If the neurologist Dr. Daniel Lesley sees 10 patients a day, at least half ask him the same question: Are the brain lapses they’re experiencing a normal part of aging? Or should they be worried?
“People have an absolute terror of losing their memory and thinking they’re losing themselves,” says Lesley, who works at Remo Health, a virtual dementia care company. “They don’t know what’s normal, what’s potentially a sign of something bad, and what’s reversible.”
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Just like every other organ in the body, the brain changes as you get older. Occasional, subtle memory problems—like not remembering where you parked at Costco—are usually no big deal. “Part of normal aging is paying less attention to details, and more attention to patterns and dynamics,” Lesley says. “It may also become more difficult to access things quickly,” like names and certain words.
When sporadic trouble becomes a regular occurrence, however, and other memory issues pop up—like repeating questions or missing appointments—it’s time for an evaluation. If you’re not sure, ask a spouse, friend, or adult child, suggests Dr. Zaldy S. Tan, director of the memory and healthy aging program at Cedars-Sinai Medical Center. “Have a conversation: ‘Have you noticed me repeating anything or asking the same questions? Have you noticed me misplacing things more often?’ Because we’re not necessarily the best judge of our memory—we don’t remember what we forget,” he says.
If you decide to make an appointment, it helps to be prepared. Don’t just tell your doctor you’re getting forgetful, Tan advises; everyone has the occasional senior moment, no matter their age. Log your memory problems in a journal that you take to the visit. That way, “you can be specific about what you’re forgetting, how often it happens, and how consequential these things are,” he says.
We asked brain health experts to share the signs that it’s time to take your memory problems seriously.
You have trouble with familiar tasks
Young people often love to multitask, jumping between texting and watching TikTok videos and cooking dinner. That’s perfectly doable, because their brains are more plastic—able to easily change and adapt—than those of older folks, and their attention spans tend to be more robust, Tan says. Once you get to middle age, your capacity for paying attention starts to decrease; plus, you’ll probably have a lot more on your plate. That means that one day, when you’re making breakfast, you might blank on how to use the toaster oven. “I liken it to having a lot of balls in the air,” he says. “I used to be able to juggle five balls, and now I’m only able to juggle four. Guess what? The fifth is the toast, and it’s burned.”
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If you’re not multitasking, however, and you suddenly can’t remember how to use the washing machine, or you forgot to turn off the stove again and it caused a small fire, that’s more worrisome. “If you were distracted, I would say, ‘Hey, maybe you should pay more attention to what you’re doing,’” Tan says. But if that task was your sole focus, and you still ruined the clothing because you washed it in bleach, consider seeking an evaluation.
You miss your usual commitments
If you start dropping the ball on routines or activities you’ve been doing for a while, something more serious than normal aging could be at play. One of Tan’s patients, for example, had picked up her grandchildren from school for years, but suddenly forgot to do so one day. “I think she thought it was a Saturday, not a Friday,” he recalls. “In and of itself, it’s not like, ‘Oh, you have dementia.’ But it’s certainly something worth noting.”
When to worry depends on your baseline, he adds. For some people, forgetting one important commitment might be so out of character that it warrants at least mentioning to a primary care doctor. Others, however, may realize they were stressed or especially busy when it happened, and probably don’t need to take it too seriously until it becomes a pattern.
Your personality or mood changes
Several symptoms that aren’t memory-related are associated with early Alzheimer’s and dementia, including irritability, depression, anxiety, and apathy. “You can see some of these changes beginning years before the diagnosis of dementia is confirmed,” says Dr. Gary Small, chair of psychiatry at Hackensack University Medical Center. “People tend to think of this as a cognitive disease, but it’s a behavioral disease, too.”
You misplace important belongings
If you’re walking in the door and talking on the phone—while making a beeline to the fridge for a snack—you might set your keys down and forget exactly where you put them. That’s because you were multitasking, Tan says. Misplacing things becomes much more concerning, he adds, if it happens frequently, which all depends on your baseline. Some people are naturally scatterbrained, while others are highly organized, so if they suddenly start losing things, it’s a red flag.
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Tan always asks patients: Did you forget something important? For example, maybe you left your credit card at a restaurant or your wedding ring at the Pilates studio. Making a habit of misplacing those types of items, which people usually pay close attention to, is more alarming than forgetting where you tossed your keys, he says. Once it happens a few times, or enough that it’s causing a real headache in your life, bring it up with your doctor.
You repeat certain questions
Some people are notorious for telling the same stories over and over again—and in those cases, it may be little more than a (sometimes annoying) personality trait. Yet one of the most common complaints Tan hears about is that people ask the same questions or repeat the same stories—and it usually comes from their spouse, friend, or adult child. “They’ll say, ‘My mom keeps repeating the same questions, or telling me the same stories,’” Tan says. He responds by asking what the allegedly forgetful person was doing the first time around. If they were driving and listening to a podcast while asking what time the birthday party at cousin Tom’s was the next weekend—and then they asked again a few days later—that’s usually no big deal. “But if there’s no reason to believe that they just weren’t paying attention, then that is of concern,” he says. It really comes down to their usual state: If your mom has always been a repeater, that’s just her. But if it’s a new development, it’s worth investigating.
You get lost in familiar places
Following directions is based on visual-spatial memory. As Tan explains: “To get to the grocery store, I know that I have to turn right here, and then left there, and then there’s a drugstore on the corner, and that’s when I make a sharp left.” When people start getting lost in familiar places, it’s usually because their visual-spatial memory is affected. Provided you’re paying close attention to where you’re driving, “That’s a red flag, unless a place has changed a lot,” he says.
Your parent developed Alzheimer’s at the same age
Age of symptom onset tends to be consistent within families. If your mother developed dementia at 85, and you’re occasionally misplacing your keys in your early 60s, you’re probably experiencing normal aging, Small says. If she was diagnosed with Alzheimer’s at age 62, on the other hand, there’s more reason to take your slip-ups seriously.
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Over the years, Small has treated plenty of people with mild cognitive impairment, and many remain relatively stable with interventions like lifestyle changes and medication. “There’s a lot of pushback to finding out,” Small says. “But you can do a lot to keep your mind healthy, and even if you do have a diagnosis of early dementia or mild cognitive impairment, it’s not a reason to run away. It’s really a reason to be proactive.”