Dear Doc, is forgetfulness normal in old age?

Dear Doc,

Hello, I have a deviated septum as a result of an accident. I had septoplasty, which helped my breathing but my nose is still crooked. Why is it so?

VT

Dear VT,

A deviated septum means that the nasal septum is not properly positioned in the middle of the nose. The nasal septum is made up of bones and cartilage and is found in the middle of the nose, dividing the nose into the right and left nostrils. Up to 80 per cent of the population have some level of nasal septum deviation, although for the majority it is mild, not easily noticeable, and it does not cause any symptoms.

A severely deviated septum will be obvious from the shape of the nose. It may also cause difficulty breathing, nasal congestion, snoring, sleep apnea (the individual stops breathing during sleep and the brain wakes them up so that they can resume breathing), nose bleeding, facial pain and headaches.

The nasal septum can be deviated due to injury, like in your case, or someone may be born with a deviated septum. Sometimes, it may develop in the course of normal development. Rarely, the deviated septum may be a result of an underlying connective tissue disease.

A surgery procedure called septoplasty is done to correct a deviated septum that is causing severe symptoms. During the surgery, parts of the septum bone and cartilage may be removed, reshaped, trimmed or replaced. Splints or gauze may be inserted after surgery to assist with the healing process.

The main purpose of surgery is to improve breathing. It is important to discuss with the surgeon what is achievable, in terms of improvement in function and appearance before and after surgery. This is because the surgical process may not be able to produce the exact shape that is desired.

In addition, the healing process itself may also lead to changes in shape. It is advisable for you to discuss your concerns with the surgeon who did the septoplasty. Depending on the severity of the crookedness, additional surgery may be an option.

 Dear doctor,

My mum is 72 years old now, and she has started forgetting things. Is this normal ageing or should we be worried?

Dear reader,

It is normal to forget things every so often, especially when you are very busy or stressed. With normal ageing, there are changes in all parts of the body, including the brain, which can cause mild memory challenges.

However, you may be concerned about a more serious problem if the person experiences these: Getting lost in a place that the person knows very well, Getting confused about day, time and people,  Having problems following direction, Asking the same questions repeatedly, Having challenges finding the right word or name when talking or writing, Relying on a lot of reminders and/or assistance to be able to function, Poor decision-making and judgment a lot of the time,  Being unable to take care of themselves e.g. personal hygiene, feeding and  Social isolation.

If your mum is experiencing these symptoms, then she should be reviewed by a medical professional for memory evaluation and screening, and management for any underlying problems. Other conditions that can cause memory loss include Alzheimer’s dementia, head injury, stroke, brain infections, brain tumours, liver disease, kidney disease, thyroid disease, nutritional deficiencies, sleep problems, alcohol abuse, side effects of some medications and also mental health conditions like severe stress, anxiety and depression.

Strategies for dealing with forgetfulness include maintaining a familiar environment and normal routines as much as possible; a healthy diet; adequate sleep; social interaction; using memory tools e,g, reminders and to-do lists; getting mental and physical exercise; learning a new skill; treating any other illnesses; and avoiding alcohol.

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