Where Did I Leave My Keys?
Worrying About The Memory Lapses That Come With Age
David Fein, MD
It can start with walking into a room and then wondering why you went in there. Or, you have trouble remembering where you left your keys. Maybe you run into someone familiar and suddenly blank on their name. Soon, you are starting to worry about whether you are developing a problem with your memory.
Memory lapses are a normal part of daily life. Like most other things, when you are young you tend to shrug them off. But as we get older, they can start to get a bit more worrisome.
Some changes in memory and cognitive function are a normal part of aging. Some of the changes are the self-inflicted consequence of our hyper-complex, multi-tasking lifestyles. However, there is a difference between the normal changes in cognitive function and the type of memory problems associated with Alzheimer’s disease and other more serious types of dementia. The key is in trying to sort out what is normal and what is a sign of a developing problem. And even if your memory problems seem to be more than just normal aging, less than 50% of the cases of memory loss turn out to be related to early Alzheimer’s Disease. Often, another underlying cause can be found and treated.
Vascular disease, such as atherosclerosis, is a common cause of changes in memory, personality and cognitive function in older people. Plaque in the arteries to the brain can cause very small blood clots to form that break off and lodge in the small arteries in the brain. This results in tiny areas of damage throughout the brain, including the centers in the brain responsible for memory, language, personality, etc. Unlike a major stroke that presents with sudden and severe neurologic deficits, these changes occur gradually over a long period of time.
Sleep disorders are also a common cause of changes in cognitive function. Even though you may think that you get enough sleep, conditions such as sleep apnea can interfere with getting sufficient deep-stage sleep. You may get 8 hours of sleep but still be sleep deprived because changes in your breathing or other disruptions pull you out of deep sleep and back to light sleep. Over time, memory and concentration begin to suffer. If you tend to snore, have daytime fatigue or often wake up still feeling tired, correcting a problem with your sleep may be an easy path to getting sharper again.
Memory problems can be caused by a wide variety of other treatable reasons, such as vitamin and nutritional deficiencies, hormone deficiencies (such as menopause, under-active thryoid or low testosterone levels) or infections. These are generally easily diagnosed with simple blood tests. Depression and stress can also cause forgetfulness and difficulty concentrating.
Our lifestyles have becoming increasingly distracting and over-stimulating in recent years. Your cellphone and computer may make staying in touch more convenient. But when you are getting a steady stream of text messages, twitter updates, and emails while your co-worker or spouse are talking to you, it is no surprise that you tend to forget what they were saying. It takes your brain several seconds to consolidate and store a memory. Get distracted by something else before that memory is fully formed and it is likely that later you will find the details of that conversation or event are missing or incorrect. In that case, there is nothing wrong with your memory. The problem is your environment.
Fortunately, there are ways to differentiate worrisome changes in recall, memory and brain function from the more typical and common brain lapses that seem to happen more with the passage of time.
In-office neuro-psychometric testing offers a fast, painless and non-invasive way to measure many aspects of cognitive function. This simple 30 minute test can quantify performance in each aspect of cognitive function.
Quantitative MRI scans of the brain can measure the areas in the brain that control memory and look for changes in volume that are characteristic of the early stages of Alzheimer’s disease. The MRI scan can also detect other causes of memory changes such as tumors or tiny areas of damage caused by mini-strokes due to atherosclerosis or certain types of heart problems.
PET/CT Amyloid Imaging can find the early build-up of the abnormal proteins in the brain that are believed to play a significant role in the development of Alzheimer’s Disease.
A variety of laboratory tests are available to detect the nutritional deficiencies or infectious processes that may be causing memory impairment.
At-home sleep monitors have made the detection of sleep apnea and other sleep problems simple, private and painless.
Memory problems are often treatable. In those cases where stress or lifestyle factors appear to be the cause, simple changes to reduce distractions are likely to cure the problem. When a specific reason can be identified, such as sleep problems, infections or nutritional deficiencies, treatments are available to correct it. Medications to lower cholesterol and blood thinners can help prevent or significantly delay further progression of vascular disease.
Most important of all, maintaining a healthy lifestyle with optimal fitness and diet may help to keep your brain functioning at its peak performance for many extra years.