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Where are my car keys?

Blue Shield of California’s senior medical director, Dr. Malaika Stoll discusses normal forgetfulness compared with more serious memory loss concerns.
Malaika Stoll
Dr. Malaika Stoll

As we age, it’s normal to become a bit more forgetful, taking longer to recall names or to find car keys, for example. "Like our bodies, our minds naturally age and if your memory isn’t as sharp as it once was, this alone is not cause for concern,” said Dr. Malaika Stoll, senior medical director with Blue Shield of California.

Some people experience more serious memory issues, and this can be a sign of dementia. One in 10 people over 65 have dementia, and one in three people over 85 have it according to a new Columbia University study. There are several types of dementia, the most common of which is Alzheimer’s disease. In California, Alzheimer’s disease was the third leading cause of death in 2018, according to a state Department of Public Health report, and that figure is expected to double in the next few decades due to the population getting older.

“Sometimes, knowing the difference between normal forgetfulness and more serious memory loss can be challenging,” says Dr. Stoll. “If you or a loved one is having trouble remembering what was just said, can’t do routine tasks such as paying bills, or can’t remember an immediate family member’s name, these are concerns that should be discussed with a doctor,” she said. One reason to see a doctor is that there are some treatable conditions that can cause memory issues, such as thyroid disease, vitamin deficiency, high blood pressure, and hormonal changes. Also, certain medications can impair memory and your doctor can help you avoid these.

Although we have yet to identify a surefire way to prevent dementia, studies suggest that a healthy diet and exercise help.

“A heart-healthy lifestyle is also a brain-healthy lifestyle,” Stoll said. ”Regular exercise and good eating habits reduce the risk of dementia, heart disease, and other chronic diseases such as diabetes.”


“The approach that’s recommended for heart, brain, and overall health is called the Mediterranean diet,” she said. This largely plant-based diet includes lots of fruits and vegetables, whole grains and beans, fish/seafood, and olive oil instead of butter and other saturated fats. Also included are moderate amounts of poultry and low-fat dairy. On the other hand, red meat and sugary and processed foods should be limited.

The MIND diet, formulated specifically for brain health, is similar to the Mediterranean diet but emphasizes leafy greens and berries.

If you drink alcohol, stick to the guidelines for moderate consumption. These guidelines generally allow up to one drink per day for women and two for men. There is some evidence that one glass of red wine a day could reduce Alzheimer’s risk; it’s actually part of the Mediterranean diet. But heavy drinking, especially binge drinking, is dangerous for your heart and mind. Smoking also increases the risk of developing dementia along with numerous other diseases and should be avoided.


The recommendation is at least 150 minutes of moderate exercise a week. A brisk 30-minute walk five times a week is a routine that works for many. “Swimming, going to the gym, jogging, dancing, anything that gets you moving is great,” Stoll said. In addition to aerobic workouts, some studies have shown yoga and meditation to be helpful. Low-impact workouts such as Pilates can also help with strength and balance.

Some risk factors for dementia are harder to address, such as the genes we inherit and the environments we may have been exposed to. “Whether an individual gets dementia depends on a complicated interface between genes and environment,” Dr. Stoll said. “If you have Alzheimer’s in your family, that doesn’t mean you are going to get it. It's best to focus on what we can control and modify.”

Silver Sneakers

Seniors enrolled in certain Blue Shield of California Medicare Advantage and Medicare Supplement plans can enroll in Silver Sneakers. This free program, sponsored by Medicare, provides no-cost memberships at participating gyms across the country as well as live and on-demand virtual classes you can do from home. To see if you’re eligible, click here.

Because dementia can be devastating and costly for patients and their families, it’s never too early to take steps that could reduce the risk or severity of this debilitating disease.