What areas of the brain are naturally lost due to aging?

The brain and nervous system are your body's central control center. They control your body's:

• Movements
• Senses
• Thoughts and memories

They also help control the organs such as your heart and bowels.

Nerves are the pathways that carry signals to and from your brain and the rest of your body. The spinal cord is the bundle of nerves that runs from your brain down the center of your back. Nerves extend out from the spinal cord to every part of your body.

AGING CHANGES AND THEIR EFFECTS ON THE NERVOUS SYSTEM

As you age, your brain and nervous system go through natural changes. Your brain and spinal cord lose nerve cells and weight (atrophy). Nerve cells may begin to pass messages more slowly than in the past. Waste products or other chemicals such as beta amyloid can collect in the brain tissue as nerve cells break down. This can cause abnormal changes in the brain called plaques and tangles to form. A fatty brown pigment (lipofuscin) can also build up in nerve tissue.

Breakdown of nerves can affect your senses. You might have reduced or lost reflexes or sensation. This leads to problems with movement and safety.

Slowing of thought, memory, and thinking is a normal part of aging. These changes are not the same in everyone. Some people have many changes in their nerves and brain tissue. Others have few changes. These changes are not always related to the effects on your ability to think.

NERVOUS SYSTEM PROBLEMS IN OLDER PEOPLE

Dementia and severe memory loss are not a normal part of aging. They can be caused by brain diseases such as Alzheimer disease, which doctors believe is associated with plaques and tangles forming in the brain.

Delirium is sudden confusion that leads to changes in thinking and behavior. It is often due to illnesses that are not related to the brain. Infection can cause an older person to become severely confused. Certain medicines can also cause this.

Thinking and behavior problems can also be caused by poorly controlled diabetes. Rising and falling blood sugar levels can interfere with thought.

Talk with your health care provider if you have any changes in:

• Memory
• Thought
• Ability to perform a task

Seek medical help right away if these symptoms occur suddenly or along with other symptoms. A change in thinking, memory, or behavior is important if it is different from your normal patterns or it affects your lifestyle.

PREVENTION

Mental and physical exercise can help your brain stay sharp. Mental exercises include:

• Reading
• Doing crossword puzzles
• Stimulating conversation

Physical exercise promotes blood flow to your brain. It also helps reduce loss of brain cells.

OTHER CHANGES

As you grow older, you will have other changes, including:

• In organs, tissues, and cells
• In the heart and blood vessels
• In the vital signs
• In the senses

Botelho RV, Fernandes de Oliveira M, Kuntz C. Differential diagnosis of spinal disease. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 280.

Martin J, Li C. Normal cognitive aging. In: Fillit HM, Rockwood K, Young J, eds. Brocklehurst's Textbook of Geriatric Medicine and Gerontology. 8th ed. Philadelphia, PA: Elsevier, 2017:chap 28.

Sowa GA, Weiner DK, Camacho-Soto A. Geriatric pain. In: Benzon HT, Raja SN, Liu SS, Fishman SM, Cohen SP, eds. Essentials of Pain Medicine. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 41.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

As we age, our brains change, but Alzheimer’s disease and related dementias are not an inevitable part of aging. In fact, up to 40% of dementia cases may be prevented or delayed. It helps to understand what’s normal and what’s not when it comes to brain health.

Normal brain aging may mean slower processing speeds and more trouble multitasking, but routine memory, skills, and knowledge are stable and may even improve with age. It’s normal to occasionally forget recent events such as where you put your keys or the name of the person you just met.

In the United States, 6.2 million people age 65 and older have Alzheimer’s disease, the most common type of dementia. People with dementia have symptoms of cognitive decline that interfere with daily life—including disruptions in language, memory, attention, recognition, problem solving, and decision-making. Signs to watch for include:

Alzheimer's disease or related dementias are not an inevitable part of aging. There are 7 ways to help maintain your brain health.

• Not being able to complete tasks without help.
• Trouble naming items or close family members.
• Forgetting the function of items.
• Repeating questions.
• Taking much longer to complete normal tasks.
• Misplacing items often.
• Being unable to retrace steps and getting lost.

10 Warning Signs

If you have one or more of the 10 warning signs, please see your health care provider. Early diagnosis gives you the best chance to seek treatment and time to plan for the future.

Studies show that healthy behaviors, which can prevent some kinds of cancer, type 2 diabetes, and heart disease may also reduce your risk for cognitive decline. Although age, genetics, and family history can’t be changed, the Lancet Commission on dementia prevention, intervention, and care suggests that addressing risk factors may prevent or delay up to 40% of dementia cases.

Here’s what you can do:

High blood pressure may increase your risk of dementia.

1. Quit smoking. Quitting smoking now may help maintain brain health and can reduce your risk of heart disease, cancer, lung disease, and other smoking-related illnesses. Free quitline: 1-800-QUIT-NOW (1-800-784-8669
2. Maintain a healthy blood pressure level. Tens of millions of American adults have high blood pressure, and many do not have it under control. Learn the facts.
3. Be physically active. CDC studies show physical activity can improve thinking, reduce risk of depression and anxiety and help you sleep better. Here are tips to help you get started.
4. Maintain a healthy weight. Healthy weight isn’t about short-term dietary changes. Instead, it’s about a lifestyle that includes healthy eating and regular physical activity.
5. Get enough sleep. A third of American adults report that they usually get less sleep than the recommended amount. How much sleep do you need? It depends on your age.
6. Stay engaged. There are many ways for older adults to get involved in their community.
7. Manage blood sugar. Learn how to manage your blood sugar especially if you have diabetes.

Symptoms of some vitamin deficiencies and medical conditions such as vitamin B12 deficiency, infections, hypothyroidism (underactive thyroid), or normal pressure hydrocephalus (a neurological condition caused by the build-up of fluid in the brain) can mimic dementia. Some prescription and over-the-counter medicines can cause dementia-like symptoms. If you have these symptoms, it is important to talk to your health care provider to find out if there are any underlying causes for these symptoms.

For more information, see What Is Dementia?

• Talk with your loved one about seeing a health care provider if they are experiencing symptoms of Alzheimer’s dementia to get a brain health check up.
• When the timing is right, talk about issues related to safety including driving and carrying identification. Symptoms of dementia include getting lost in familiar places, difficulty judging distance, determining color or contrast, and reading which can make driving especially difficult.
• Help your loved one start gathering important documents such as their advanced health care directive or living will, durable power of attorney for health care, and financial or estate planning documents. CDC has a Care Planning Form [PDF – 1 MB] available to download at no cost.
• Schedule a family meeting. When caring for someone with Alzheimer’s disease or a related illness, family meetings are important to ensure information is shared, to put care plans in place, and to help divide tasks among family members.

More than half of people with memory loss have not talked to their healthcare provider, but that doesn’t have to be you. Get comfortable with starting a dialogue with your health care provider if you observe any changes in memory, or an increase in confusion, or just if you have any questions. You can also discuss health care planning, management of chronic conditions, and caregiving needs.

Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commissions. Lancet. 220;396(10248):413-446. doi:10.1016/S0140-6736(20)30367-6.

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