The ‘pre-disease’ adult is generally an active member of our society, with hobbies, social contacts and probably performing volunteer work or even part-time employment. The age of retirement can mean ‘on to other adventures’ and continued activity and health management generally means productive relationships with other older adults and generational family interaction. People of this generation are more apt to live by themselves or with a significant other. There are a larger number of older adults who continue to drive, travel and engage in more independent living styles. With continuing medical advances, people are living longer, healthier and happier.

Cognitively, people have learned the importance of keeping the mind happy also. Reading, word games, using the computer and other ‘brain games’ help to keep our independence for a longer period of time. We have our “senior moments” of word loss, misplacing and forgetfulness. Our reading and decision-making time is slowed and it is sometimes difficult to compete with the younger generations in answering game questions quickly or even to be heard, because they are already on to another subject. Yet, all-in-all, we remain adequately functional and independent of daily care.

If the elders are fortunate to have family nearby, there is an element of safety which cuts stress and general anxiety levels about “what-if” situations, emergency care and routine assistance. Role boundaries are clear (at least not any worse) with other generations in the family and as much as we prize time with children and grandchildren (if fortunate enough), elders cherish alone time. We and our children pay little or no attention to cognitive slips and while we can become frustrated with the changes occurring in the older folks, we tolerate without much significant bother. Hopefully, much of the financial, health, medical and general living decisions have been taken care of with the parent’s participation.

Elders can have safe, appropriate time with younger grandkids without having to be chaperoned by our children. There is an opportunity to become important role models for grandchildren and may even travel with them if appropriate.

Regular professional appointments are kept with clarity about life planning and an active role in the future. Assistance with other medical conditions is available and, with a clear mind participates in accepting potential life threatening changes and medical planning.

This time frame may include what we consider age associated memory impairment. We find subjective complaints of memory deficit with forgetting where we place familiar objects, forgetting names of people we have known well, and increased difficulty with multi-tasking. The elder may speak their medical physician about what they notice but there is no objective evidence of memory deficit noted with work or in social situations. This may be considered a very mild cognitive decline. Is it the earliest stage of Alzheimer’s disease? There is no clinical evidence at present, to support that notion.

Younger children will not notice the subtle decline but teens may pick up on slowed responses or forgetfulness. Generally, the family, if they do notice any changes, will not comment or make light of incongruence’s. Family patterns and routines remain with safety not an urgent matter.