3 Warning Signs of a Potential Memory Problem

How to tell a "brain blip" from a memory problem, and what to do about it.

Posted Jul 21, 2018

Nadino/Shutterstock
Source: Nadino/Shutterstock

Forgetfulness is common and happens to most people, including memory champions. Distraction, fatigue, depression, anxiety, absentmindedness, and many other factors may contribute. Luckily, most memory problems are simply “brain blips”: temporary episodes of forgetfulness that are not a harbinger of Alzheimer’s or another memory disorder.

Common brain blips include misplacing frequently used objects, such as keys or glasses, forgetting why we walked into a room, and periodic difficulty remembering a word we want to say. Brain blips are frequently linked to situational factors and normal age-related changes. For most people, mental flexibility starts to become a bit less efficient with each passing decade from our late 20s onward, and memory starts to decline in our late 30s, so it is common to notice more memory problems as we age.  

However, because the rate of Alzheimer’s and other memory disorders also increases with age, and because memory impacts nearly every aspect of daily life, many people are eager for guidance on how to distinguish between normal age-related memory changes and signs of a memory disorder. This focus has surged in recent years as America’s population of older adults has reached historically high levels.

A 2011 Met Life Survey showed that America’s 76 million baby boomers feared Alzheimer’s only second to cancer. In addition, a 2015 United States of Aging survey found that 35 percent of people over age 60 were concerned about memory loss (about 23 million), and a 2017 survey by West Health Institute found that memory loss was the top concern of adults over age 60. Furthermore, the Alzheimer’s Association refers to Alzheimer’s as “the defining disease of the baby boomers,” and estimates that 10 million baby boomers will eventually have Alzheimer’s (representing a significant increase from the 5.4 million Americans who currently have the disease).

So how do we begin to tease apart the signs of normal versus abnormal memory changes when memory itself can be impacted by dozens of different variables? Here are three signs that may signal a potential memory problem:

1. Current memory is notably weaker than previous levels, as evidenced by increasing forgetfulness for well-known, frequently used information. This might include forgetting the route to the grocery store, a well-known recipe, a familiar procedure at work, the name of a well-known friend, or the names of common, well-known objects. Such forgetting of familiar, frequently used information goes well beyond related “brain blips” that might include forgetting the names of acquaintances you haven’t seen in years, forgetting how to navigate to a location you’ve only been to a couple of times, forgetting to run an errand, or “forgetting” information you never fully learned.

2. Increased or new forgetfulness that can’t be explained. Increasing forgetfulness for recent events (e.g., conversations, activities, and appointments) and/or new difficulty managing daily tasks due to memory problems (e.g., forgetting whether you have taken medication or paid the bills) may be problematic. This is especially the case if it does NOT appear to be explained by a known medical, emotional, or situational issue (e.g., some people experience temporary memory problems due to stress, lack of sleep, medication side effects, thyroid issues, or other medical problems, and memory bounces back after the underlying issue is corrected). Note that forgetting childhood memories and other “remote” information from many years ago is not a common early sign of a memory problem (though it may occur in the later stages of a memory disorder), and waiting for this type of memory problem can result in a delay in seeking help.

3. Others have noticed that memory is worsening. It is not uncommon for someone with a memory problem to not be fully aware of it, because they may not remember their own forgetfulness. Often, those we spend the most time with are the first to notice a memory problem, and can comment on whether it has worsened over time.

Notice that the signs above have a few commonalities: Forgetfulness may be a potential problem if it:

  • Reflects a notable decline from previous levels
  • Does not improve when potential contributing factors are addressed (and often worsens over time)
  • Involves forgetfulness for well-known information
  • Impairs performance of well-known tasks
  • Is noticeable to others

Next Steps

If you or a loved one have any or all of the warning signs noted above, it does not mean there is definitely a memory disorder present (especially because memory can be impacted by dozens of factors). Rather, it suggests that the following steps may provide some help:

1. Discuss memory concerns with a health-care provider. This may lead to a “work-up” to investigate possible contributing factors, which may include (a) laboratory tests to measure thyroid, vitamin, and other metabolic levels; (b) analysis of possible medication side effects; (c) brief memory screening (which provides a basic measure of thinking skills, though usually not enough detail to make a diagnosis or detect subtle memory problems); (d) a neuropsychological evaluation which statistically analyzes memory, attention, visual functioning, reasoning, strategy formation, and other skills (i.e., the “software” of the brain) to determine if memory problems are present and how best to treat them; and (e) possible neuroimaging (e.g., head CT or brain MRI) to evaluate the “hardware” of the brain.

2. Exercise. Multiple studies have shown that the most powerful treatment for mild memory problems is cardiovascular exercise, which can slow the rate of memory loss and even improve memory. Exercise also increases the density of brain tissue in the hippocampus (a core memory processing area) and the frontal lobes. Given that Alzheimer’s-related brain changes can start 10-30 years prior to diagnosis (in the late-onset variant, where symptoms begin after age 65), and given there is no treatment to stop the progression of Alzheimer’s, it is most advantageous to exercise proactively. However, it is never too late to begin. Exercise can also slow the rate of memory loss for those who already have moderate Alzheimer’s.

3. Increase neuronal density. In addition to cardiovascular exercise, increasing the number and density of neuronal pathways in the brain by building “Cognitive Reserve” has been shown to help the brain compensate for Alzheimer’s-related changes, and may even prohibit Alzheimer’s symptoms from being expressed!

Whether or not forgetfulness is a “brain blip” or a sign of a potential memory problem, it is never too late to start building better brain health.

     “The best time to plant a tree was 20 years ago. The second best time is today" —Chinese proverb

References

Rajan, K.B., Wilson, R.S., Weuve, J., Barnes, L.L., & Evans, D.A. (2015). Cognitive impairment 18 years before clinical diagnosis of Alzheimer disease dementia, Neurology, 10.

Ritchie, K., Ritchie, C.W., Yaffe, K., Skoot, I., & Scarmeas, N. (2015). Is late-onset Alzheimer's disease really a disease of midlife? Alzheimer’s & Dementia: Translational Reseearch & Clinical Interventions,1, 122-130.  

Salthouse, T.A. (2009). When does age-related cognitive decline begin? Neurobiology of Aging, 30, 507-514.

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