age-related memory loss_ what's normal, what's not, and when to seek help

Age-Related Memory LossWhat's Normal, What's Not, and When to Seek Help

We've all misplaced keys, blanked on an acquaintance's name, or forgotten a phone number. But

because memory loss is not an inevitable part of the aging process it's important to distinguish

between what's normal when it comes to memory loss and when you should be concerned. The

first step to staying mentally sharp as you age is to understand the difference between normal

forgetfulness that may be due to stress or other factors and serious memory problems.

Memory and aging: What's normal, what's not

Forgetfulness is a common complaint among older adults. You start to talk about a movie you saw recently when you realize you can’t remember the title.

You’re giving directions to your house when you suddenly blank on a familiar street name. You find yourself standing in the middle of the kitchen wondering

what you went in there for.

Memory lapses can be frustrating, but most of the time they aren’t cause for concern. Age-related memory changes are not the same thing as dementia.

As we grow older, we experience physiological changes that can cause glitches in brain functions we’ve always taken for granted. It takes longer to learn and

recall information. We’re not as quick as we used to be. In fact, we often mistake this slowing of our mental processes for true memory loss. But in most

cases, if we give ourselves time, the information will come to mind.

Memory loss is not an inevitable part of the aging process

The brain is capable of producing new brain cells at any age, so significant memory loss is not an inevitable result of aging. But just as it is with muscle

strength, you have to use it or lose it. Your lifestyle, health habits, and daily activities have a huge impact on the health of your brain. Whatever your age,

there are many ways you can improve your cognitive skills, prevent memory loss, and protect your grey matter.

Furthermore, many mental abilities are largely unaffected by normal aging, such as:

Your ability to do the things you’ve always done and continue to do often

The wisdom and knowledge you’ve acquired from life experience

Your innate common sense

Your ability to form reasonable arguments and judgments

What causes age-related memory loss?

The hippocampus, a region of the brain involved in the formation and retrieval of memories, often deteriorates with age.

Hormones and proteins that protect and repair brain cells and stimulate neural growth also decline with age.

Older people often experience decreased blood flow to the brain, which can impair memory and lead to changes in cognitive skills.

Older people are less efficient at absorbing brain-enhancing nutrients.

Normal forgetfulness vs. dementia

For most people, occasional lapses in memory are a normal part of the aging process, not a warning sign of serious mental deterioration or the onset of

dementia.

Normal age-related forgetfulness

The following types of memory lapses are normal among older adults and generally are not considered warning signs of dementia:

Ocassionally forgetting where you left things you use regularly, such as glasses or keys.

Forgetting names of acquaintances or blocking one memory with a similar one, such as calling a grandson by your son’s name.

Occasionally forgetting an appointment.

Having trouble remembering what you’ve just read, or the details of a conversation.

Walking into a room and forgetting why you entered.

Becoming easily distracted.

Not quite being able to retrieve information you have “on the tip of your tongue.”

Does your memory loss affect your ability to function?

The primary difference between age-related memory loss and dementia is that the former isn’t disabling. The memory lapses have little impact on your daily

performance and ability to do what you want to do.

When memory loss becomes so pervasive and severe that it disrupts your work, hobbies, social activities, and family relationships, you may be experiencing

the warning signs of Alzheimer’s disease, or another disorder that causes dementia, or a condition that mimics dementia.

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Normal age-related memory changes Symptoms that may indicate dementia

Able to function independently and pursue normal activities, despite

occasional memory lapses

Difficulty performing simple tasks (paying bills, dressing appropriately,

washing up); forgetting how to do things you’ve done many times

Able to recall and describe incidents of forgetfulness Unable to recall or describe specific instances where memory loss caused

problems

May pause to remember directions, but doesn’t get lost in familiar places Gets lost or disoriented even in familiar places; unable to follow directions

Occasional difficulty finding the right word, but no trouble holding a

conversation

Words are frequently forgotten, misused, or garbled; Repeats phrases and

stories in same conversation

Judgment and decision-making ability the same as always Trouble making choices; May show poor judgment or behave in socially

inappropriate ways

If you or a loved one is experiencing any signs of a more serious memory problem, it’s important to see a doctor to root out the cause.

