As we age and our memory declines, many people worry about dementia. However, most individuals who come in claiming they have dementia are often not actually suffering from it, while those who are told they do not have dementia may actually have it. Depression and dementia prevention actually overlap. One of the best ways to check how much your brain has aged is to note that dementia cases sharply increase after the age of 65. The prevalence rises steadily with age. It is important to start developing habits to prevent dementia in your 50s, rather than waiting until you are older to begin managing it. If dementia is present, activity levels can drop significantly, and later on, individuals may struggle with swallowing or eating. Common issues that accompany dementia include pneumonia, fractures, and falls, which are typical problems in the elderly. Additionally, dementia is the most significant concern.

The problem is that individuals who live alone without support often suffer from malnutrition. Research so far indicates that depression that occurs at a young age is not significantly related to dementia. However, if depression first appears after the age of 65, there is a correlation. In such cases, depression is often accompanied by cerebrovascular issues. When we perform an MRI, we can see that small blood vessels in the brain are blocked, appearing white on the scan. Individuals with these conditions are more likely to develop depression, and the incidence of Alzheimer's disease or vascular dementia is about one to two times higher in this age group. However, this is not caused by taking antidepressants, nor is it due to not taking dementia medication; it is related to the mechanisms that cause depression and vascular factors. Therefore, conditions like diabetes, hypertension, and hyperlipidemia are associated with an increased risk of dementia.

I see many people with depression. The most common symptom of depression is insomnia; it's the most frequent issue. Not being able to sleep doesn't mean that everyone is depressed, but when you can't sleep, you wake up frequently. Even when you wake up, you feel tired, and you don't want to do anything. There's a lack of motivation, and one of the things you might not want to do is eat. For older individuals, if they experience depression and lose weight, it can lead to serious health problems. I saw someone today who lost 10 kg in three months. To lose 10 kg in three months, you would probably have to stop eating and exercise all day, which is unlikely. However, the weight loss from depression can be more severe than that of cancer patients. People become lethargic and just want to lie down, which leads to secondary issues.

Pneumonia and similar issues can ultimately lead to such problems. There is research indicating a connection between depression and dementia, and studies have been conducted on preventing dementia by preventing depression in older adults. However, a definitive conclusion has not yet been reached. From our perspective, when depression improves, activity levels increase, and chronic disease management becomes more effective, which seems to reduce the occurrence of dementia. This is currently the prevailing theory, but more large-scale studies are needed. As we age and experience memory decline, many worry about dementia, but that is somewhat hasty. Memory loss can occur due to normal aging, and individuals with depression often believe their memory is declining. However, since everyone experiences some memory loss, confusion can arise, but there is a qualitative difference. The most significant difference is in spatial awareness.

This is a difference. In depression, the sense of direction does not deteriorate. For example, today I had to go to the hospital for a consultation, so I took the bus and the subway by myself, waited, and then received my treatment. I told the doctor, My memory is so poor that I think I have dementia. However, it is more likely that you do not have dementia. If your sense of direction is maintained to that extent, it is often not dementia. It is more likely to be depression. In cases of dementia, individuals often do not recognize that they have dementia and frequently deny it. Family members often bring them in for evaluation. Initially, it may seem like depression, but there are some characteristics that indicate it could progress to dementia. In cases of depression, if an MRI is taken, the brain may show signs of atrophy, which raises concerns about the possibility of dementia. Additionally, the blood vessels may not be in good condition. However, those individuals often have very little expression; they are depressed, but it is still depression.

It's not that they are crying or sad; their face just seems blank, perhaps. In such cases, there is often suspicion. Earlier, I mentioned that the likelihood of brain issues is high when there is suspicion. Initially, they may feel depressed, but they start to suspect their family members or spouse. In these cases, there are quite a few instances where it leads to dementia, so we need to be vigilant. Most people who come in claiming they have dementia are often not actually suffering from it, while many who are not suspected of having dementia actually do have it. This is because the disease of dementia creates issues that hinder self-awareness of having dementia. When someone is depressed, they tend to develop health anxieties, which increases their worries about dementia. Additionally, when a husband has dementia, the caregiver often struggles, leading to a higher likelihood of depression. This is especially common among elderly couples, where one may have dementia while the other suffers from depression. If one is depressed, they also feel down themselves.

It can often be difficult to provide proper assistance, especially in challenging situations. In such cases, the government offers various services, such as long-term care insurance for the elderly and home care services, which are very well provided. So, when I come here, I ask if they are utilizing those services, and they usually are. The reason is that when someone is feeling depressed, they may not have the energy to pay attention to such matters. For individuals with dementia, it is natural that they may not be able to seek help themselves, and their families usually need to take the initiative. However, sometimes children may be living abroad or may not be well-informed about the situation. Therefore, it would be very beneficial to discuss these matters thoroughly with the responsible staff to receive the necessary assistance. I would like to share one impressive case. There was a person who ran a large company and was socially successful. However, at around the age of 70, he began to exhibit strange behaviors. He would often pass by...

Women keep poking and making comments that are somewhat vulgar, which they didn't do before, almost like they're acting like babies, causing problems at the company. Eventually, because of these issues, the company ended up being sued by those employees. Later, it turned out that this person had frontotemporal dementia. Among the types of dementia, there is one where the frontal lobe of the brain shrinks, which can lead to depression and a lack of control over one's behavior. When we diagnosed this and explained it, the employees understood, and although he is not currently managing the company, he was able to maintain the reputation he had fought for in the past. Therefore, when older individuals suddenly show signs of depression or exhibit unusual behavior, it's important to observe them closely and address any concerns.

