Forgetfulness or Something More

Older woman wearing a sweater while looking out the window and drinking coffee

Everyone has had moments of brain fog: missing an appointment, forgetting an acquaintance’s name, misplacing car keys. But for some, it can be difficult to know whether this is related to aging, stress or something more serious.

Normal cognitive aging —those moments of forgetfulness or absentmindedness—isn’t something to be overly concerned about, says C. Neill Epperson, MD, director of the Penn Center for Women’s Behavioral Wellness.

“When people come to me with memory problems, we have to figure out what they really mean,” she says. “Is it name recall or not having the word you want to say, or having trouble remembering phone numbers? This is all very, very common as we age, and it’s not typically considered something to be overly concerned about—it’s not always a sign of impending dementia.”

As people age, the brain’s capacity to multitask and divide attention between different areas is diminished, which can contribute to these moments of forgetfulness.

“If you’re having a serious discussion and the person you’re talking with has your undivided attention, you’re probably not going to forget that interaction,” Epperson says. “But if you’re in the car trying to navigate heavy traffic and your child is also trying to talk with you, you may not remember the details of that conversation. I wouldn’t be worried about that.”

Though relatively harmless, these memory lapses can be particularly distressing for women who experience premature menopause due to ovarian failure or cancer treatment.

“Those normal things we experience with aging – such as moments of forgetfulness – become very upsetting for women in premature menopause because they seem more abrupt and noticeable,” Epperson says. “Plus, they’re occurring alongside other sudden physical changes.”

But when should you be concerned about memory loss?

“Spouses, other family members, employers or colleagues will often pick up on changes in your ability to remember details or other aspects of cognition before you do,” says David Wolk, MD, co-director of the Penn Memory Center. “This can be an early indicator of more serious problems.

He suggests that anyone who is experiencing memory issues discuss them with their primary care physician.“Your doctor can give you some perspective on whether you’ll require further evaluation or not,” says Wolk. “They can also make sure that medications you may be taking for other conditions aren’t a factor and assess things like mood and anxiety, which can be drivers of memory problems in your 50s and 60s.”

In some cases, patients may be referred to a specialist to try and pinpoint a root cause of mild cognitive impairment.“We have more and more diagnostic tests to help with this,” Wolk says. Although it can be difficult to diagnose Alzheimer’s disease and dementia, we are now able to pick up on memory problems that suggest these conditions sooner than we have been in the past.

Dementia is a generic clinical diagnosis referring to impairment in thinking that impacts a person’s ability to function. Alzheimer’s disease is just one kind of dementia, but there are many others.

“Normal aging comes with some memory decline too, I encourage people to see me if they have a concern,” Wolk says. He shares that, for some people, simple lifestyle changes can stave off memory problems long before symptoms set in. “The lifestyle factor that’s most frequently and consistently shown to have benefits is physical fitness,” Wolk says. “Exercising your brain is something you see advertised a lot, but exercising your body, particularly with aerobic exercise, may be even more beneficial at reducing your risk. You should be doing that even before you have symptoms.”

Other ways to reduce memory deficit include following a heart healthy diet and engaging in activities that are enjoyable, healthy and reduce stress – such as spending time with friends.

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