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Dementia: What’s Cause for Worry and What Isn’t?

Not all brain changes are signs that something may be wrong


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You probably know that your brain, like the rest of your body, changes as you get older. Just as you may move at a slower pace with age, your brain may run a little more slowly, too. That means you could take a beat to recall someone’s name or to take in all the details of a story that someone tells you.

Many changes you may notice are nothing to worry about, but others should prompt a discussion with your doctor. Memory loss or changes in thinking skills that make it hard to live your daily life are not normal signs of getting older; they could be indicators of dementia.

Below are a few scenarios that indicate you should consider taking notice and action — and a few more situations that are generally no cause for concern.

Talk with your doctor if…

You’ve gotten lost in familiar places or confused in new places

If you get lost on your way to the supermarket that you’ve used every week for years, or you can no longer find your way around that familiar store, it could be a sign of abnormal memory loss.

As for new places, it’s no big deal to get lost on the way there, but if you find that you often get confused in new places — say, you can’t remember where you are or how you got there — this could be a sign of brain changes that go beyond normal aging.

People close to you say that you repeat yourself often

You may not realize that you ask the same questions or tell the same stories again and again. “If you remembered, you wouldn’t ask the question again,” says Zaldy Tan, a neurologist and director of the Memory and Aging Program at Cedars-Sinai Medical Center in Los Angeles. “You may need another person to verify this.”

So when a friend or partner tells you that you just told that story or that she already answered that question, pay attention. This may be an issue you should discuss with your doctor.

You forget things you recently learned

This is another thing that someone may need to point out to you. So, say you hear that your neighbors invited you to dinner tonight. Then, an hour later, when your spouse says, “Let’s be ready to leave at 6,” you say, “Leave for where?” To briefly forget about the dinner invite and then remember it is no big deal. But it could be a problem if you don’t recall it even after you’re reminded.

You consistently miss appointments

The occasional forgotten appointment is just a common human error. But if you simply can’t keep appointments anymore as you used to, this may be cause for concern.

You have trouble with tasks that require planning and execution or problem-solving

Tasks in which you have to follow several steps, like cooking from a recipe or checking your bank balance and paying bills, can become difficult to complete for people who have dementia. For example, you may not be able to concentrate long enough to follow a recipe. Or perhaps the system you’ve always used for keeping track of and paying bills feels too complicated now. Maybe you’re no longer able to take inventory of your fridge and write a shopping list. Or it may take you much longer to complete these multistep tasks than it used to.

It could be that you struggle to use gadgets and devices that caused you no trouble in the past. “If you’ve always had a smartphone, and then you switch from, let's say, an Apple to a Google device, and you can’t figure it out, not even to make a call,” Tan says, “that may be one of the earliest signs of dementia.” 

If daily activities that you used to do with no trouble now seem too hard, mention it to your doctor.

Research indicates you probably don’t need to worry if…

Multitasking (doing more than one thing at a time) isn’t as easy as it once was

In the past it may have been perfectly normal for you to do several things at once and actually pull them off. (To be clear, no one is great at this. It is not how our brains are meant to work. But some people get by.)

Maybe you talked on the phone while preparing a meal and half paying attention to something on the radio. Back then, you probably got the gist of the phone conversation and the radio segment without messing up your recipe. Nowadays, not so much.

“Juggling five or six different things at the same time may not work as well when we get older,” Tan says.

Now each of those activities — talking on the phone, listening to the radio and following a recipe — probably requires individual focus for you to get it right. You’ve got to call your friend back later, after you finish baking that cake. Or you’ve got to turn off the radio to follow a phone conversation.

That’s because multitasking relies on your working memory (the part of your memory that holds information for a short period). An example is when you quickly read off all the ingredients for your recipe and try to remember them for long enough to pull each item out of the fridge or pantry.

But when we get older, Tan points out, “our working memory may not be as robust.”

So now when you try to follow a recipe while talking on the phone, you carelessly add a cup of salt to your cake instead of sugar. That’s not dementia, though; you just need to pay attention.

You forget an appointment, an item at the grocery store or someone’s name but remember it later

It happens to everyone: You’re going about your day and, suddenly, it hits you. “Shoot! I was supposed to get my hair cut at 4!”

We all forget things. There are several theories as to why this happens. The interference theory says that we forget important information when other information crowds it out. When you try to keep a shopping list of five items in your head, for example, that fifth item might bump item number one from the list. According to the decay theory, that information simply deteriorates over time in your mind.

It’s also worth noting that sometimes you only think you committed something to memory. People often can’t remember where they parked their car or left their keys because they weren’t paying attention in that moment. Sometimes, when you mindlessly drop your keys onto the kitchen table, you’re already thinking about what you’re going to do next.

Whatever causes you to forget things occasionally, it’s just your normal human brain.

You make an isolated mistake when dealing with numbers

If you make an error while paying bills or counting out change in a store, it simply means that you’re human. It’s a blunder that can happen at any age and isn’t a cause for concern.

Learning and remembering may take a little longer

Your brain may not process information as quickly as you age, so don’t be surprised if it sometimes takes a few extra seconds to think of someone’s name or to find the word you want to say.

“Speed of information processing has been shown to slow down with normal aging,” Tan says. “It doesn't mean that you have dementia just because it took you five minutes to remember the name of that restaurant that you went to last.”

Slower processing time could also make it harder to learn how to use a new gadget.

“Older people tend to learn new things less efficiently,” Tan says. “So if [you’re trying to learn] to use an iPhone when you’ve always had a flip phone, you’re going to have problems.” A need to take a beat, or a little longer, to absorb or recall information is just a part of getting older.

Forgetting the day of the week and then remembering it later

It may seem like a red flag, but everyone blanks out occasionally and forgets what day of the week it is.

“Especially [during the COVID] pandemic,” Tan says, “every day is ‘Blursday.’ ” This is not a big deal, as long as you soon snap out of your haze and recall what day it is. Now, frequently forgetting what year it is — or what decade — could be a more troublesome sign of memory loss.

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