Aging: When should I be concerned about a senior’s forgetfulness?

Caring for an older parent can be a difficult responsibility. Many adults feel “sandwiched,” caring for their parents and their children. Noticing that an aging parent is becoming increasingly forgetful and absent-minded can be frightening.

Mild changes in memory and other thinking skills are common as we age. For example, brief lapses in memory or attention—such as misplacing car keys or forgetting someone’s name—are usually not cause for concern. On the other hand, getting lost in familiar places, regularly burning food due to forgetting to turn off the stove, or being unable to recall recent conversations could be signs of a more significant problem.

For some, these difficulties may indicate a condition such as Alzheimer’s disease or another age-related form of dementia. A professional can assess any cognitive impairment and recommend a course of treatment.

Dementia refers to significant problems with memory and at least one other cognitive ability such as language or reasoning. Dementia can be caused by Alzheimer’s disease or other age-related problems such as stroke or Parkinson’s disease. Dementia is not an inevitable consequence of aging, although it is age-related and doubles in prevalence from a low rate in 60–64 age group to 40–50% of those older than 85.

Another condition, mild cognitive impairment or “MCI,” refers to problems with memory or other cognitive skills that, while present, do not cause noticeable problems in daily life. For some, MCI can lead to future dementia, but not all persons with MCI develop dementia.

While there are no known treatments or strategies to guarantee that an individual will not develop Alzheimer’s or other dementias, there are a few strategies that can help maintain “cognitive health” throughout life.

Given that stress can cause problems with thinking skills, older adults and their caregivers should regularly engage in enjoyable and relaxing activities to improve well-being and quality of life. Being socially active also appears to have benefits on mood and cognitive skills.¹

Intellectually stimulating activities (reading, visiting a museum, or completing craft or woodworking projects) create richer connections between brain cells, helping to maintain or improve brain function even in the face of age-related reductions in brain tissue. And while there is an association between engaging in mentally stimulating exercises, the benefit of such activities to reduce cognitive decline are not confirmed. However, there is a growing industry in brain training or brain fitness exercises, and people who practice these exercises do get better at them.

Some studies suggest that there are long term benefits to these activities, but the benefits are related to overall physical well-being rather than cognitive functioning. There is no hard evidence yet that cognitive exercises prevent dementia. At this time, there is limited evidence that these exercises, while neurologically healthy, translate into objective everyday cognitive improvements such as recalling names more readily or remembering where you left your eyeglasses.

There is also evidence from population studies that activities which reduce the risk for vascular problems, such as diabetes, high blood pressure, and stroke, are also associated with better cognitive function and lower risk of dementia. These include having a healthy body weight, engaging in regular aerobic exercise, and good eating habits. Research shows that healthy diets rich in unsaturated fats, such as vegetable and fish oils, can also decrease the risk of cognitive decline.²

Cognitive decline is common with age, but certain types can be more of a concern. Reaching out to get the recommendations and assistance of a specialist can address some of the decline and increase an older adult’s quality of life. If you are concerned about an older adult’s thinking skills, meet with your primary care physician to discuss whether a referral to a neuropsychologist is appropriate.

A neuropsychologist is a licensed psychologist with specialized training in assessment and treatment of cognitive problems associated with dementia or other neurological conditions. Early detection of abnormal memory decline by a neuropsychologist can be helpful in initiating appropriate treatment. Neuropsychologists play an integral role in the treatment and management of individuals with dementia, planning appropriate cognitive, psychological, and behavioral interventions, and training seniors with mild cognitive difficulty in strategies to improve daily functioning.³

Special thanks to neuropsychologist John Randolph, PhD, ABPP-CN and Liz Zelinski, PhD, and Peter Lichtenberg, PhD, of APA’s Div. 20 (Adult Development and Aging) who assisted us with this article.