Getting Older – Memory and Cognitive Concerns
Written By: Vanessa Buonopane, Psy.D.
As we get older, it is inevitable that we are going to experience memory and cognitive concerns. Many people who begin to have memory complaints worry that it is a sign that they are developing Alzheimer’s disease. However, not all people with memory problems have Alzheimer’s. There are many other reasons why an individual is experiencing memory and/or cognitive concerns, including medical complications, psychological issues, mild cognitive impairment, or another type of dementia.
Forgetfulness can be a normal part of aging and growing older. Middle-aged and older adults may begin to notice that it takes longer to learn new things, recall information, and lose things that might be right in front of them (e.g., cell phone or glasses). These are common to the human experience and are likely not a cause for concern.
So, when should you start to worry that something more serious is going on? If you or a loved one starts to engage in poor decision-making, loses track of the date and time of the year, forgets important details of conversations, misplaces things often, and has problems taking care of activities of daily living or those pertinent to living (e.g., paying bills, transportation, hygiene), you may want to consider speaking with your primary care physician (PCP). Your PCP can do a medical evaluation to determine if there may be any medical reasons for your memory and cognitive complaints. For example, did you know that urinary tract infections (UTIs) can cause sudden confusion (also known as delirium) in older individuals, as well as individuals with dementia? This confusion, along with increased agitation and withdrawal can mimic some of the same symptoms as dementia. When a UTI is treated, the memory and cognitive concerns typically resolve as well. Other medical conditions can also contribute to and cause memory problems, including tumors, blood clots, or infections in the brain; thyroid, kidney, or liver disorders; excessive alcohol use; head injuries; medication side effects; and lack of important vitamins and minerals (e.g., B12). Typically, once these problems are treated, any associated memory problems subside or go away altogether.
There are some psychiatric diagnoses, such as anxiety and depression, that can contribute to forgetfulness and may mimic symptoms of dementia. Significant stressors or transitions, such as recent retirement or the death of a loved one, can lead to an individual feeling sad, lonely, worried, or bored, and can also leave people feeling confused or forgetful. Similar to certain medical conditions, once the psychiatric issue is resolved, the memory or cognitive concerns typically also resolve.
Some older adults may be experiencing a condition called mild cognitive impairment (MCI), which means that they are experiencing more memory or other cognitive concerns than other people their age; however, individuals with MCI are able to continue their normal activities and take care of themselves. Currently, there is no standard treatment or approved medication for MCI, but there are many things an individual can do to stay healthy and manage memory and cognitive changes, such as learning a new skill, following a daily routine, exercising regularly, eating well, limiting alcohol use, and finding meaningful activities to engage in (e.g., volunteering, hobbies/interests). It is important to check-in with your PCP every six to twelve months to track any changes in memory and other thinking skills over time, as this can help understand the progression of a specific condition.
Ultimately, it is possible that MCI can progress into a specific dementia. Dementia is the loss of cognitive functioning, which includes thinking, remembering, learning, and reasoning, in addition to behavioral abilities to the extent that it interferes with the person’s quality of life and activities. Other concerns may be present, such as problems with language skills, visual perception, paying attention, and personality changes. Most people believe that Alzheimer’s is the only form of dementia; however, there are actually many different kinds of dementia.
If you, a family member, or a loved one believes that significant memory and cognitive concerns are present, it is best to talk with your PCP. Your PCP may recommend a neuropsychological evaluation, which will not only assess for any abnormal memory concerns, but can pick up on any cognitive deficits. An assessment psychologist or a neuropsychologist can look at the test results to determine if the individual might be matching the cognitive profile of someone experiencing normal aging concerns, mild cognitive impairment, or a specific type of dementia. Recommendations and “next steps” can also be made at the conclusion of the evaluation and are often catered to the individual needs of the person.
Image from: https://relish-life.com/blog/dementia-types
(n.d.). Urinary tract infections and dementia. Alzheimer’s Society. https://www.alzheimers.org.uk/get-support/daily-living/urinary-tract-infections-utis-dementia#:~:text=UTIs%20can%20cause%20sudden%20confusion,be%20because%20of%20a%20UTI.
(n.d.). Do Memory Problems Always Mean Alzheimer’s Disease? National Institute on Aging. https://www.nia.nih.gov/health/do-memory-problems-always-mean-alzheimers-disease#:~:text=Forgetfulness%20can%20be%20a%20normal,lose%20things%20like%20their%20glasses.