Alzheimer's disease Brain Mental health The Memory Doctor

Forgetfulness and aging: what’s normal?

Dr. Nathan Herrmann

Question: Is it normal to have a bit of difficulty with your memory as we get older?

Answer: Yes. Research into the normal changes in cognitive function as we age has been ongoing for decades. Colourful and sometimes confusing names for this process have included “Age Associated Memory Impairment” and “Benign Senescent Forgetfulness,” with the latest label being “Cognitive Aging.”

While the brain ages for everyone, it does so at a different rate, and in a different pattern for each individual. The rate and pattern of change depends on genetic, environmental, and general health characteristics. Many of these factors are now well-known, and it is generally accepted that some of these can be modified to slow the process.

Cognition includes several different and often inter-related functions beyond memory. Short term memory declines slowly with aging, as well as executive function (a group of skills including decision-making and thinking abstractly). Wisdom and knowledge on the other hand, tend to remain intact or even improve with age. Furthermore, many people can adapt to memory changes by using calendars, writing lists, using smart phones, and mnemonics (e.g. tricks to remember names with word association).

So how does someone know if they are aging cognitively in a normal fashion or if there is something more serious going on? In general, if the memory and cognitive changes are not interfering with daily activities and the adaptations described above seem to be working effectively, there should be little to worry about. If however, function is starting to become impaired, family or friends are noticing the changes, or the person themselves begins to worry about their cognitive function, it is worthwhile speaking to your physician and have them perform a cognitive screening test. It is perhaps not surprising that people who worry about memory decline are at higher risk of eventually developing dementia, even if they test normally initially.

There are numerous medical conditions that can affect cognitive aging. These include heart disease, stroke, diabetes, hearing and vision problems and sleep disorders. Emotional problems like depression and anxiety can also lead to accelerated memory decline. Finally, medications including over the counter antihistamines and sleep aids can also worsen cognitive aging. Some of these conditions can be treated to reduce the risk.

Besides working with your physician to optimize the medical conditions, physical exercise, a Mediterranean-type diet, and mentally stimulating activities may slow cognitive aging and reduce the risk of developing pathological memory problems leading to dementia. All of these important preventative activities will be discussed in detail in other blogs in this series.

About the author

Dr. Nathan Herrmann

Dr. Nathan Herrmann

Dr. Nathan Herrmann holds the Lewar Chair in Geriatric Psychiatry and is Head of the Division of Geriatric Psychiatry at Sunnybrook Health Sciences Centre. For 25 years, Dr. Nathan Herrmann has been a memory disorders specialist. He has done research in the fields of mental health in the aging, including dementia, Alzheimer’s disease, depression, and suicide. Read his blog series: The Memory Doctor.