Memory Malfunctions: Signs of Dementia or Normal Aging?

An estimated 6.7 million Americans who are ages 65 and older currently have Alzheimer’s dementia, and this number is expected to grow to 12.7 million by 2050, according to the Alzheimer’s Association. Based on these numbers, it’s only natural that people in their 60s and beyond are prone to interpreting brief memory lapses and longer learning times as possible early signs of this neurodegenerative disease.

The best defense against growing worry about Alzheimer’s disease (AD) is to gain an understanding of which types of changes in brain function do and don’t suggest the possibility of dementia.

Identifying Signs of Normal Aging

First, let’s do away with the mistaken belief that a healthy 65-year-old brain and a healthy 25-year-old brain will function much the same.

“It is a fact that changes in your cognitive abilities will occur as a normal part of aging,” says Lisa Ravdin, PhD, director of the Weill Cornell Neuropsychology Service in the Department of Neurology.

“Your memory absolutely does change as you get older. Just as there are physical changes that occur in your bones, muscles, and organs, there are also changes in the structure of the brain associated with aging that affect your brain function, including memory,” she explains.

Age-Related Changes

As your brain ages, some cells become damaged or die, the brain shrinks and loses volume, and your brain neurons transmit information more slowly.

“The aging brain processes, stores, and retrieves information at a slower pace, so older brains don’t function as efficiently as younger brains. It also takes longer to learn new things, and you may need repeated exposure to information in order to retain it,” explains Dr. Ravdin.

For all of us who are not memory experts, here’s information that can help us differentiate between normal cognitive changes and changes that suggest the possibility of dementia.

Examples of Differences

Normal, age-related changes won’t interfere with your ability to engage in activities of daily living, such as dressing, shopping, doing household chores, and paying bills. But changes that are caused by AD do interfere with daily activities.

A person who has AD may stop practicing good hygiene. They may consistently forget regularly scheduled appointments or be unable to remember the three things they need during their five-minute trip to the grocery store. They may also become inattentive to safety hazards, such as clutter in the hallway or a hot stove that’s been left on. As the disease progresses, so do the frequency of the unsafe behaviors.

Dr. Ravdin says your own observations about how your brain is working provide important information.

“People who have AD usually aren’t as concerned about memory problems as the people around them,” she explains. “On the other hand, people experiencing normal, age-related cognitive changes may worry when they misplace their keys or have trouble remembering someone’s name. People who are very aware of their own occasional memory lapses generally don’t need to worry.”

Word Usage and Recall

A person’s response to neurological testing can shed light on his or her degree of memory loss.

“People who have normal, age-related changes will usually be able to tell you most or all of the test items, as well as what items they got wrong. But people with dementia may be unable to remember most of the items—or they may be unable to recall they even took a test,” says Dr. Ravdin.

Problems with word usage and recall are often mentioned. Older adults often complain that they sometimes have trouble finding the “right” words; they may feel like the word is on the “tip of their tongue.” In a brain that’s aging normally, the word is not lost; you just aren’t able to retrieve it immediately. In most cases, eventually, you’ll think of the word. But patients who have AD cannot retrieve these “missing” words later, since the brain connections required for retrieval have been damaged, and they can’t be repaired.

Forgetting someone’s birthday or where you put your glasses does not suggest that you have AD. However, if you regularly forget your spouse’s name or you ask the same questions over and over, it’s time to see a memory disorders specialist for an evaluation.

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