As we get older, it’s normal to experience some changes in memory, thinking skills, and other cognitive functions. Sometimes the changes are subtle, like taking a bit longer to learn new skills or remember names. But for some people, the changes are more significant and begin to impact day-to-day life. If you’ve noticed your thinking skills slipping, you may be wondering “Am I losing my cognitive function?” Let’s take a closer look at some signs of cognitive decline and what you can do about it.
Common Signs of Cognitive Decline
Here are some common indications that you may be experiencing a decline in cognitive function:
- Forgetting important dates, events, appointments, or conversations
- Frequently misplacing items
- Trouble learning new information or skills
- Difficulty concentrating or increased distractibility
- Taking longer to do routine tasks
- Confusion when performing complex tasks
- Changes in mood like increased anxiety or agitation
- Withdrawing from social interactions
- Problems with speech and language
- Difficulty balancing checkbook or managing finances
If you notice several of these issues in yourself or a loved one, it may signify cognitive changes beyond normal aging. But it doesn’t necessarily mean you have dementia or Alzheimer’s disease. There are a number of causes of cognitive impairment.
Mild Cognitive Impairment
Many older adults experience a condition known as mild cognitive impairment (MCI). With MCI, you may have more significant memory and thinking problems than normal aging, but not as severe as dementia. An estimated 15-20% of people over 65 have MCI. Key features include:
- Memory loss – Forgetting recent events or conversations
- Difficulty performing familiar tasks – Struggling with steps of a recipe you’ve made for years
- Concentration problems – Easily distracted and trouble focusing
- Limited executive function – Difficulty making plans or organizing
For some, MCI remains stable or even improves over time. But for many, it progresses to Alzheimer’s dementia within a few years. Having MCI puts you at higher risk of developing dementia.
Potential Underlying Causes
Mild cognitive impairment and more severe decline can be caused or exacerbated by a number of underlying medical, psychological, and lifestyle factors. Some potential causes to consider:
Physical Health Issues
- Vitamin deficiencies – Particularly vitamins B12 and D
- Hormone imbalances – Such as thyroid dysfunction
- Chronic conditions – Heart disease, diabetes, kidney dysfunction
- Medication side effects – Especially anticholinergics, sedatives
- Head injury
- Stroke
- Sleep apnea
- Infections – Urinary tract, sinus, etc.
Mental Health Issues
- Depression
- Anxiety
- Bereavement
- Loneliness and isolation
- Stress
Unhealthy Lifestyle Habits
- Lack of exercise
- Poor diet – Especially lack of vegetables, fruits, whole grains
- Dehydration
- Excess alcohol consumption
- Smoking
- Lack of quality sleep
- Lack of social and mental stimulation
Identifying and addressing any underlying causes can help minimize further decline and may even reverse some impairment.
When to See a Doctor
If your forgetfulness and mental fuzziness is persisting and impacting your daily activities and quality of life, it’s important to see a doctor. They can perform tests to identify any underlying conditions and determine if prescription medications or other treatments may help.
Your doctor should take a full health history, conduct a physical exam, assess your mental status, and order lab tests. They may also recommend scans like an MRI or CT to look at the structure of the brain. Neuropsychological testing can also help evaluate the extent of any cognitive impairment.
Based on the results, your doctor can determine if MCI or dementia is present and pinpoint any treatable causes. If the impairment is not reversible, they can suggest ways to manage symptoms and help maintain mental function.
Tips to Maintain Cognitive Health
While some cognitive decline is inevitable with aging, there are steps you can take to help minimize it:
- Get regular physical activity – Aim for 150 minutes per week
- Follow a Mediterranean style diet – Emphasize fruits, vegetables, whole grains, fish
- Manage chronic health problems – Work closely with your doctor
- Get quality sleep – Aim for 7-9 hours per night
- Stay socially and intellectually engaged – Maintain relationships and learn new skills
- Manage stress – Try yoga, meditation, therapy
- Don’t smoke
- Limit alcohol – No more than one drink per day
- Use memory aids – Calendars, to-do lists, reminders
- Do brain exercises – Puzzles, card games, learning a language
- Get organized – Declutter and keep items in designated spots
Making lifestyle changes can help keep your brain healthy and delay onset of more serious impairment. But check with your doctor before radically changing your diet or exercise habits.
When to Be Concerned About Dementia
While mild cognitive impairment does not severely impact daily life, dementia causes major decline that interferes with function. Warning signs that may indicate Alzheimer’s or another type of dementia include:
- Severe recent memory loss – Forgetting details of recent events or conversations
- Difficulty performing familiar tasks – Forgetting how to cook a meal you’ve made for years
- Disorientation – Getting lost in familiar places, confused about date or time
- Problems with language – Trouble finding the right words, rambling sentences
- Impaired judgment – Dressing inappropriately, poor financial decisions
- Misplacing items – Putting items in odd places then being unable to find them
- Changes in mood and personality – Increased agitation, withdrawal from socializing
- Loss of initiative – Decreased interest in hobbies, events
If you notice these red flags in yourself or someone close to you, see a doctor right away. Though dementia is not reversible, early diagnosis allows the best chance to manage symptoms and delay progression.
