body dementia (LBD), or frontotemporal dementia (FTD). Signs of dementia include: 

• forgetting names of loved ones, like grandchildren  
• difficulty with daily living activities, like eating and dressing  
• feeling the need to isolate and withdraw from family, which is often mistaken for depression (common in LBD) 
• significant personality changes (common in FTD), which may include no longer going to your child’s football games, sitting on the couch all day, or having a flat affect or change in mood  

Be a Detective

This holiday season, Jessie suggests spending a little time “being a detective” around the house of loved ones if you are concerned about cognitive decline. This involves looking at the environment and assessing if there is anything out of the ordinary. There may be subtle changes that your loved one won’t bring to you, but you can observe and take notes. 

• Look in the office space: Did it used to be clean and organized, and now papers are all over the place? 
• See if closets are disorganized. 
• Is there mail piled up on a counter? 
• Does the refrigerator have a lot of old food that should have been thrown out? 

Then keep an eye out for your loved one’s behavior. 

• See if they are engaging in back-and-forth conversations at the dinner table. 
• Do they ask repetitive questions? 

• Is there difficulty with finding words while talking? 
• Going for a walk, are they trying to figure out where you went and how to get back? 
• Can they stay on task and focused while playing a game? 

Become an Advocate

If you see anything unusual, try not to accuse your loved one of anything. Take notes and save them to bring to a doctor’s appointment for them to review. You can even write up notes and hand them to the front desk so the doctor can bring up the issues with your loved one directly. Keeping track of symptoms and having information available for the doctor helps you be an advocate for your loved one and family.  

Often, if there is a diagnosis of a cognitive disorder, you are given little information about what it really means and what comes next. When a doctor says “I’ll see you in six months,” what happens in between? Family dementia coaches like Jessie advocate on behalf of families for the services that help with communicating with loved ones, ways to support memory, and supporting a good environment for the patient. They also help build a village of support for caregivers to complement services given by the healthcare world.  

Take Care of Yourself!

It can feel overwhelming to take care of a loved one with Alzheimer’s or dementia.  The key is finding the right balance of what you can do to take care of your loved one and also take care of yourself. Jessie shares that caregivers often wonder what they can do to promote their own cognitive health. There are many lifestyle factors that support cognitive function including diet, exercise, sleep, social relationships, using your brain in different ways, and keeping on top of cardiovascular and metabolic health. These are the “Six Pillars of Brain Health.”   

At NeuroReserve, we support the diet and nutrition pillar with education and dietary supplementation, particularly through the MIND and Mediterranean diets, which have been shown to reduce the risk of Alzheimer’s. Learn about these brain healthy diets here. Unfortunately most of us don’t eat enough of the foods and nutrients that are crucial for long-term brain health, and caregivers are especially at risk.  Our flagship product, RELEVATE, fills the gaps where diet falls short, and includes 17 nutrients that evidence suggests may strengthen memory, reduce inflammation, and protect the brain from aging.  Learn more about RELEVATE here.   

You can find Jessie on Instagram @thememorycompass or at thememorycompass.com. 

Please reach out if you think you could use Jessie’s support.  Also, visit https://www.caregiver.org/ for more resources. 

We wish everyone a wonderful holiday season full of joyful reunions! And remember to keep an eye out for your loved ones, take care of them, and take care of yourself, especially your all-important brain health!