As individuals age, experiencing occasional forgetfulness, such as struggling to recall a name or a specific word, is a normal part of the aging process. However, these common memory lapses can sometimes lead to concerns about developing dementia, with a significant portion of older adults reporting worries about cognitive decline. Experts emphasize that cognitive changes are individual, and while some may maintain high cognitive function into their later years, others might experience changes earlier.
Dr. Carolyn Fredericks, an assistant professor of neurology at Yale School of Medicine, explains that cognitive functions, including memory, attention, and language, naturally begin a slow decline on average after age 30. "It’s very normal to see changes in how we do, not just on formal cognitive testing, but on day-to-day situations in our lives as we get older," Fredericks stated.
There is a distinct difference between normal age-related thinking and memory changes and the indicators of dementia. What is considered normal aging includes a longer time to learn new things. Dr. Adjoa Smalls-Mantey, an emergency psychiatrist in New York City, notes that it becomes slightly harder to absorb new information, requiring more repetition for learning.
Difficulty finding the right word, often described as the "tip-of-the-tongue phenomenon," is another common experience. Dr. Robert Underwood, a neuropsychologist at the UofL Health — Brain & Spine Institute, explains that while it might take longer to retrieve a word or piece of information, it is still accessible. "If you forget a word ... and then you remember the word five seconds later or a minute later, that’s normal," Smalls-Mantey added.
Forgetting why you entered a room and then remembering upon leaving is also characteristic of healthy aging, according to Fredericks. Similarly, misplacing items like glasses occasionally is normal, as long as it does not significantly disrupt daily activities.
Multitasking can also become more challenging with age. Smalls-Mantey points out that tasks that were once manageable simultaneously may become difficult, potentially leading to errors like burning food while cooking and trying to perform other activities.
Concerning brain changes are those that significantly impact daily life. Fredericks advises that if family members notice repetitive questioning or memory lapses, it warrants attention. Other red flags include difficulty navigating familiar routes, forgetting long-held information such as a long-term employer's name, or misnaming objects. "I think that people should be worried when these changes are getting worse in their thinking and memory, when they’re happening more often, when they disrupt day-to-day functioning and they get in the way of doing things they used to be able to do successfully and without any confusion or problems," Underwood said.
When cognitive changes impair functional ability, requiring more assistance for daily activities, it may indicate more serious signs of dementia. However, cognitive decline can sometimes stem from reversible causes like new medications, lack of sleep, or mood changes.
Experts also highlight that lifestyle plays a crucial role in dementia risk. Fredericks notes that nearly half of dementia risk is related to modifiable factors. Adopting healthy habits such as managing high cholesterol, diabetes, and hearing loss, engaging in regular exercise, following a nutritious diet, addressing depression, and avoiding smoking can help lower dementia risk. Sufficient, high-quality sleep is also vital. While genetics can play a role, Underwood encourages those concerned about cognitive changes to consult a doctor promptly for assessment and potential treatment options.