Is Forgetfulness in Older Adults Normal, or Could It Be a Sign of Dementia?

As you get older, changes take place in your brain that may impact your ability to recall information. You may notice that it can take a little longer to process new information or recall a detail from your past. These changes are a normal part of aging.If you’ve become more absent-minded as time has passed, you may wonder if your occasional memory lapses could mean that you have dementia. Mild changes can be part of the normal spectrum of aging, but more significant forgetfulness may be a sign of mild cognitive impairment or dementia. Dementia and mild cognitive impairment are medical conditions, not a normal part of aging.

Mild cognitive impairment is a condition that causes noticeable changes in cognition. The changes are problematic, but they won’t seriously impede your ability to function independently.You can live on your own with mild cognitive impairment, but it may be hard for you to learn new things or master the latest tech gadgets. You might leave yourself reminders everywhere so you don’t forget anything important. You may need someone’s help when you’re working on complicated tasks that you don’t do very often.

Mild cognitive impairment may worsen until it becomes dementia, a progressive condition that impairs memory and functioning. Alzheimer’s disease is the most common type of dementia.In its early stages, Alzheimer’s disease usually causes short-term memory loss. You may have very good autobiographical memories about high school, but you have difficulty remembering what you did last week. As the disease progresses, your ability to speak or understand language may become impaired.People with Alzheimer’s dementia are unable to fully and independently manage their activities of daily living. You may first lose your ability to handle complex tasks, like managing your finances or taking medication at set intervals throughout the day. You may start getting lost in familiar places or misplacing things around the house more than usual. If you begin doing a task, you may forget what it was you were going to do. You may forget to buy something you need at the store, or you may come back with multiples of the same item, unaware that you already have it at home. Some people with Alzheimer’s dementia say things that are socially inappropriate or embarrassing or become more irritable or argumentative than they were before. Eventually, you would lose the ability to do simple tasks, like bathing, dressing and going to the bathroom.

Some health conditions and certain medications may impact the sharpness of your brain, causing symptoms that mimic mild cognitive impairment or dementia. For example:

• Depression, severe anxiety, obstructive sleep apnea and/or untreated hearing loss may impact memory or cognition in some older adults.  

• Several types of medication may cause cognitive side effects in older adults. Benzodiazepines, which can treat anxiety, are common culprits. So are anticholinergic medications, including drugs that treat bladder incontinence. Even certain over-the-counter antihistamines cause cognitive effects, especially older antihistamines that have been around for decades. 

• Taking five or six medications every day (polypharmacy) may lead to unwanted drug interactions and additive side effects that may cause confusion or memory problems. 

If a provider discovers that your cognitive symptoms are caused by medication or health conditions, addressing those matters may improve your symptoms.

If problems with memory or cognition are impacting your ability to function in your day-to-day life, see a provider for an evaluation. During the evaluation, the provider will ask about your medical history and perform a physical exam to rule out other conditions. They’ll also ask questions to determine whether you could be experiencing cognitive changes. It’s important to have someone who knows you well accompany you, who can share their perspective on any changes that might be occurring.  Sometimes others close to you, including family, may observe changes that may not be obvious to you. Having both perspectives can help your provider perform a detailed assessment and determine the correct diagnosis.The provider should compare your current state to the way you’ve acted in the past. For example, if you’ve always had difficulty remembering people’s names, it’s less of a concern than if you always knew everyone’s names but lately, you can’t recall your friends’ names when you see them.If you’re seeking an evaluation, keep in mind that your lifestyle and personal expectations may influence how you perceive your cognitive functioning. For example, if you’re still working, or if you’re very active socially or in the volunteer world, you may have a very demanding lifestyle. You may be more likely to notice occasional memory lapses than someone with a very routine, scaled-down lifestyle.

Ask them to go with you to see a provider for an evaluation. Sometimes, family members have to say something to get their relative to think about their brain sharpness. Why? Because some people with mild cognitive impairment or dementia are unaware or may minimize that they’re experiencing cognitive problems. They need the nudge from a concerned loved one.Occasionally, people are diagnosed with mild cognitive impairment or dementia after their spouse or partner passes away. While the partner was alive, that partner may have helped the person with cognitive challenges manage their symptoms. (If cognitive problems developed slowly, the partner might not have realized that the other person’s forgetfulness was actually a medical condition). Without their partner to lean on for support, remaining family members may suddenly become aware of the depth of the person’s cognitive deficits.

Habits like these may benefit your brain health:

• Managing chronic conditions. If you have high blood pressure, high cholesterol or diabetes, see your provider regularly to control the conditions. Maintaining a healthy heart can support better brain health.

• Maintaining social contacts. Research has shown that loneliness and isolation may cause cognitive problems. Make an effort to get together with family or friends regularly; you’ll give yourself things to look forward to while benefiting your brain. 

• Keep your brain busy. Lean into activities that you enjoy doing. If music is something you’re passionate about, take up an instrument or join a choir. If you love words, do crossword puzzles. If you hate math, don’t force yourself to do Sudoku because you think it’s brain-healthy; instead, find something else that brings you joy.  

Call 302-320-2620 to schedule an appointment to discuss brain health or memory concerns with a provider whose focus is older adults at the Swank Center for Memory Care.Locations: Wilmington, Smyrna and Rehoboth.