Because I’m a student pharmacist, my grandmother is constantly asking me what medication she should have her doctor prescribe to improve her memory. The tough part of discussing this with her is that she doesn’t have any type of dementia that is causing her memory loss, it is simply related to age.

Since there are no prescription medications that have been approved to treat the expected memory loss that comes along with aging, many older adults struggle to find solutions they can work into their daily lives that will preserve their memory function. This series of articles aims to educate pharmacy professionals on how we can best counsel our patients who have concerns regarding their brain health.

These articles will explore the various alterations seniors can make in their daily lives that can lead to real, lasting change in their memory function.

The first step to addressing your patients’ concerns with memory loss begins with identifying the patients who might be affected by it. There are some key factors that distinguish between standard age-related memory loss and memory loss due to dementia, and it is critical that pharmacy professionals are able to differentiate between the two.

The patient would likely need to be referred to a provider for specialized dementia treatment if they have difficulty performing small tasks, such as getting dressed and maintaining hygiene, if they lack the ability to follow directions and find themselves getting lost in places that should be familiar, and struggling to make decisions or articulate thoughts.¹

Contrarily, some signs that a patient’s memory loss can be contributed to the normal aging process include being forgetful, but still able to recall specific instances in which they were forgetful, unable to immediately recall directions, but not getting lost in an area that is familiar to them, and the ability to maintain the same level of decision-making as they always have, despite having occasional bouts of forgetfulness.¹

Once you’ve identified a patient who may be experiencing age-related declining cognitive functioning, ask them whether they have any concerns with their memory. If they affirmatively respond, it’s important to ask permission to share more information.

Some older adults may find it difficult to accept the fact that their memory is not what it once was and may not be ready to discuss the ways in which they can preserve their memory and promote brain health. To deliver true patient-centered care, we must allow the patient to have full autonomy. If they would prefer not to hear the information you have to offer, accept that it is their choice and document the interaction in your pharmacy system. You can always bring it up again, but give the patient time after your first encounter to think it over and consider your offer.

If and when a patient accepts your offer to share more information on the topic, there are several different avenues you can propose to the patient. Today, we will focus mainly on the benefits of exercise on brain health, but the rest of the series will address perceived and actual benefits of other topics, such as playing brain games, learning new languages, and altering the diet as effective nondrug strategies that preserve and improve memory function.

Exercise is emphasized as a key nondrug activity in many different disease states, including diabetes, hypertension, and hyperlipidemia. What many older adults don’t realize, however, is that exercise does more than just keep their body physically healthy. It has also been shown to improve and maintain brain health by facilitating circulation of BDNF and increasing the volume of the hippocampus, the memory center of the brain.² Some exercises are better than others, however.

Aerobic exercises are the main type of physical activity that has been shown to improve memory function in older adults.² The best aerobic exercises for older adults include walking, swimming, water aerobics, dancing, and even yard work. All of these methods, at about 150 minutes per week of activity, would be suitable fitness recommendations for your patients who complain of decline in memory function.

Although aerobic exercise on its own plays a key role in improving brain health, there has been evidence pointing to an even greater improvement in memory function when aerobic activity is coupled with a cognitively-stimulating activity, such as a video game.² For seniors, video games may not be the most practical option, but senior centers and other areas in which seniors socialize may benefit from introducing a console that allows older adults to partake in a mild version of Dance Dance Revolution or a similar strategic fitness games.

One team of researchers even created a game that can be played by older adults while cycling. The game includes various memory and attention tasks that require spatial navigation to complete. Thus far, combining both standard aerobic exercises with cognitively engaging activities seems to hold promise in improving memory function for older adults complaining of declining cognition.

As pharmacists, we have an accessible platform which we can use to provide this information on exercise to our patients who have concerns about their memory function. Not only is it important to emphasize the benefits of aerobic exercise both on its own and in combination with brain-stimulating games, community pharmacists should also consider having a compiled resource on-hand for activities that seniors can engage in within their communities, such as the nearby senior centers.

Even a small change in fitness habits can create real, lasting change for your older patients. Take the time to talk with them about their memory concerns and what they can do daily to keep their memory strong.

References
  1. Smith M , Robinson L, Segal R. Age-related memory loss. HelpGuide; July 2019. https://www.helpguide.org/articles/alzheimers-dementia-aging/age-related-memory-loss.htm. Accessed June 16, 2020.
  2. Raichlen DA, Alexander GE. Why your brain needs exercise. Scientific American; January 2020. https://www.scientificamerican.com/article/why-your-brain-needs-exercise/. Accessed June 16, 2020.