Dementia or Normal Age-Related Forgetfulness: Telling the Difference

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Some people worry that their forgetfulness could signal a dementia disorder. But some degree of incremental forgetfulness is a normal part of the aging process.

Dementia or Normal Age-Related Forgetfulness: Telling the Difference

As you get older, you may notice you’re becoming more forgetful. You may misplace your keys or your glasses, or you may occasionally forget the word you wanted to use in a sentence or the name of someone you used to know.

Some people worry that their forgetfulness could signal a dementia disorder, which includes Alzheimer’s disease and other less common disorders that are characterized by progressive memory loss and cognitive impairment that interfere with daily life. Alzheimer’s disease impacts about 1 in 9 people ages 65 and older, according to the Alzheimer’s Association. 

But some degree of incremental forgetfulness is a normal part of the aging process.

“What’s helpful to know is that change in all of our organ systems is expected and normal as we get older,” says Marzena Gieniusz, M.D., a geriatrician who is the medical director of the Alzheimer’s and Dementia Care Program at Northwell Health in New Hyde Park. “Just as our kidney function and heart function decline and our skin becomes thinner and more fragile over time, brain function changes as well.”

According to Dr. Gieniusz, older adults generally do not remember information as well as they did when they were younger, and they process information at a slower speed. This may make it more difficult for people to multitask or learn new information, such as a new language, as they get older. 

Forgetting things occasionally is completely normal, even for younger people. 

“Missing a bill here or there or forgetting about an appointment can happen to anyone,” Dr. Gieniusz says. “Usually, when we forget something as part of the normal aging process, we eventually remember that information. But for patients with dementia, recall of the forgotten information is less likely.” 

It’s also important to note that normal age-related forgetfulness does not disrupt someone’s life in a significant way. 

“People with normal age-related forgetfulness tend to be more worried about their forgetfulness than others around them, who don’t really notice it,” Dr. Gieniusz says. The opposite is typically true with dementia: The patient doesn’t notice the change, but family members and friends do.

The Long Island Alzheimer’s & Dementia Center in Westbury, which provides programs and resources for people living with dementia and for their caregivers, sometimes receives inquiries regarding concerns over memory or other symptoms. 

“We encourage people who have a concern to speak to their doctor,” says Melissa Katz, L.C.S.W., senior director of programs and services. People often see their primary care physician first, who may refer them to a geriatrician or cognitive neurologist for a diagnosis. 

The most common early symptom of dementia is memory loss that affects the activities of daily living. 

“People may start to have trouble managing their finances, such as bill paying, or managing medications or doctor’s appointments,” Dr. Gieniusz says. “With some types of dementia, there may also be changes in mood, behavior and personality.” 

Another early warning sign is disorientation in familiar places. 

“Someone may have been driving to the same supermarket or visiting their children for years and all of a sudden they forget the direction, take a wrong turn and aren’t able to find their way back,” Dr. Gieniusz says. 

“For some patients, an early warning sign may be that they begin showing poor judgment and making bad decisions,” says Tori Cohen, L.C.S.W., executive director of the Long Island Alzheimer’s & Dementia Center. 

There is no cure for dementia, but certain interventions can help with symptom management, improve quality of life, and potentially slow the progression of the disorder.

“Certain medications have shown some evidence of effectiveness at slowing progression of some types of dementia, but they have potential side effects, and their effectiveness is moderate at best,” Dr. Gieniusz says. 

Lifestyle modifications may also slow the progression or decrease the risk of developing dementia. 

“Studies have shown the importance of building up cognitive reserves over time by exercising the brain,” Dr. Gieniusz says. “We do this by learning new things and challenging our brains, which builds new neurons and strengthens existing neurons. Socialization is also important to cognitive stimulation.”

There is also evidence that a healthy lifestyle – including physical activity, a healthy diet such as the Mediterranean diet, maintaining a healthy body weight, managing stress, refraining from smoking, limiting alcohol, and limiting certain medications – helps slow the progression and lower the risk for dementia, according to Dr. Gieniusz. 

The Long Island Alzheimer’s & Dementia Center offers a day program with socialization and mental stimulation activities that are appropriate to each individual’s stage in the disease process. There are also one-on-one programs for dementia patients in their homes, as well as support groups, informational seminars, and counseling for caregivers.