You need to think that there is an issue with the brain's judgment or mood. Our cognitive functions can decline just from a night of poor sleep, affecting memory and cognitive abilities. However, that doesn't mean it's dementia. Drinking a lot can also impair memory. So, during such times, you shouldn't worry about dementia; instead, you should manage your own condition well to maintain memory and brain function. What we want to emphasize is that you should compare it to the past. If, as you age, you start exhibiting unusual behaviors that you didn't have before, or if you find yourself repeating things differently than before, using vulgar language more often, or swearing a lot, then there is some change happening. When there are changes in behavior or language, you should check if it might be dementia. Depression can also be an early symptom of dementia or can occur during dementia, so try doing a simple calculation: subtract 7 from 100. If you start with 100, you get 93, then 86.

You go like 79, 72, 65. This is something that people with depression struggle with. Try doing this: it's called serial sevens, where you continuously subtract numbers and remember them. People with depression have a hard time with this. When distinguishing between dementia and depression in daily life, dementia struggles with tasks that have complex steps. For example, if you're preparing side dishes, you might have trouble figuring out what to make and how to prepare it, which involves multiple steps. Ultimately, if you teach them step by step, they can do it. However, with depression, it's not that they can't do it; it's that they lack the motivation to do so. They actually have the ability to perform the tasks. So, when their energy is restored, they can do everything again. For instance, if there's something they used to do regularly but now can't, that might indicate dementia. In the case of depression, it's more about losing interest in activities that used to be enjoyable, especially when the excitement that used to be there disappears. This is a characteristic of depression.

In old age, depression and dementia prevention actually overlap. The common risk factors for depression and dementia are ultimately chronic diseases, such as hypertension, diabetes, and hyperlipidemia. It is difficult to prevent depression and dementia if blood sugar is not well controlled. We need to check the hemoglobin A1c levels. There are cases where the hemoglobin A1c is over 10, while it should generally be maintained around 6. High levels of hemoglobin A1c increase the risk of both dementia and depression by more than double. However, if diabetes is well managed and hemoglobin A1c levels stabilize, the risk disappears. Therefore, it is important to manage that well. Secondly, adjusting the daily rhythm to ensure good sleep is crucial. Research has shown that getting good sleep significantly helps in preventing dementia. While it is important to sleep well, excessive use of sleeping pills is detrimental to both depression and dementia. Overuse of sleeping pills can be harmful.

Taking both medications is not advisable. You should only receive the prescribed amount from your doctor, and if possible, it is better not to take them at all. That is something I really want to emphasize. 

Next, among the common factors of depression and dementia, head injuries also play a role. For example, there are various reasons for head injuries, but many occur when people trip while going down stairs. Injuring the frontal lobe can lead to a higher risk of depression. If you are older, for men, wearing a beret or a hat can be very preventive. Women often have hairstyles that provide some cushioning, but men may not have hair, so a direct impact can be more severe. Wearing a hat is a good idea. Additionally, you should wear sturdy shoes to prevent falls, so I want to stress the importance of being cautious about that.

When we have depression, it slightly affects our thought processes. I remember very well the times when I was depressed. Our memories are connected to our feelings, so the memories of when I was sad or anxious all come flooding back. This often leads to a habit of sitting blankly at home, constantly recalling past sad events. In such moments, the person I find most unbearable is my husband, as he is often the main source of my frustration. I also think about the difficulties of living with my in-laws and my mother-in-law. For men, when they experience depression, a common habit is to drink alone. This happens because when they feel down, consuming alcohol can provide a brief moment of relief. However, it ultimately leads to feeling even more depressed.

It is advisable to adjust some habits. While it may not be entirely accurate to call it food, alcohol is the main issue. Alcohol consumption is proportional to its dosage. If you consume too much strong liquor, it can lead to memory loss, and there are cases where it actually affects memory. Additionally, since dementia is related to chronic diseases, poor dietary choices associated with high blood pressure, diabetes, and hyperlipidemia are also not good. Most of these problematic foods tend to be greasy. In our book, Counseling for Highly Sensitive People, there is a famous study involving nuns from the Notre Dame convent. The research showed that nuns who used a lot of new vocabulary and wrote many sentences from a young age experienced less dementia and, even when they had brain atrophy, did not develop dementia. Therefore, among brain exercises, I...

I recommend reading books, especially those that contain many new words. Reading new books is beneficial, and studying languages is also good. For example, studying English can help with mental exercise, and exploring books in new fields is advantageous as well. I believe counseling services for very sensitive individuals could also be helpful. One of the best ways to assess how much your brain is aging is to get an MRI. I had my MRI done, and for instance, if I compare the MRI I had five years ago with the current one and see that there is no change, it means I have been managing my health well. Of course, experts will verify the images, but aside from that, as I mentioned earlier, in cases of depression and similar issues, it is important to understand how much...

Can you quickly check if you can do a hundred times? As you get older, it becomes more difficult. The speed and other aspects often go wrong in the middle. However, practicing repeatedly can help. Another thing is, for example, thinking of words as memories; this is called word flow. You can check if that works well by continuously saying a word, like thinking of ni-eun and just talking about it. This can be a way to see how much aging is affecting you. Language fluency decreases, so by comparing how much it differs from what I used to do, you can find out. However, the most accurate way is to go to a hospital for tests and imaging, which can provide very precise information. That's what I wanted to say.

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