Signs of cognitive decline that we should worry about

Aging successfully

It was recently reported that tip-of-the-tongue phenomena isn’t something that we need to worry excessively about.

It appears that older people have the experience of not being able to identify someone famous or find the name of something more frequently than younger people (“Tip-of-the-Tongue Moments May be Benign“, American Psychological Science, 16 Oct 2013). But it has been found to be unrelated to cognitive changes associated with onset of dementia, suggesting that we shouldn’t be too concerned when we can’t name an actor in the midst of our frenetic discussion of the current k-drama series during family reunion dinners.

In contrast, there are other signs which we should be paying attention to. The Agency for Healthcare Research and Quality (US) for example lists a number of symptoms which might indicate dementia, which include experiencing increased difficulty remembering recent conversations and appointments, performing complex tasks which involve a number of steps, orienting and finding one’s way to familiar places. The Alzheimer’s Association (US) lists 10 symptoms which distinguishes the signs that someone may have Alzheimer’s from that of typical age-related cognitive changes. Given that dementia is a progressive condition, where there is “deterioration in memory, thinking, behaviour and the ability to perform everyday activities” (WHO), these early stage signs serve as a useful guide. The tendency to confuse time and place, resulting in one going to an appointment at the wrong time or at the wrong place, is another such sign – mentioned here by the Health Promotion Board.

There is also much talk about a scan which may determine if one’s cognitive difficulties are caused by Alzheimer’s disease (“Alzheimer’s Anxiety“, NY Times, 16 Nov 2013). But perhaps more pressing for most of us is the issue of whether we’re experiencing cognitive difficulties which warrant a closer look. And the answer to that might just be in a 12-question pen-and-paper questionnaire (known as the SAGE) which has been found useful for discerning cognitive decline, and for which validity research findings were recently published in the Journal of Neuropsychiatry and Clinical Neurosciences and reported in this article in Forbes (14 Jan 2014).

Sleep is key to doing well in school

Sleep is important for examination and academic performance

We think of being exam smart, having the right study techniques, studying for longer hours and more frequently as being the key to academic success. But one of the ways to boost school performance is rooted in doing the opposite: nothing. More exactly, sleeping.

A study on medical students in 2012 showed that those experiencing more stress and poorer sleep before exams, performed more poorly than their peers, while a 2010 meta- analysis of 17 studies found that children and teenagers who reported feeling sleepy were those with poorer academic performance. In short, inadequate sleep either from not sleeping adequate durations or having interrupted sleep can spell trouble for maintaining learning performance at school.

And sleep quality has a profound effect on our daily functioning. Studies suggest that getting adequate dream sleep (also known as rapid eye movement or REM sleep) maintains our mood, mental wellbeing and problem solving abilities. These websites offer a detailed explanation of how sleep is crucial to our cognitive functioning: NIH, Harvard Medical School, American Psychological Association (APA), WebMD, Harvard Business Review, the Guardian, Huffington Post, Mayo Clinic.

In keeping with the existing literature on the importance of sleep, as this article explains, recent studies show this to be true. Sleep research published in last year demonstrated that sleep is critical to maintain a healthy lifestyle – specifically, not having adequate sleep impacts us both physically and mentally (Science Daily, 15 Oct 2013).

A recent Swedish study found that missing just one night of sleep is associated with signs of brain tissue loss (Science Daily, 31 Dec 2013) – a conclusion shared by other researchers. A literature review published this year explains that sleep allows the the brain to strengthen neural connections (“SHY hypothesis explains that sleep is the price we pay for learning”, Science Daily, 9 Jan 2013).

In short, not having enough sleep impairs our ability to make decisions, remember things, and learn new things. And school’s about learning new things and remembering them.

Here’s a few things you can do:

1. Cultivate good sleeping habits

Discovery Health has 10 useful tips. Not every tip may be appropriate or useful to everyone but we need to start somewhere. And a dark room can help: here’s why. And here are few more ideas for boosting your sleep efficiency.

2. Read about sleeping

Try the book Why We Sleep: The Functions of Sleep in Humans and Other Mammals. You might find yourself soon extolling the virtues of sleep to other busy bees.

3. Sleep the sleep

Children will do as they see. Parents who don’t practice good sleeping habits or play an enabling role for their children to have poor sleeping habits, probably aren’t going to have children who get enough rest (to do their bestest at school)!