First, it is important to know that dementia cannot be diagnosed from afar or by someone who is not a doctor. A person needs a detailed doctor’s exam for a diagnosis. Sometimes, brain imaging is required. And, forgetting an occasional word — or even where you put your keys — does not mean a person has dementia. There are different types of memory loss and they can have different causes, such as other medical conditions, falls or even medication, including herbals, supplements and anything over-the-counter.
Normal memory loss
As we age, we experience many physical and cognitive changes. Older people often have a decrease in recall memory. This is normal. Ever have trouble fetching a fact from the deep back part of your “mind’s Rolodex”? Suppose you spot someone at the grocery store you haven’t seen in years. Maybe you recognize the face, but don’t remember their name until later that night. This is normal, part of the expected changes with aging.
When you have troubles with memory — but they don’t interfere with your daily activities — this is called mild cognitive impairment. Your primary care doctor can diagnose it. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.
- Memory
- Attention
- Communication
- Reasoning, judgment and problem solving
- Visual perception beyond typical age-related changes in vision
More severe issues
When memory loss interferes with daily activities, see your doctor about what to do and how to make sure you’re safe at home.
There are numerous types of severe memory loss. Dementia tends to be a slow-moving progression that occurs over months or years. Delirium is more sudden and can occur over hours or days, usually when you have an acute illness. Depression can also cause memory changes, particularly as we get older.
Dementia and other brain issues
Alzheimer’s dementia is the most common type of dementia, followed by vascular dementia. They have similar symptoms: confusion, getting lost, forgetting close friends or family, or an inability to do calculations like balance the checkbook. Certain medical conditions — thyroid disorders, syphilis — can lead to dementia symptoms, and less common types of dementia can have different kinds of symptoms. Alzheimer’s has a distinct set of symptoms often associated with certain changes in the brain.
It’s also important to be aware of two other things that can lead to decreased mental functioning — delirium and depression.
Delirium, a rapid change in cognition or mental functioning, can occur in people with an acute medical illness, like pneumonia or even Covid-19 infection. Delirium can occur in patients in the hospital or at home. Risk for delirium increases with age or previous brain injuries; symptoms include decreased attention span and memory issues.
Depression can happen at any time, but it’s more common with aging. How can you tell if you’re depressed? Here’s one simple definition: when your mood remains low and you’ve lost interest or joy in activities you once loved.
Sometimes people have recurring episodes of depression; sometimes, it’s prolonged grieving that becomes depression. Symptoms include anxiety, hopelessness, low energy and problems with memory. If you notice signs of depression in yourself or a loved one, see your doctor. If you have any thoughts of harming yourself, call 911 to get help instantly.
Any of these conditions can be frightening. But even more frightening is unrecognized or unacknowledged dementia. You must, openly and honestly, discuss changes you notice in your memory or thinking with your doctor. It’s the first step toward figuring out what is happening and making sure your health is the best it can be.
Laurie Archbald-Pannone is an associate professor of medicine, geriatrics, at the University of Virginia.