Factors Other Than Dementia May Affect Your Memory

No need to panic

People understand and accept many of the changes associated with aging, such as changes in skin appear-ance or hair color, but they often don’t extend this same acceptance to brain function. Dr. Ravdin says that, at age 60, it is normal, for example, to have trouble recalling the name of a casual acquaintance you made last week.

“People assume that, as soon as they have memory problems, something is drastically wrong, when, usually, there isn’t. It’s just normal, age-related changes,” said Dr. Ravdin. Exactly when these changes happen differs from person to person, she says.

Dr. Ravdin explains that, among new patients, the most common complaint is “word find-ing”—the inability to come up with the right word. “Difficulty in retrieving words is a very common complaint with aging; it is well described in the medical literature, and not necessarily a cause for wor-ry,” says Dr. Ravdin.

Memory modifiers

Medications affect different people in different ways, and some can affect memory. Common culprits include anti-anxiety drugs, tricyclic antidepressants, anti-seizure drugs, opioids (narcotic painkillers), beta-blockers (used to treat hypertension, heart failure, and abnormal heart rhythms), and antihistamines.

Life factors, including stress, poor sleep, and changes in schedule and environment, all can disrupt memory. The loss of a friend, family member, or spouse also can cause distress and impair one’s ability to think clearly. Even an event such as retirement can affect memory, because the retiree may suddenly become less active mentally and physically.

“People who remain physically and mentally active do better on tests of thinking abilities. Being active helps promote healthy brain aging,” notes Dr. Ravdin.

The most common cognitive issues for older adults are language, visual-spatial problems, attention problems, and memory. In particular, source memory—when you remember the content, but not where you heard or saw it—tends to change as we get older.

“We’re not built to remember everything,” says Dr. Ravdin. “Some degree of forgetting is normal; it’s not pathologic in any way.”

When testing is warranted

There is cause for concern when forgetting becomes more than just an annoyance—when it disrupts your normal activities, like taking daily medications, or forgetting important dates even when you’ve written them on a calendar. When you find yourself or a loved one frequently groping for the correct words, repeating questions or statements several times, behaving differently, or when family members begin to express concern about behavior, it’s time for a formal test.

Ironically, the people who worry the most usually have pretty good memories. “They often remember every instance of forgetting—which means their memory is pretty good,” Dr. Ravdin explains. The patients for whom she has the most concern are those who come in with a family member, saying that their memory is still pretty good—but the family member is sitting in the background, shaking his or her head.

“The people who really have problems with memory forget that they forgot,” says Dr. Ravdin.

Family members or the primary care physician are the best judges of cognitive change, says Dr. Ravdin. It’s a simple matter to have a mental status test with your personal physician, who can then decide whether it’s appropriate to make a referral to a neuropsychologist or neurologist for further testing.

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