Is It Normal Forgetfulness or Something More Serious?
We toss them off with a laugh as “senior moments,” but those memory lapses that keep us from finishing a story or remembering the names of people we’ve met before can stir some not-so-funny worries that dementia is right around the corner.
When your mind starts to assign something serious to a momentary mental mix-up, it’s important to maintain some perspective, advises Jennifer Gatchel, MD, PhD, a geriatric psychiatrist at Massachusetts General Hospital. “Not all ‘senior moments’ or mid- to late-life changes in our thinking are signs of dementia or signs that we are going to progress to dementia,” she says. “It’s like other symptoms you might have in your body. Not every pain or other symptom is going to lead to the worst possible outcome. Try to minimize your worry about it, because unfortunately, worry and depression can actually make our thinking and brain function worse.”
The Aging Brain
Dr. Gatchel further suggests that it may be helpful to think of changes in our memory and other brain functions as you would other physical changes that develop as we get older. “A good analogy is that these moments represent normal wear and tear on the brain,” she explains. “It’s like joints that become less efficient as we age because of simple wear and tear over time. But we don’t think of that as a disease process.”
As the brain ages, certain changes occur in its structure and function. Volume in certain regions of the brain shrinks. There is decreased neurotransmitter production. Neurotransmitters are chemical messengers that relay signals from one brain cell to another. And the connectivity between different regions of the brain decreases over time, too.
All of these changes can contribute to moments of confusion, greater difficulty concentrating, and trouble recalling both new and old pieces of information. But how do you know if a memory lapse is just a benign blip or a red flag?
Is This Something New?
Dr. Gatchel says it’s important to know how you normally think and behave. “Always relate these things to yourself,” she says. “Is this a change for you? You may be someone who always misplaces things, so forgetting where you put your keys one day isn’t a big change. But if you’re someone who has a system and always puts things where you can find them and then you start misplacing them, that would be a concern. If you start doing that regularly, that would be a noticeable change for you.”
Another important way to determine whether memory lapses are possible signs of cognitive decline is whether the information you drew a blank on comes back to you later. If you can’t come up with a name in the moment, but then think about it later and it comes right to you, then that could be considered a minor and harmless moment to chalk up to age-related brain change. But if you have more and more moments in which names or other information completely escape you, even after coming back to them later in the day or the next day, you may want to take note of how often these things happen.
It’s also worth noting that minor details, like the name of a character actor from an old movie or the entrée you ordered on your anniversary dinner a few years ago, tend to slip away over time, in part to make room for new information and new memories.
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Occasional memory lapses or moments of confusion are normal, unavoidable aspects of aging. But when they become more frequent or you find yourself unable to recall important, personal information or make sense of a particular situation, you should consider talking with a doctor about this change in your thinking skills.
“If you’re forgetting names or other information that are salient to you—things about your friends and family, for example—that would represent a change and should be a concern,” Dr. Gatchel says. “Another concern is having difficulty navigating places you travel to regularly.”
When you’re not sure which road to take or you get confused at a busy intersection, you may be compromising your safety and the safety of others. “That sort of thing is a change to your baseline and should be concerning,” Dr. Gatchel says.
Reversible Changes
Not all new moments of confusion or forgetfulness are due to normal, age-related brain changes or more serious cognitive decline. Certain medications or metabolic changes, such as vitamin B12 deficiency or thyroid disease, can affect cognition. The same is true for a period of poor sleep or too much stress.
Dr. Gatchel notes that if a noticeable change in memory or thinking skills appears abruptly, then think about what is new in your life. Did you just start a new medication or increase the dosage of an existing medication? Do these moments occur around the same time each day?
If you suspect that changes in your thinking may be linked to something new—like your diet, medication regimen, or other lifestyle change—then talk with your doctor. Some medical conditions, such as urinary tract infections or other infections, can affect how you think. Dr. Gatchel says that treating a new health problem or making other adjustments may reverse any new nagging memory lapses or similar concerns.
Keys to Healthy Aging
Dr. Gatchel notes that some age-related change in brain function and structure is inevitable—the result of time and genetics, primarily. But other changes are largely affected by environmental and lifestyle factors over which we have some control. And one of the most important behaviors we can control that helps promote healthy circulation to the brain, greater brain cell production, and protection is exercise.
“It doesn’t have to be rigorous exercise,” she says. “But some regular physical activity can have a positive impact on cognitive health and mental health.” She also recommends staying mentally active and engaged, especially through social interaction. In addition, quitting smoking and adopting a heart-healthy diet, such as the Mediterranean-style eating plan, will promote greater vascular health and better brain function.
“It’s also very important to maintain an adequate level of sleep,” she says, adding that sleep apnea or other sleep problems should be evaluated by a doctor. Remedies for insomnia or other sleep challenges don’t always involve medications. You may be able to try some non-medication options first.
Takeaway
The next time you stumble trying to recall something you know is in your memory somewhere, relax. Don’t let your mind race to a scary place. “If you’re prone to thinking the worst, set some boundaries for yourself,” Dr. Gatchel says. “Talk with someone else about it. Ask if they’ve noticed a change. Remember, you’re not alone. Everyone deals with this eventually, and most age-related changes are not signs of dementia.”
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