Diagnosing Dementia
Doctors use a combination of diagnostic tools to determine if someone has dementia, including:
- Medical history – Looking for risk factors and onset of symptoms
- Physical exam – Checking vitals, nerve function, balance
- Blood tests – To identify any vitamin deficiencies or thyroid problems
- Brain imaging – CT or MRI scans check for strokes or brain changes
- Mental status tests – Assess memory, language, problem solving
- Psychological evaluation – Identifies changes in mood, behavior, personality
Based on the results, doctors can diagnose Alzheimer’s disease or other types of dementia and rule out any reversible factors. Though no cure exists, early diagnosis opens the door to treatment options that can temporarily improve symptoms.
Treatment Options for Dementia
While dementia cannot be cured or reversed, several therapies are available that can temporarily help symptoms. Treatment options may include:
- Medications – Cholinesterase inhibitors and memantine can improve memory, concentration, behavior.
- Occupational therapy – Helps retain independence longer with daily activities.
- Physical therapy – Exercises to improve balance, mobility, and prevent falls.
- Speech therapy – Exercises and strategies for retaining language abilities.
- Music therapy – Can improve mood, behavior, and memory.
- Pet therapy – Bonding with animals can increase social engagement.
- Cognitive behavioral therapy – Helps develop coping skills and strategies.
- Home safety modifications – Handrails, grab bars, better lighting prevents falls.
Doctors also focus on managing any chronic conditions optimally and creating a predictable daily routine. Though not curative, this combination of therapies can temporarily stabilize symptoms and improve quality of life.
Caring for Someone With Dementia
When a loved one develops dementia, it presents many challenges for caregivers. Caring for their physical and emotional needs can become a full-time job. Tips for family caregivers include:
- Learn about the disease – Understanding its course helps ease your fears.
- Develop a daily routine – Follow a consistent schedule of meals, activities.
- Simplify their environment – Remove clutter, keep essential items in plain sight.
- Use notes and reminders – Post signs and write notes to cue desired behaviors.
- Communicate clearly – Speak slowly using simple words and phrases.
- Engage their senses – Look at photos, cook familiar foods, play favorite music.
- Allow safe walking and movement – Provides exercise and stimulation.
- Reassure them during frustration – Validate their feelings and gently redirect.
- Take care of your needs – Eat well, rest properly, take breaks.
- Join a support group – Share experiences and tips with other caregivers.
Despite the difficulties, focusing on creating joyful moments and nurturing the bond with your loved one can bring great fulfillment. There are also professional services available to provide assistance and give you an occasional respite.
Outlook for Cognitive Decline
Mild cognitive impairment may remain stable over time or progress gradually. But those with MCI have a higher risk of eventually developing Alzheimer’s or another type of dementia. According to the Alzheimer’s Association:
- 10-15% of MCI cases revert back to normal cognition each year
- 10-15% of MCI cases progress to dementia annually
- Over 50% of MCI patients develop dementia within 5 years
Once dementia develops, it is progressive with symptoms gradually worsening over an average course of 4-8 years. On average, people with Alzheimer’s disease live 4-8 years after diagnosis but some live up to 20 years. Maintaining overall health and engaging in early treatment provides the best chance of slowing progression.
While cognitive decline is currently irreversible and incurable, researchers are working hard to find more breakthrough treatments and hopefully one day a cure.
When to Contact a Doctor
Reach out to your physician if you notice any of the following:
- Increasing trouble remembering recent events and conversations
- Difficulty learning new information or following instructions
- Confusion about where you are or what day it is
- Trouble finding the right words in conversation
- Forgetting how to do routine tasks
- Changes in mood like increased irritability or withdrawal
- Family or friends express concern over your memory
- New issues performing daily self-care tasks like dressing, bathing, cooking
The earlier you seek help, the sooner underlying causes can be identified and addressed. While true dementia cannot yet be reversed, today’s treatments can temporarily improve symptoms and quality of life.
Questions to Ask Your Doctor
When visiting your physician about cognitive concerns, come prepared with questions including:
- What tests will you conduct to evaluate my cognitive function?
- Do I show signs of mild cognitive impairment or dementia?
- What underlying conditions could be causing my symptoms?
- What treatments do you recommend based on my exam and test results?
- If I have dementia, how can we optimally manage my symptoms?
- What lifestyle changes may help minimize further decline?
- How often should I follow up to monitor my condition?
- Are there clinical trials I may qualify for?
- How can you coordinate care with my other doctors?
- Can you refer me to community resources and support services?
Don’t hesitate to take notes, bring a friend for support, and ask any other questions you may have. The more information you gather from your appointment, the better equipped you’ll be to optimize your brain health going forward.
Conclusion
Noticing some decline in memory, thinking skills and cognitive function is common as we age. Mild cognitive impairment affects many older adults but may remain stable over time. However, persisting cognitive decline that interferes with daily activities may signal an underlying condition like dementia.
If you notice your mental sharpness slipping, schedule an appointment with your doctor for prompt evaluation. Diagnosing and addressing any reversible factors early provides your best chance of improving or stabilizing symptoms. Though not yet curable, today’s therapies can temporarily improve quality of life for dementia patients. And engaging in a brain-healthy lifestyle offers the best opportunity for protecting your cognition as you age.