Memory Problems: What is Normal Aging and What is Not

Memory and aging

Memory is defined as “the power or process of reproducing or recalling what has been learned and retained” (Merriam-Webster Dictionary). Our ability to remember and to recall our past is what links us to our families, our friends and our community.

As we age, subtle changes in memory occur naturally as part of the aging process. However, sometimes these changes occur sooner than anticipated or faster than expected. These changes often go unnoticed, but at other times can be disturbing to ourselves or others. There are a number of things that can cause problems with memory or make normal age-related changes worse. For example, sometimes changes in memory might be due to a medication side effect or an existing or developing health problem, such as depression, anxiety, sleep problems, heart disease, infections in the brain, brain tumor, blood clots, head injury, thyroid disease, dehydration, or vitamin deficiency. If this is the case, identifying and treating the condition can improve your memory.

However, when memory loss prevents us from performing daily tasks and our accustomed roles in life, it becomes a health concern that needs further evaluation by healthcare professionals.

What memory problems are an expected part of normal aging?

Simple forgetfulness (the “missing keys”) and delay or slowing in recalling names, dates, and events can be part of the normal process of aging. There are multiple memory processes, including learning new information, recalling information, and recognizing familiar information. Each of these processes can get disrupted, leading to the experience of forgetting. There are also different types of memory, each of which can be affected differently by normal aging as shown below.

Preserved memory functions

• Remote memory (ability to remember events from years ago)
• Procedural memory (performing tasks)
• Semantic recall (general knowledge)

Declining memory functions

• Learning new information
• Recalling new information (takes longer to learn something new and to recall it)

What other cognitive changes occur with normal aging?

• Language is modestly affected by normal aging. Language is the “words, their pronunciation, and the ways they are used in combination to be understood.”
• Language comprehension (understanding the rules of language) is typically preserved, as are vocabulary (semantic memory) and syntax (the way in which words are put together).
• Trouble remembering names and finding words in conversations (“tip of the tongue”) are very common and verbal fluency (takes longer to “get the words out”) can also be affected
• While verbal intelligence (vocabulary) remains unchanged with aging, the speed of information processing gradually slows (such as problem-solving skills).
• Executive functions (planning, abstract thinking) remain normal for everyday tasks, but are slowed when faced with new tasks or divided attention (“multi-tasking”).
• A slowing of the speed of cognitive processing and reaction time (“hitting the buzzer”) occur with aging.

What memory problems are not considered a part of normal aging?

Memory problems that begins to interfere with normal daily life and activities are not considered normal aging. Forgetting where you put your glasses is a simple sign of forgetfulness, disorganization, or normal aging; however, forgetting what your glasses are used for or that they are worn on your face is not a normal memory problem.

The memory loss and thinking problems seen in mild cognitive impairment (MCI) or dementia are not normal aging. Researchers now believe that mild cognitive impairment is a point along the pathway to dementia for some individuals and the stage between the mental changes that are seen in normal aging and early-stage dementia. Not all individuals diagnosed with mild cognitive impairment will develop dementia. The following highlights some of the abnormal changes in memory that are seen in MCI and dementia.

Memory problems in people with mild cognitive impairment

• Forgets recent events, repeats the same questions and the same stories, sometimes forgets the names of close friends and family members, frequently forgets appointments or planned events, forgets conversations, misplaces items often.
• Has trouble coming up with the desired words. Has difficulty understanding written or verbal (spoken to) information.
• Loses focus. Is easily distracted. Needs to write reminders to do things or else will forget.
• May struggle, but can complete complex tasks such as paying bills, taking medications, shopping, cooking, household cleaning, driving.
• Has many important memory impairments but can still function independently.

Memory problems in people with dementia

Has many of the same symptoms of MCI plus as dementia progresses:

• Is unable to perform complex daily tasks (for example, paying bills, taking medications, shopping, driving).
• Loses insight or awareness of memory loss.
• Displays poor judgment.
• Declines in rational thinking and ability to problem solve.
• Memory, language, and cognition become so impaired that self-care tasks can no longer be performed without assistance from another person.

Can memory be preserved during the aging process?

According to the American Academy of Neurology’s practice guideline for patients with mild cognitive impairment, the best thing you can do to maintain your brain health is to exercise (particularly aerobic exercise) twice a week.

Although there is no clear-cut proven link that doing any of the following will help slow memory and thinking skill decline, these are general recommendations for maintaining good health.

• Maintain good blood pressure, cholesterol levels, and blood glucose levels.
• Stop smoking and avoid excess drinking.
• Eat a healthy diet -- one high in antioxidants and olive oil -- lowers the risk of dementia. Consider the Mediterranean or Dash diets.
• Maintain appropriate weight,
• Stay positive, find happiness, be grateful.
• Reduce stress.
• Get an adequate amount of sleep.
• Exercise your body (include aerobic exercises [exercises that increase your heart rate such as swimming, biking, or walking], strength training, stretching exercises, and balance training).
• Exercise your brain (do puzzles, quizzes, card games, read, learn a new language or play a new instrument, learn a new skill or hobby, take a class).
• Stay socially active (share hobbies with like-minded people, join clubs, volunteer).