Are you mildly concerned that one day the police will find you walking the streets at midnight, wearing only your underwear, swinging a bat at a tree? After all, you couldn’t find your iPhone this morning, and isn’t that the first sign you’re losing your marbles?
Forgetfulness is very common in old age. But when does it become a real problem and transition from mere forgetfulness to outright dementia? At what point will you find yourself so forgetful that you’re routinely unable to finish what you . . . Where were we?
In medical circles, the term “dementia” describes a progressive decline in memory that interferes with overall quality of life. Common signs include an inability to recall names or identities, correctly identify your location, or complete multistep tasks. The biggest concern is that dementia will become so severe that living independently is no longer possible.
Dementia is not itself a disease, but rather a cluster of symptoms that result from an underlying disease. The most common is Alzheimer’s, though dementia also frequently occurs as the cumulative effect of multiple small strokes (blockages in blood flow to the brain, which cause a loss of working brain tissue).
The main risk factors for dementia are high blood pressure, smoking, high cholesterol levels, and chronic alcohol use. You might be able to delay the onset of dementia by staying physically active and keeping your mind sharp (see the Quick Consult).
So you’re having trouble remembering names and can’t always recall where you left your keys. Is that normal? Or Alzheimer’s?
Take a Chill Pill
You keep pulling all-nighters. During sleep, your brain transfers memories from the day’s events into long-term storage. Inadequate sleep is therefore one of the most common causes of forgetfulness. Other symptoms include poor concentration, irritability, depression, and anxiety. Fortunately, you may have the solution to your sleep problem already in your hands (see the section on insomnia).
Your head is about to explode with stress. Are you worried about your finances? Work? A recent major change in your life? Stress can drive you to distraction, keeping your brain so preoccupied that it fails to pay proper attention to the outside world. Perhaps, as you were replaying that conversation with your boss for the hundredth time, you walked away from your car without locking the door. One solution is to schedule times to stress out, so your mind can vent all of its pent-up worries. Seriously—mark your calendar for thirty minutes when you can go to town on your deepest fears. Having exorcised those demons, you may find it easier to focus for the rest of the day.
You keep leaving your credit card at the bar. You may know from personal experience that too many vodka sodas can slur your speech, slow your reaction time, impair your memory, and interfere with your sleep. Even after the alcohol wears off, a few nights of poor sleep can have lingering effects on your memory. Try to limit yourself to one or two servings per day. As an aside, long-term alcoholism can occasionally result in a condition known as Korsakoff syndrome. One major feature is confabulation: the invention of (and sincere belief in) elaborate stories created to fill the gaps left by blackouts and memory loss.
With age comes . . . something . . . In late middle age and beyond, it’s common to experience a mild loss of short-term memory and difficulty processing new information. (If you don’t believe us, try teaching your great aunt how to use Snapchat.) These changes, however, should not interfere with overall quality of life. Interestingly, long-term memory is spared, so you’ll be able to remember your first phone number . . . but maybe not your current one.
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It’s like you’re always stuck in second gear. The thyroid gland helps regulate your metabolism. If it’s tuned up too high, you get sweats, shakes, diarrhea, and weight loss. If it’s in low-power mode, you get fatigue, constipation, weight gain, and memory loss. A simple and cheap blood test can uncover thyroid problems and is part of the standard dementia workup. (Also, you’re welcome for our putting the Friends theme song in your head.)
You aspire to be the Marlboro Man. Add memory loss to the long list of injuries that result from smoking. A lifetime of light-ups often causes blockages in the blood vessels that supply oxygen to the brain, causing small strokes that chip away at your memory. Your doctor may perform a brain MRI to look for evidence of previous strokes.
You never cared much for condoms. A one-night stand can leave behind many unwanted souvenirs. A dirty pair of underwear—not yours—found under the bed. A mystery number in your phone. And, of course, advanced syphilis. Even though you might associate syphilis with prostitutes from World War I, it is still very much out there, and over the course of decades it can spread to the brain and cause problems like memory loss, mood disorders (depression, mania), and tremors. Believe it or not, a syphilis test is part of the standard dementia workup. The treatment for syphilis infection is antibiotics.
There’s always a cloud above your head. Depression may present as forgetfulness and impaired concentration. Other symptoms include hopelessness, irritability, loss of interest in activities, fatigue, changes in appetite, loss of sex drive, sleep disturbances, and weight loss or gain. Interestingly, a depressed person usually acknowledges memory problems, whereas someone with Alzheimer’s usually denies or minimizes them. If you think you’re depressed, talk to your doctor about the many treatments that could improve your quality of life.
Your ticker was recently under the knife. Heart surgery usually requires the use of a bypass machine, which may cause a condition known as bypass brain or pump head. Patients describe a vague mental cloudiness, with loss of memory and acuity. Speak to your doctor if you recently had open-heart surgery and believe your memory issues started soon afterward.