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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


A man sitting in a home and thinking
JGI/Jamie Grill/Getty Images

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 someone tells you.

Many changes 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 signs of a health problem.

Below are a few scenarios. Some are worth a call to the doctor; others are 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 where you’ve been a regular customer, 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 — 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, M.D., a memory specialist and director of the Lynn Family Memory and Healthy Aging Program at Cedars-Sinai Medical Center in Los Angeles. So, when a friend or partner frequently tells you that they already answered your question, pay attention. This may be an issue to discuss with your doctor.

You forget things you recently learned.

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 being reminded.

You consistently miss appointments.

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

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

Tasks that require several steps, like cooking from a recipe or tracking and paying bills, can become difficult or take much longer for people with dementia. Or maybe you’re no longer able to take inventory of your fridge and write a shopping list. 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 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. Maybe you talked on the phone while preparing a meal and watching TV. Back then, you followed the phone conversation and the show without messing up your recipe. Nowadays, that’s not so easy.

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

That’s because multitasking relies on your working memory, the part of your memory that holds information for a short period. Research shows that the natural aging of the frontal lobe, located at the front of the brain, causes working memory and multitasking skills to erode. So now, when you try to follow a recipe while talking on the phone, you might mistakenly add a cup of salt instead of sugar to your cake. That’s not dementia, though; you just need to pay attention.

Interestingly, not all frontal lobe-based thinking skills decline with age. Your ability to do math, to perceive other people’s emotions and control your own, and to understand things in general won’t fade as you grow older. 

And as for those abilities that get a little weaker, it’s not a foregone conclusion that these strengths will plummet. Just how much changes depends on genetics and your lifestyle. Besides paying closer attention, you can take steps to preserve your working memory, multitasking skills and other frontal lobe functions as you age. A healthy lifestyle that includes the six pillars of brain health can help stave off these brain changes as you get older.

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 about why this happens. The interference theory says that we forget important information when other information crowds it out. According to the decay theory, information simply deteriorates over time in our minds.

There’s some debate as to which of these influences causes people to forget. Some studies have even tried to measure brain activity in healthy adults to decipher which one of these theories plays out during an episode of forgetting.

In a study of 51 college students published in 2022 in Frontiers in Behavioral Neuroscience, researchers recorded brain activity while the young adults performed a task involving remembering visual details. The researchers found that the number of details the students were expected to remember — not the time since encoding the memory — contributed most to forgetting. That’s interference, which would imply that trying to remember fewer things at once might help you recall them better later. 

It’s also worth noting that sometimes you only think you committed something to memory. You might mindlessly drop your keys on the kitchen table, 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’s just 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 week.”

Slower processing time could also make learning how to use a new gadget harder. “Older people tend to learn new things less efficiently,” Tan notes. Research shows that the need to take a beat, or a little longer, to absorb or recall information is just a part of getting older and may be a positive adaptive mechanism. In one experiment, 33 young adults ages 18 to 23 and 33 people ages 61 to 80 were given words to try to remember and recall later. When given more time to process the words before being asked to remember them, both groups’ memory performance improved, but older adults benefited most, especially those with stronger cognitive abilities. This suggests that extra time can be useful to support memory in older adults, according to the 2021 report in Aging, Neuropsychology, and Cognition.

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.

“We saw this especially [during the COVID] pandemic,” Tan says, “when every day [was] ‘Blursday.’” This is not a big deal as long as you soon snap out of your haze and recall what day it is.

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