Occasional memory lapses are common with age, but persistent changes deserve a closer look. Know the warning signs, other possible causes and when to seek medical attention.
November is National Alzheimer’s Disease Awareness Month, a time to raise awareness about a condition affecting millions of Americans and the importance of recognizing early signs. While occasional forgetfulness can be part of aging, persistent or worsening symptoms may signal a condition requiring evaluation.
“Just because someone is forgetful doesn’t mean they have dementia,” said Dr. Prabhjot Singh Khalsa, a neurologist affiliated with Washington Health. “However, persistent or progressively worsening memory changes warrant attention.”
When is forgetfulness normal?
As people age, recalling information or learning something new may take longer, Khalsa shared. Using calendars, diaries, and smartphones to track appointments and responsibilities is common and does not, by itself, indicate a memory problem. The key difference is whether changes persist or begin to interfere with daily activities.
Poor sleep, depression and other factors affecting attention can also cause “brain fog.” Occasionally forgetting someone’s name but recalling it later differs from repeatedly forgetting familiar people. Momentarily forgetting the day is different from becoming disoriented about the time, season or location.
When should you contact your primary care physician?
Talk with your doctor if changes in memory, thinking or behavior persist, worsen or affect everyday life. Warning signs include:
- Repeated memory lapses: Asking the same questions or forgetting recent conversations despite reminders.
- Difficulty with familiar tasks: Struggling to manage finances, follow recipes or handle routine responsibilities.
- Disorientation: Getting lost in familiar places or losing track of dates or seasons.
- Communication difficulties: Often struggling to find words or follow conversations.
- Changes in judgment: Making unusual financial decisions or having difficulty assessing risks.
- Misplacing belongings: Putting items in unusual places and being unable to retrace steps.
- Personality or behavior changes: Becoming unusually withdrawn, suspicious, anxious or irritable.
- Visual or spatial difficulties: Having trouble judging distances or navigating familiar surroundings.
Mild cognitive impairment (MCI) involves changes in memory or thinking beyond those expected with age, but generally does not significantly affect independence. MCI can precede Alzheimer’s disease; however, not everyone with MCI develops dementia. Sudden confusion, trouble speaking or other possible stroke symptoms require emergency care. Call 911. Do not wait for a routine appointment.
What else can cause forgetfulness?
Memory problems can have other causes, including sleep disorders, depression, medication side effects, alcohol or drug use, and nutritional deficiencies.
Vitamin B12 deficiency can affect memory and thinking, and is treatable. Older adults and people taking medications such as metformin face increased risk. Identifying underlying causes is an important part of the evaluation.
What happens during a memory evaluation?
A primary care physician is a good starting point for someone experiencing memory changes. The initial evaluation generally includes reviewing symptoms, medical history, medications, sleep patterns and mood. Bring examples of changes and a current medication list. A family member who has noticed changes may also provide useful context.
Brief cognitive tests can assess memory, attention, language, problem-solving and orientation, but they cannot diagnose Alzheimer’s disease on their own.
A physician may order laboratory tests to check for treatable conditions or, when indicated, an MRI or CT scan to look for structural changes, prior strokes or other abnormalities.
Neurological evaluation may also consider conditions such as seizures, prior strokes or hydrocephalus. Depending on the findings, the physician may refer the patient to a neurologist for further testing.
What to know about new Alzheimer’s blood tests
Advances in blood-based biomarker testing are giving physicians new tools to investigate Alzheimer’s disease. These tests measure certain proteins in the blood, including amyloid-beta and phosphorylated tau, that may indicate changes in the brain associated with the disease. They offer a less invasive option than some traditional diagnostic tests, but cannot diagnose Alzheimer’s on their own.
For people experiencing memory or thinking changes, biomarker testing may provide additional information as part of a broader medical evaluation. These tests are not intended for routine screening of people without symptoms, and their accuracy can vary. A primary care physician can evaluate symptoms, investigate potentially treatable causes and determine whether additional testing or referral to a neurologist or memory specialist is appropriate.
To find a Washington Health primary care physician, visit washingtonhealth.com/PrimaryCareCenters.