Tilda’s Story
Last Updated: Oct 16 2024
Memory Protection at Any Age
Anxiety, Falls, Sleep, B12, and High Blood Pressure
Tilda was in her 89th year and loving it. She was living as she’d always wanted - on her own, without help, keeping to herself as someone who had always liked being alone.
She had taken steps over the years to protect herself from dementia, including:
Walking every day
Eating a relatively healthy diet
Doing crossword puzzles and other things to keep her mind active
Watching dementia prevention advice on late-night TV.
That’s why she was a bit irritated when her family doctor suggested she see a geriatrician after her nieces noticed her memory was getting worse. They lived out of town, and they were worried about Tilda continuing to live on her own.
What Did They Discover?
Her geriatrician helped Tilda identify her main risk factors for memory problems, which were:
1. A recent fall and head injury
About 2 years ago Tilda had a major fall down the stairs in her home. She was up at night, walking in the dark, and missed a step. She broke both of her wrists and needed 16 stitches in her head.
Ever since then, her memory has been a bit worse than before.
2. High blood pressure
Tilda’s blood pressure in the clinic was 156/89. For dementia prevention, the top number should be around 120.
3. Low Vitamin B12
Tilda’s B12 level on her most recent bloodwork was only 200 pmol/L, when geriatricians like to see a number higher than 300 pmol/L.
4. Getting less than 6 hours of sleep a night
Tilda liked to stay up late watching late night TV, and often only got 5 hours of sleep.
5. No longer pursuing new interests or hobbies
Tilda was spending more and more time inside, and hadn’t tried something new or outside her comfort zone in years.
What did they do?
Her geriatrician helped Tilda come up with the following plan to optimize each one of her prevention targets:
1. Fall Prevention
This became Tilda’s number one target. Another big fall like her last one and she might have permanent memory problems, or even break a hip, which would almost guarantee she’d need to stop living on her own.
Her geriatrician arranged:
An occupational therapist visit to her home to look for ways to prevent falls (free through the government)
A physiotherapist program for balance, flexibility, and strength
Vitamin D 2000units every day to protect her bones
A dietician visit to increase her calcium intake
2. Blood Pressure
Everyone needs a different target for the top number of their blood pressure. For Tilda, her doctor suggested a target between 120-130.
Tilda didn’t want more medications, and so her doctor suggested she try:
Nutrition and exercise (with the dietician and physiotherapist)
If this didn’t improve her blood pressure naturally in about 3-6 months, she could start a medication.
3. Replace Vitamin B12 levels
Even if Tilda improved her diet, it is hard for people over 65 to absorb enough B12 in the body because they naturally lose their “intrinsic factor” (which is required to absorb b12 properly).
The simple fix was:
Start taking Vitamin B12 1000mcg daily
4. Get 7 hours of Sleep
Tilda got around 5-6 hours of sleep, but they were often disrupted.
She went to bed a different times depending on what was on TV that night, which meant she sometimes slept in, took long naps, or had trouble falling asleep some nights.
She tried:
Setting a routine bedtime of 11pm for 2 weeks
Setting a routine wakeup time of 6-7am for 2 weeks
One 20 minute nap in the afternoon but not after 5pm
5. Start a Hobby
Tilda didn’t like to do things with other people - which was perfectly okay. She never felt lonely, and she had people to call on if she needed them (which she hoped she never would).
However, she needed to keep her mind active, and her heart inspired.
Being 89 didn’t mean there wasn’t anything left in this world that she’d always wanted to do.
She decided she’d like to:
Learn photography, using her iPhone, by taking an online course for $150 that she found by googling “online photography lessons”.
How Did Things Go?
Tilda is now celebrating her 92nd birthday, and still living at home.
Her house is peppered with some of her favourite photographs of the outdoors - all taken on her iPhone.
This turned out to be a great way to learn something new, make new (virtual!) friends, and get outside for exercise and sunshine.
She hasn’t had another fall, and feels much stronger walking around. After the physiotherapy sessions, she took what she’d learned and started doing her own exercises at home 3 times a week. She still continues to walk every day (taking pictures along the way).
She didn’t like the sleep schedule - being able to follow her own whims of desire based on what interesting thing was on TV was important to her. Who’s to say this joyful activity isn’t providing more benefit to Tilda than 7 straight hours of sleep? Tilda, like all of us, gets to choose what matters most to her.
Lastly, her B12 level is now >300. That was easy.
Congratulations to Tilda on seizing the chance to build her mind at 89 years old.
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Disclaimer: The stories shared on this website are composites of several clinical cases, designed to protect individuals' privacy. They are intended for educational and informational purposes only and should not be construed as medical advice or a reflection of any specific person. Any resemblance to actual persons, living or deceased, is purely coincidental.