How Much Forgetfulness Is Normal?
Ways to differentiate a normal aging brain from dementia
(This article previously appeared on Grandparents.com.)
Do you forget where you put your keys? Are you confounded when you see your neighbor’s youngest son and can’t remember his name? And where are your reading glasses?
How much forgetfulness is normal — and when should you be concerned?
Becoming more forgetful is a natural part of aging, experts agree.
“Our brains age just like the rest of our bodies,” says Dr. Gary Small, director of the UCLA Longevity Center and co-author with Gigi Vorgan of Two Weeks to a Younger Brain. “One of the manifestations of brain age is forgetfulness. It’s a common experience. We joke about it all the time. The concern behind all the humor is that these changes may be the first sign of something more serious. How do you differentiate the normal from dementia?”
Unfortunately, there’s no easy answer to that question, says Dr. Richard C. Senelick, a neurologist and medical director of Health South in San Antonio, Texas.
Unlike various types of cancer for which there are screening tests and then courses of treatment, dementia and Alzheimer’s disease cannot be screened. And even if they are discovered, there is no treatment that can reverse their course.
Senelick says most of us will experience memory loss as a natural course of getting older. “One of the first things to go is the speed of information processing. Your ability to quickly read, understand and process information slows, as does your ability to handle more than one task at a time," he says. “And of course, you will find yourself grasping for words every now and then. But more worrisome is a major change in your ability to function in the world."
Small agrees. “If you forget where you placed your keys, that’s normal,” he says. “If you forget how to use your keys, that’s a problem. You may once in a while forget where you parked your car, but if that happens to you once a week, that’s more like dementia.”
Normal Forgetting Is a Function of Distraction
“One reason we forget is that we haven’t given the information meaning. If something’s meaningful, it’s memorable,” Small says. “Pay attention to what you are doing.”
In addition to age-related brain changes, graying Americans are often full of information that distracts them from what they wish to remember. “We focus on what’s important for our goal, and we leave all the other stuff aside,” Small says.
You may remember that the meal you had was great, even if you can’t remember the name of the restaurant. “As our businesses grow or our lives become more complex, we don’t pay attention because some information is not necessary to accomplish our goals,” notes Small.
But if you are truly worried about how serious your forgetfulness is, Senelick says a test developed by researchers at Washington University in St. Louis to differentiate between normal aging and cognitive decline is a helpful tool. It consists of eight yes-or-no questions that assess whether there has been a marked change over time in the person’s behavior as seen through a series of scenarios. If you answer yes to two of them, then it may be the first signs of dementia or Alzheimer’s. Called the AD8 Interview, the test can be given to you, your spouse or your children to assess your cognitive status.
Most Common Memory Complaints
Even if memory problems are a common sign of aging, forgetting important things can be annoying and embarrassing. With Small’s help, we’ve summed up the four most common memory complaints and some tips for dealing with them:
Remembering names and faces You recognize the face, but can’t recall the name. “Our memories live in neighborhoods,” Small explains, “and when we try to remember something, it helps if we can associate it with something that will get us into the right neighborhood.”
Advice: As soon as you meet someone, try to associate his or her name with something familiar. If, for example, you’re introduced to Mr. White and he has grey hair, you can think, “White has white hair.”
Tip-of-the-tongue problems You can’t think of the name of the movie you saw last night — until you’re driving home from the dinner party where you made a fool of yourself groping for it. It’s again about making an association for yourself that allows you to pull it out of the right file in which you’ve stored it in your brain.
Advice: Small recommends writing down (on paper or on your smartphone) the name of the movie and as many words as you can associate with it. That simple exercise will allow you to access those words the next time and make it easier to remember the movie title (or book name or painting or whatever it is that’s on the “tip of your tongue.”)
Memory places Forgetting where you put things can be solved simply by always putting them in the same place every time you put them down.
Advice: If you can’t put your keys or your wallet down in its usual home, then say to yourself as you’re putting it down, “I am putting my keys on the nightstand.” And, says Small, if you can’t do either of those things at the moment you’re about to put them down, then don’t put them down.
Prospective memory If you forget to bring things to appointments, or walk out of the house without what you need for an important meeting, then the fix is to slow down.
Advice: “It’s about creating memory habits,” Small says. “What I recommend is to check your calendar at the same time and in the same place each day. Before you leave your house, think through what’s involved in what you are going to do. Do you have your insurance card? Do you have the folder you need to prepare your taxes? Do you need to bring anything else with you?”
Some Other Tricks for Keeping Your Memory Sharp
If you want to have a strong brain as you age, it also helps to take care of your heart. Put another way: The same things that ensure heart health ensure brain health, Small says. To keep your brain flexible and young, try to do the following:
Exercise That gets your heart pumping, which means more oxygen reaches your brain, which means that your brain gets healthier. Exercise also releases hormones that create a hospitable environment for the growth of brain cells.
Reduce stress That's because stress rreleases hormones like cortisol, which can inhibit brain cells. If you are stressed, you may also be taxing your memory because you are focusing on those things that worry you instead of the things that you need to do.
Eat well Filling your body with lots of sugar and empty carbohydrates could leave you with a serious case of brain fog because you’re not fueling your brain’s needs. Add Omega fatty acids (like those that come from fish and olive oil) and you’ll be giving it the building blocks it needs to create new cells. Meat (especially liver), seafood, eggs, milk and cheese are foods rich in Vitamin B-12 can help the brain by encouraging methylation, a process that brains need to be healthy, and which, in some studies, is shown to be lacking in people with Alzheimer’s disease.
A new study from Rush University Medical Center and published in the journal Alzheimer’s & Dementia says that older adults who rigorously follow a specific diet appeared to be 7.5 years younger cognitively than those who did not.
The study followed 960 adults who had no dementia and who were average age of 81 at the start of the study. Participants ate the Mediterranean diet and the DASH diet, which have both been shown to improve cardiovascular health. It includes eating three servings a day of whole grains, green leafy vegetables and one other vegetable each day, along with a glass of wine. Snacks include nuts, beans and berries. The diet includes poultry and fish at least twice a week. Key to success on this diet is to limit unhealthy foods, especially butter and sweets, as well as whole-fat cheese, fried or fast food.
Check your medications Pain medications, tranquilizers (like Xanax) and blood pressure medicines can all affect how your brain works, Senelick says. If you’ve been on a medication and are feeling confused or like your memory is not working, check the Internet to see if memory loss might be a side effect, and then ask your doctor to prescribe something else. “For most medicines, you have another choice,” Senelick says.