When memory changes are more than 'just getting older'
You've probably heard this phrase before: "I'm just getting older." The statement is often made to explain myriad aches and pains, memory lapses and mobility limitations, and may reflect acceptance that some parts of the body do not work as well as they once did due to aging – a truth that all creatures experience.
The explanation should be used with caution, though. Often, I tell my patients not to blame something they are experiencing on "just getting older," because they might miss something that could be treatable. This expression is frequently used to dismiss daily symptoms, which could result from an underlying disease, leading to needless suffering that could have been evaluated and appropriately treated.
Memory complaints do occur very frequently as one gets get older. Delays in recalling words and names – feeling that what you want to say is "just on the tip of your tongue" – are a part of normal aging, and unfortunately these delays lengthen as a person gets older. Multitasking and learning new things also become more challenging. These are normal aging experiences, but none of these changes should affect one's ability to remain independent in performing basic and instrumental daily living activities.
Often, a person who experiences a memory complaint never brings up the issue with his or her doctor. Sometimes the same patient has so many medical problems that, despite the best efforts of the patient's primary care physician, managing other medical problems takes away the time needed to address a memory concern appropriately.
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Memory complaints become significant when you start to see them affect daily life. Sometimes a person's ability to remain employed, perform work-related tasks, participate in community activities or maintain hobbies declines, leading that person to retire or quit an activity. When memory problems impair a person's ability to engage in everyday routines such as managing finances, driving in familiar areas or taking medications regularly and reliably, then the memory problems should not be ignored or brushed off as a normal part of aging. An evaluation focused on memory complaints should be performed if such signs are observed.
A basic workup includes a review of the memory or cognitive issues, specifically how long the problems have been noted, and any other associated mood, behavioral or movement problems. Cognitive testing (such as a Folstein Mini-Mental State Examination or Montreal Cognitive Assessment) should be performed to document the presence and severity of the cognitive impairments. A screening for depression should also be performed, along with routine bloodwork. A CT scan of the brain could also be performed to exclude other problems. Ultimately, all of this information should be reviewed to uncover the most likely explanation for the memory problems and to determine the best ways to manage those issues.
Though dementia may be the first cause that comes to mind, there can be others. Sometimes depression can trigger memory complaints, although they're often accompanied by other symptoms, such as loss of interests in hobbies or activities a person previously enjoyed, a feeling of worthlessness, sleep problems or loss of appetite. A recent illness or hospitalization could cause a temporary period of confusion called delirium, which typically resolves over time. Medications – prescribed, over-the-counter or herbal – that affect the brain, and medical conditions such as stroke, thyroid problems or vitamin deficiencies, could also produce memory and/or cognitive problems.
It's important to remember that changes with memory and cognitive function accompany, but aren't necessarily explained by, normal aging. If there is a concern or if function becomes compromised because of memory problems, it should always be brought up with your physician. The ultimate goal is to preserve independence and to plan ahead if you need assistance.
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