Normal forgetfulness vs. mild cognitive impairment (MCI)

Mild cognitive impairment (MCI) is an intermediate stage between normal age-related cognitive changes and the more serious symptoms that indicate

dementia. MCI can involve problems with memory, language, thinking, and judgment that are greater than normal age-related changes, but the line between

MCI and normal memory problems is not always a clear one. The difference is often one of degrees. For example, it’s normal as you age to have some

problems remembering the names of people. However, it’s not normal to forget the names of your close family and friends and then still be unable to recall

them after a period of time.

If you have mild cognitive impairment, you and your family or close friends will likely be aware of the decline in your memory or mental function. But, unlike

people with full-blown dementia, you are still able to function in your daily life without relying on others.

While many people with MCI eventually develop Alzheimer's disease or another type of dementia, that doesn’t mean it’s inevitable. Some people with MCI

plateau at a relatively mild stage of decline while others even return to normal. The course is difficult to predict, but in general, the greater the degree of

memory impairment, especially when accompanied by trouble moving your legs and feet, the greater your risk of developing dementia some time in the

future.

Symptoms of mild cognitive impairment (MCI) include:

Frequently losing or misplacing things

Frequently forgetting conversations, appointments, or events

Difficulty remembering the names of new acquaintances

Difficulty following the flow of a conversation

If you suspect MCI:

The sooner you address the problem, the better, so make an appointment with your doctor right away. Your doctor can assess your personal risk factors,

evaluate your symptoms, eliminate reversible causes of memory loss, and help you obtain appropriate care.

Keep a list of your symptoms and concerns and ask family members for their observations. Write down specific information about the frequency, nature,

and setting of your memory, cognitive, or behavior concerns.

Take charge by learning how to cope with the impact of MCI. Also, learn how to recognize the symptoms of dementia. Knowing what to look out for can

help you plan, adjust, and live life as fully and independently as possible.

MCI / Alzheimer’s Questionnaire

The following 21-question test is designed to measure mild cognitive impairment and your risk of developing Alzheimer’s disease.

The questions are intended to be answered by a spouse, close friend, or other loved one.

While the Alzheimer’s Questionnaire is considered quite accurate, it should not be used as a definitive guide to diagnosing mild cognitive impairment or

Alzheimer's disease, but as a tool to test whether your loved one needs further assessment.

Use this questionnaire to test whether a person's memory loss needs further assessment.

Memory

1. Does your loved one have memory loss? Yes

No

2. If yes, is his or her memory worse than a few years ago? Yes

No

3. Does your loved one repeat questions, statements, or stories in the same day? (2 points) Yes

No

4. Have you had to take over tracking events or appointments, or does your loved one forget appointments? Yes

No

5. Does your loved one misplace items more than once per month, or so that he or she can't find them? Yes

No


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Memory

6. Does your loved one suspect others of hiding or stealing items when he or she can no

t find them?

Yes

No

Orientation

7. Does your loved one frequently have trouble k no

wing the day, date, month, year, or time, or check the date more than once a day? (2 points)

Yes

No

8. Does your loved one become disoriented in unfamiliar places? Yes

No

9. Does your loved one become more confused outside the home or when traveling? Yes

No

Functional Ability (exlcuding physical limitations)

10. Does your loved one have trouble handling money (tips, calculating change)? Yes

No

11. Does your loved one have trouble paying bills or doing finances? (2 points) Yes

No

12. Does your loved one have trouble remembering to take medicines or tracking medications taken? Yes

No

13. Does your loved one have difficulty driving or are you concerned about him or her driving? Yes

No

14. Is your loved one having trouble using applicances (e.g. microwave, oven, stove, remote control, telephone,

alarm clock)?

Yes

No

15. Does your loved one have difficulty completing home repair or other home-related tasks, such as

housekeeping?

Yes

No

16. Has your loved one given up or significantly cut back on hobbies such as golf, dancing, exercise, or crafts? Yes

No

Visuospatial Ability

17. Does your loved one get lost in familiar surroundings, such as their own neighborhood? (2 points) Yes

No

18. Does he or she have a decreased sense of direction? Yes

No

Language

19. Does your loved one have trouble finding words other than names? Yes

No

20. Does your loved one confuse names of family members or friends? (2 points) Yes

No

21. Does your loved one have trouble recognizing familiar people? (2 points) Yes

No

Score:

Interpreting the score:

0 to 4: No cause for concern

5 to 14: Memory loss may be MCI, an early warning of Alzheimer's

15 and above: Alzheimer's may have already developed

This questionnaire is not intended to replace professional diagnosis.

