Normal Aging or Dementia

It starts with the little things. You misplace your phone, forget an appointment, or drive off with your coffee mug on the roof of your car. After a while, the trickle of small memory lapses can start to feel like a flood. You may wonder, "Is this normal, or is something wrong with me?"

Or maybe you're worried about a family member or friend. This person, who once seemed so sharp and on top of things, now appears overly forgetful or confused or irritable. You wonder if you should talk with them about this, but you don't want to hurt their feelings or make them angry.

You're Not Alone

The first thing to remember is that you're not alone in your concerns. The Alzheimer's Association estimates that half of all Americans over age 65 report sometimes or often noticing changes in their ability to think, understand, and remember things. About 22% worry that these changes significantly interfere with their ability to function. As of 2024, about 6.9 million Americans were living with Alzheimer's or related dementias. (For more information, see 2024 Alzheimer's Disease Facts and Figures.)

Most people experience some changes in their thinking and memory as they get older. You may need more time to take in new information or recall information you already know. You may have some trouble finding the right words to express your thoughts, or thinking through a problem situation. In fact, even some younger people experience these symptoms as a result of stress, inadequate sleep, or multitasking.

When to Worry

So how do you know what's normal and what's cause for concern? Here are some red flags to look out for:

• Noticeable memory loss, especially for recently-learned information
• Confusion about where you are, how you got there, what day or season it is
• Trouble communicating your thoughts or understanding what others are saying
• Trouble with spatial skills, such as getting lost when walking or driving
• Trouble with motor skills, like how to get dressed or use eating utensils
• Significant changes in personality or mood

Finding Out What's Wrong

Your first step should be to consult your family physician, who can help rule out medical causes for your symptoms (disease, infection, medication side effects, etc.). Your doctor may give you a brief cognitive screening test to get a rough estimate of your thinking and memory skills, and may recommend lab tests or brain scans to provide additional information. You may also be referred to a neurologist to evaluate your movement, balance, and reflexes.

The next step is to meet with a psychologist for a comprehensive neuropsychological evaluation. The psychologist will talk with you and your family about your symptoms and how they compare to your previous levels of functioning. Then the psychologist will administer a series of tests to measure your skills in the following areas, among others:

• Verbal skills - listening and using language
• Visual perception, spatial orientation, and visual/motor skills
• Memory or auditory and visual material
• Short-term, long-term, and working memory
• Reasoning, judgment, and problem-solving
• Attention and concentration
• Depression, anxiety, or other psychological factors that can interfere with your ability to function

Living with Dementia

If you are diagnosed with dementia, ask your doctor what type of dementia it is and what treatment options are available for you. Although there is currently no cure for dementia, there are many treatment strategies that can slow the progression of the disease and help you maintain your ability to function for as long as possible. Some of these include:

• Medication to address the brain changes contributing to dementia symptoms
• Occupational therapy to help you learn to maintain your balance and avoid falls
• Environmental modifications to maximize safety and familiarity with your surroundings
• Exercise to maintain fitness and optimal physical functioning
• Psychotherapy to help you and your family adjust to the life changes that dementia brings. (PPA's Psychologist Locator can direct you to a psychologist specializing in this area. Click on "Areas of Practice" and then on "Alzheimer's/Dementia" to find a specialist near you.)

For more information on dementia, including links to local and online support groups, explore the resources offered by the Alzeheimer's Association and the National Institute on Aging. Dementia is a difficult journey, but extensive support is available for both patients and caregivers.

Talk to someone who can help! Find a licensed psychologist near you, use PPA's Psychologist Locator at www.papsy.org/locator. For information on other mental health topics, go to www.papsy.org, Resources, and then Public Resources. PPA offers these articles for informational purposes only; they are not a substitute for professional diagnosis or treatment.

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