Milk in the cupboard, cornflakes in the 'frig. Women of 'a certain age' find these moments infinitely amusing...and definitely scary. Are we overwhelmed, inattentive, or just moseying on down the road to dementia?
I'm an aging female internist, and I invite you to share your own menopause moments, or just take a moment to read stories and information from my life, my practice, and the latest from the world of medical research.
Oh this was too rich to relegate to the comments section. I recently wrote a post about a hare-brained encounter with the kindly Korean lady at my local dry cleaners, and wondered therein how I could explain my 'menopause moment' to her lest she suspect I was losing my mind.
This menopause moment brought to you by Wendy, a blogger friend whose exploits rival mine; either neither one of us is losing it, or we both are!
I was walking round the neighbourhood this morning. The sun was out and the air was nice and warm. We still have snowbanks all around, but they are fast receding. Coming to a muddy ditch, I stopped to watch the fast-moving, icy-looking water, as it ran downhill towards the village.
Smiling and happy, I reach the end of my street, where our post-boxes stand like soldiers by the side of the road. Reaching into my coat pocket, I grasp my set of keys and nonchalantly push the button. Nothing happens. I push again. Oh no!
Quickly, I look around. Nobody has seen me. Whew! Fitting my key into the lock on my mailbox, I take out the day's mail. I can't believe I just tried to open my mailbox with my car door opener! And my car, of course is at home, sitting innocently in the garage.
Just untangling the conclusions of this Swedish study was a brain workout in its own right, a downright 'how much wood would a woodchuck chuck..." sort of puzzle:
Neither high neuroticism nor low extraversion alone was related to significantly higher incidence of dementia. However, among people with an inactive or socially isolated lifestyle, low neuroticism was associated with a decreased dementia risk (hazard ratio [HR] = 0.51, 95% confidence interval [CI] = 0.27-0.96). When compared to persons with high neuroticism and high extraversion, a decreased risk of dementia was detected in individuals with low neuroticism and high extraversion (HR = 0.51, 95% CI = 0.28-0.94), but not among persons with low neuroticism and low extraversion (HR = 0.95, 95% CI = 0.57-1.60), nor high neuroticism and low extraversion (HR = 0.97 95% CI = 0.57-1.65).(1)
Got it? So do we fret and socialize, stay home and calmly knit, or placidly go out drinking with our buddies? Don't freak out while you discuss this conundrum with your friends because, as you will see once you sort out the various possibilities here, being a Buddha of a buddy is your best bet for the brightest brain. _____ Wang, HX, et al. Personality and lifestyle in relation to dementia incidence. Neurology. 2009 Jan 20;72(3):253-9.
We used to think is that what you got (in the way of neurons or nerve cells) was all you'd ever have. In fact, during the process of brain development in early of life, not only do millions of neurons migrate but also many die in the process of forming mature circuitry. Recent research, however, confirms that the process of neurogenesis or production of new nerve cells is alive and well in fully formed adult brains. The more we stimulate neural pathways, the more we spur on new growth in areas critical to cognition and memory.
One of our best features as successful actors in a challenging world is our ability to adapt to and learn from new experiences. Known as neural plasticity, this process involves both the generation of new neurons as well as novel hook-ups between the new and old cells in order to generate pathways capable of change and new behavior.
Scientists at the Institute for Cell Engineering at Johns Hopkins University have identified one step on the road to new brain cell development (albeit in mice)(1). Through an epigenetic process(2), they observed that nerve cells stimulated by brain activity--say the little mice were put in new environments which set their little mousy brains awhirl (Hmm, new stuff to climb, new things to sniff and eat, a brand new exercise wheel...)-- produced growth factors, thus stimulating the production of new neurons in the activated region.
One study that illustrates how this principle works in people as well as rodents was done by German scientists working with students learning to juggle. They performed magnetic resonance imaging (MRI) scans on new jugglers three months into their studies and noted a 3% increase in brain matter in certain juggling-related areas of the brain. When the students quit their juggling lessons (perhaps out of frustration, or too much to do, or just persuaded by the researchers to watch TV instead of throwing balls around), those juggling-amplified gray matter regions shrank back to pre-juggling levels.
So carry on with those Thursday, Friday, and Saturday New York Times crossword puzzles, or acrostics, or your Saturday a.m. Spanish language lessons. All those sparks flying about your aging brain are generating new cells and new circuitry even in your later years. _____ 1)Dengke, KM et al. Neuronal Activity-Induced Gadd45b Promotes Epigenetic DNA Demethylation and Adult Neurogenesis. Science Feb. 20, 2009, Vol 323 pp 1074-1077.
2)Epigenetics refers to changes in gene expression without change in underlying DNA. In this study, electrical activation of mature neurons induced a gene called Gadd45b to produce growth factors which trickled out into the immediately surrounding brain tissue causing local generation of new neurons.
Another example of epigenetics is the misguided series of events that occurs due to overeating of the wrong sort of food coupled with undermoving in a couch potato sort of way resulting in the metabolic syndrome and ultimately diabetes.
Halfway through the Jazzercise class, I remember with a start that I've forgotten to pick up the dry-cleaning. Dry-cleaning that is getting dangerously near that unclaimed, overdue point at which the facility donates it to charity. After class, I sort through my purse for the ticket, but alas, that is missing along with my brain. No problem, these nice cleaners know me by sight.
No, says the little Korean lady at the counter, there's no record of cleaning here for you. Are you sure, I ask, two men's jackets, one khaki one navy blue? No, she says, sorting through computer records and racks in the back. I'm wondering what to tell the owner of those jackets (who will not be pleased) when she announces, with triumph, you pick clothes up February 19th.
Oh heavens, how do you say menopause moment in Korean?