Source: BMC Geriatrics

How to Limit the Impact of MCI

Mild Cognitive Impairment (MCI) affects different areas of cognition for different people. But you can limit MCI’s daily impact with simple steps.

Memory

Good habits can help you compensate for a bad memory. If you’re having trouble remembering develop a routine to reinforce consistent habits. Keep your


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keys on a hook by the door, park in the same area so you can find your car with less effort, and link medication regimens with other activities, such as

eating a meal. Memory aids, such as notebooks or smartphones, are also helpful for tracking to-do lists, appointments, and important dates.

Executive function

Your executive function controls decision-making, planning, and organization. To combat potential confusion, simplify your choices and get rid of clutter.

Clear out your closet to limit your clothing choices, pare down the number of cooking utensils and pots and pans in your kitchen. Label doors, cabinets,

and boxes if you can’t remember what’s inside.

Visuospatial cognition

MCI often impairs your ability to interact with your visual world, which may include finding your way home and judging distances when you’re driving. For

early MCI, you can use GPS in your car and avoid driving during high-traffic times and in unfavorable weather conditions. For more advanced MCI, an

on-the-road driving evaluation with a driver rehabilitation specialist can help determine if you have the skills to continue driving.

Language

Your ability to recall words and use them properly may become impaired. But continuing to chat with family and friends is the best way to keep language

skills fresh. When you can’t think of a word figure out another way to get the meaning across—or just say that you’re having trouble finding the precise

word. Getting anxious will only inhibit recall, so pause to allow for the possibility that the word may or may not come back to you, then move on in your

conversation.

Social cognition

More effort may be required to recall someone’s name, remember shared experiences, or hold up your end of a conversation. However, it’s vital to

regularly stay in touch with friends and family, beyond the telephone. Maintaining social interaction is beneficial for preserving cognition, and many of the

most pleasurable experiences are those you share with others. Regularly schedule any activity you enjoy—dancing, a visit to the theater, a walk in the

park—that involves interaction with other people.

Adapted with permission from Harvard Health Letter: November 2013, a special health report published by Harvard

Health Publications.

Reversible causes of memory loss

Before diagnosing dementia or mild cognitive decline, it’s important to rule out reversible causes of memory loss. Your health, environment, and lifestyle can

all contribute to memory problems. Sometimes, even what looks like significant memory loss can be caused by treatable conditions and reversible external

factors.

Depression. Depression can mimic the signs of memory loss, making it hard for you to concentrate, stay organized, remember things, and get stuff

done. Depression is a common problem in older adults—especially if you’re less social and active than you used to be or you’ve recently experienced a

number of important losses or major life changes (retirement, a serious medical diagnosis, the loss of a loved one, moving out of your home).

Vitamin B12 deficiency. Vitamin B12 protects neurons and is vital to healthy brain functioning. In fact, a lack of B12 can cause permanent damage to

the brain. Older people have a slower nutritional absorption rate, which can make it difficult for you to get the B12 your mind and body need. If you

smoke or drink, you may be at particular risk. If you address a vitamin B12 deficiency early, you can reverse the associated memory problems. Treatment

is available in the form of a monthly injection.

Thyroid problems. The thyroid gland controls metabolism: if your metabolism is too fast, you may feel confused, and if it’s too slow, you can feel

sluggish and depressed. Thyroid problems can cause memory problems such as forgetfulness and difficulty concentrating. Medication can reverse the

symptoms.

Alcohol abuse. Excessive alcohol intake is toxic to brain cells, and alcohol abuse leads to memory loss. Over time, alcohol abuse may also increase the

risk of dementia. Because of the damaging effects of excessive drinking, experts advise limiting your daily intake to just 1-2 drinks.

