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 medical examination for a diagnosis. Brain imaging is sometimes needed. And forgetting an occasional word – or even where you put the keys – doesn’t 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 medications, including herbs, 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. It’s normal. Have you ever had trouble retrieving a fact from the deepest part of your “Rolodex of mind”? Suppose you spot someone at the grocery store you haven’t seen in years. Maybe you recognize the face, but you don’t remember their name until later that night. This is normal, part of the expected changes with aging.
When you have memory problems but they don’t interfere with your daily activities, this is referred to as mild cognitive impairment. Your primary care physician can diagnose. But sometimes it gets worse, so your doctor should follow you closely if you have mild cognitive impairment.
- Reasoning, judgment and problem solving
- Visual perception beyond the typical age-related changes in vision
More serious problems
When memory loss interferes with daily activities, consult your doctor about what to do and how to make sure you are safe at home.
There are numerous types of severe memory loss. Dementia tends to be a slow progression that occurs over the course of months or years. Delirium is more sudden and can occur for hours or days, usually when you have acute illness. Depression can also cause changes in memory, particularly as we age.
Dementia and other brain problems
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 make calculations such as checkbook balance. Some medical conditions – thyroid disorders, syphilis – can lead to symptoms of dementia, and less common types of dementia can have different types of symptoms. Alzheimer’s has a distinct set of symptoms often associated with certain changes in the brain.
It is 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, such as pneumonia or even Covid-19 infection. Delirium can occur in patients in the hospital or at home. The risk of delirium increases with age or with previous brain injury; symptoms include impaired attention span and memory problems.
Depression can occur at any time, but it is more common with aging. How can you tell if you are depressed? Here’s a simple definition: when your mood stays low and you’ve lost interest or joy in the activities you once loved.
Sometimes people have recurring episodes of depression; sometimes, it is prolonged bereavement that turns into depression. Symptoms include anxiety, hopelessness, low energy, and memory problems. If you notice any signs of depression in yourself or a loved one, consult your doctor. If you have thoughts of harming yourself, call 911 for help immediately.
Any of these conditions can be frightening. But even scarier is unrecognized or unrecognized dementia. You must, openly and honestly, discuss with your doctor the changes you notice in your memory or thinking. It’s the first step to understanding what’s going on 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.