Dehydration. Older adults are particularly susceptible to dehydration. Severe dehydration can cause confusion, drowsiness, memory loss, and other

symptoms that look like dementia. It’s important to stay hydrated (aim for 6-8 drinks per day). Be particularly vigilant if you take diuretics or laxatives or

suffer from diabetes, high blood sugar, or diarrhea.

Side effects of medication. Many prescribed and over-the-counter drugs or combinations of drugs can cause cognitive problems and memory loss as a

side effect. This is especially common in older adults because they break down and absorb medication more slowly. Common medications that affect

memory and brain function include sleeping pills, antihistamines, blood pressure and arthritis medication, muscle relaxants, anticholinergic drugs for

urinary incontinence and gastrointestinal discomfort, antidepressants, anti-anxiety meds, and painkillers.

Are you taking three or more drugs?

As well as certain individual medications, taking too many medications can also create cognitive problems.

A recent study found that the more medications you take, the higher your risk for brain atrophy. Researchers found that the loss of gray matter was

most acute in people who took three or more different medications.

If you are concerned about the medications you're taking, talk to your doctor. But do NOT stop taking your medications without your doctor's

consent.

Preventing memory loss and cognitive decline

The same practices that contribute to healthy aging and physical vitality also contribute toa healthy memory.

Exercise regularly. Regular exercise boosts brain growth factors and encourages the development of new brain cells. Exercise also reduces the risk for

disorders that lead to memory loss, such as diabetes and cardiovascular disease. Exercise also makes a huge difference in managing stress and alleviating

anxiety and depression—all of which leads to a healthier brain.

Stay social. People who don’t have social contact with family and friends are at higher risk for memory problems than people who have strong social ties.

Social interaction helps brain function in several ways: it often involves activities that challenge the mind, and it helps ward off stress and depression. So

join a book club, reconnect with old friends, or visit the local senior center. Being with other people will help keep you sharp.

Watch what you eat. Eat plenty of fruits and vegetables and drink green tea as these foods contain antioxidants in abundance, which can keep your

brain cells from “rusting.” Foods rich in omega-3 fats (such as salmon, tuna, trout, walnuts, and flaxseed) are particularly good for your brain and

memory. Eating too many calories, though, can increase your risk of developing memory loss or cognitive impairment.


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Manage stress. Cortisol, the stress hormone, damages the brain over time and can lead to memory problems. But even before that happens, stress or

anxiety can cause memory difficulties in the moment. When you’re stressed out or anxious, you’re more likely to suffer memory lapses and have trouble

learning or concentrating.

Get plenty of sleep. Sleep is necessary for memory consolidation, the process of forming and storing new memories so you can retrieve them later.

Sleep deprivation reduces the growth of new neurons in the hippocampus and causes problems with memory, concentration, and decision-making. It can

even lead to depression—another memory killer.

Don’t smoke. Smoking heightens the risk of vascular disorders that can cause stroke and constrict arteries that deliver oxygen to the brain.

Walking: An easy way to fight memory loss

New research indicates that walking six to nine miles every week can prevent brain shrinkage and memory loss. According to the American Academy of

Neurology, older adults who walked between six and nine miles per week had more gray matter in their brains nine years after the start of the study

than people who didn't walk as much. Researchers say that those who walked the most cut their risk of developing memory loss in half.

Brain exercises to prevent memory loss and boost brainpower

When it comes to memory, it’s “use it or lose it.” Just as physical exercise can make and keep your body stronger, mental exercise can make your brain work

better and lower the risk of mental decline. Try to find brain exercises that you find enjoyable. The more pleasurable an activity is to you, the more powerful

its effect will be on your brain. You can make some activities more enjoyable by appealing to your senses—by playing music during the exercise, for example,

or lighting a scented candle, or rewarding yourself after you’ve finished.

Here are some ideas for brain exercise, from light workouts to heavy lifting:

Play games that involve strategy, like chess or bridge, and word games like Scrabble.

Try crossword and other word puzzles, or number puzzles such as Sudoku.

Read newspapers, magazines, and books that challenge you.

Get in the habit of learning new things: games, recipes, driving routes, a musical instrument, a foreign language.

Take a course in an unfamiliar subject that interests you. The more interested and engaged your brain, the more likely you’ll be to continue learning and

the greater the benefits you’ll experience.

Take on a project that involves design and planning, such as a new garden, a quilt, or a koi pond.

Compensating for memory loss

Even if you are experiencing a troublesome level of memory loss, there are many things you can do to learn new information and retain it.

Tips to Help You Remember

To keep track of dates, schedules, tasks, phone numbers

Leave yourself notes or make checklists.

Put appointments and important dates on calendars and in a day planner or electronic organizer.

Ditto for phone numbers and other contact information.

If you have trouble remembering how to do something, write down the steps.

To remember where you put things

Put the things you use regularly (keys, glasses, purse, watch) in the same spot when you’re not using them.

If you have to put something down in a different place, look at the place when you put down the object and say the location out loud.

If necessary, write down where things are.

To stay on top of times and places

Set an alarm clock or timer to remind you when to leave for an appointment or do something in your home.

Use a map to help you get from one place to another.

Enlist friends and relatives to remind you of where you need to be and what you’re supposed to do.

To learn new information

Listen closely when someone talks to you.

Repeat back the information.

Try to talk with people in quiet places.

Focus on one thing at a time; screen out distractions.

When to see a doctor for memory loss

It’s time to consult a doctor when memory lapses become frequent enough or sufficiently noticeable to concern you or a family member. If you get to that

point, make an appointment to talk with your primary physician and have a thorough physical examination.

The doctor will ask you a lot of question about your memory, including:

how long you or others have noticed a problem with your memory

what kinds of things have been difficult to remember

whether the difficulty came on gradually or suddenly

whether you’re having trouble doing ordinary things

The doctor also will want to know what medications you’re taking, how you’ve been eating and sleeping, whether you’ve been depressed or stressed lately,

and other questions about what’s been happening in your life. Chances are the doctor will also ask you or your partner to keep track of your symptoms and

check back in a few months. If your memory problem needs more evaluation, your doctor may send you to a neuropsychologist.


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More help for age-related memory loss

How to Improve Your Memory – Tips and Exercises to Sharpen Your Mind and Boost Brainpower

Understanding Dementia – Signs, Symptoms, Types, and Treatment

Alzheimer's and Dementia Prevention – How To Reduce Your Risk and Protect Your Brain as You Age

Staying Healthy As You Age – How to Feel Young and Live Life to the Fullest

Depression in Older Adults and the Elderly – Recognize the Signs and Find Treatment that Works

What’s Causing Your Memory Loss? It's Not Necessarily Alzheimer’s

Resources and references

Memory Loss: Protecting Your Mind and Coping with Concerns (PDF) includes tips to help keep your mind sharp as you age: (Pri-Med Patient Education

Center, Harvard Medical School)

Mild Cognitive Impairment – Description of Mild Cognitive Impairment, how it differs from dementia, and how it can be diagnosed and handled. (University of

California, San Francisco, Medical Center)

Nutrition and memory

Folate May Help Forestall Forgetfulness – Summarizes research on how folate improves mental function and reduces memory loss. (US Department of

Agriculture)

Omega-3 Fatty Acids Improve Cognitive Function (commercial site) – Report on how fish oils, specifically DHA, help prevent memory loss. (Life Enhancement)

Other resources about memory loss and aging

Confusion, Memory Loss and Altered Alertness – Q & A about memory loss, what to do if you're worried about losing your memory, and what to expect as

you grow older. (University of Michigan Health System)

Understanding Memory Loss (PDF) – Uses case-study examples to show different degrees and causes of forgetfulness and other lapses in cognition, with

advice for diagnosis and ways to compensate for memory loss. (U.S. Department of Health and Human Services: National Institute on Aging)

Forgetfulness: Knowing When to Ask for Help – Discusses the distinction between memory lapses and dementia. (National Institute on Aging)

Symptoms of Alzheimer’s – Lists the ten warning signs of Alzheimer's disease and differentiates them from normal, occasional forgetfulness. (Alzheimer's

Association)

Authors: Melinda Smith, M.A., Lawrence Robinson, and Robert Segal, M.A. Last updated: December 2014.

©Helpguide.org. All rights reserved. This reprint is for information only and NOT a substitute for professional diagnosis and treatment.

Helpguide.org is an ad-free non-profit resource for supporting better mental health and lifestyle choices for adults and children.


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