Dementia or common age-related forgetfulness: How to know the difference

As we enter our golden years, it’s common to experience occasional bouts of forgetfulness. Misplacing keys or momentarily struggling to recall a word can often be attributed to getting a little older.

However, distinguishing between ordinary forgetfulness and the early signs of dementia can be challenging, as they may present with similar symptoms. While forgetfulness is typically a normal part of ageing, dementia represents a more significant and progressive decline in cognitive function.

During Dementia Action Week (September 16-22), Australians are encouraged to learn more about dementia. With this in mind, join Starts at 60 as we explore the fundamental differences between forgetfulness and dementia, how to obtain a proper diagnosis, and strategies for maintaining cognitive health well into your later years.

Age-related forgetfulness and dementia: An overview

Age-related forgetfulness is considered a normal part of the ageing process and is often caused by minor changes in the brain, such as a slight decline in the speed of information processing and a decrease in the size of certain brain regions.

While these memory lapses can be frustrating, they do not typically interfere significantly with daily functioning or independence. On the other hand, dementia represents a more serious and progressive decline in cognitive abilities, including memory, thinking, and reasoning skills.

By familiarising ourselves with both age-related forgetfulness and dementia, we can better comprehend the variations between the two.

Clinical Psychologist and Author, Dr Tracey Zielinski shed some light on both forgetfulness and dementia, explaining that “forgetfulness, as we get older, is largely due to normal age-related changes in the brain.”

“These changes mean that you process new information more slowly, need to concentrate more to remember someone’s name when you’re first introduced, and have reduced working memory space,” Zielinski says.

Dementia, on the other hand, is “not the same as normal ageing”, according to Zielinski.

“While dementia can strike different people in different ways, affecting different parts of the brain at different times and progressing at different rates, the most common and well-known type of dementia is Alzheimer’s disease,” she explains.

“Alzheimer’s progresses gradually and typically impacts the memory early on.

“Symptoms of Alzheimer’s disease include repetition of conversations without awareness of having said the same thing to the same person earlier. There might be problems learning new information, such as how to use a new device, or remembering something you told them.

“They may struggle with remembering where information came from – the source of the information – so they may not recall who said what. They may also have difficulty remembering the order in which things happened. They may get lost or disoriented in a relatively familiar place.”

How to differentiate forgetfulness from dementia

While having a thorough understanding of both age-related forgetfulness and dementia is important, being able to identify key differences is essential.

It allows us to make informed decisions, seek appropriate medical attention, and provide timely support to ourselves or our loved ones. Recognising these distinctions not only brings clarity but can also alleviate unnecessary worry or confusion.

By being able to differentiate between the two, we can better navigate the landscape of cognitive changes that occur with age, ensuring that we take the right steps toward maintaining cognitive health and seeking help when necessary.

Zielinski tells Starts at 60 that a key determining factor in knowing the difference is that forgetfulness “doesn’t last”.

“Your memory clicks into gear with a prompt or cue, the word you were looking for turns up in your mind a little later, when you find your keys you can remember the circumstances that led you to leaving them there in the first place,” Zielinski says.

“If you are experiencing normal age-related forgetfulness, you are likely still functioning well, still capable of learning new information and adapting to new situations. It just takes a little more time and effort to learn new stuff or to come up with the solution to a problem than it did when you were younger.”

However, if you are experiencing the symptoms of dementia then “cueing or prompting is less likely to help them remember. They won’t necessarily recall having said the same thing previously.”

“New learning is problematic, and they are less likely to adapt readily to new situations or be able to problem-solve complex issues,” Zielinski explains.

“Often, if a person has a well-entrenched routine, it may not be obvious they have dementia until they have to adapt to a new situation. So, for example, if asked to make a cup of tea and piece of toast in a strange kitchen, they may struggle to do so.”

When to seek professional help

If you feel that your forgetfulness has progressed to a point where dementia may be a concern, or if you simply have worries and want to put your mind at ease, it is important to know that there are numerous medical services available to assist you.

Seeking professional help is a proactive step towards understanding and addressing your cognitive health. Healthcare providers, including primary care physicians and specialists in geriatric medicine or neurology, can conduct thorough evaluations to assess your cognitive function and determine if there are any underlying causes for concern.

They may employ various diagnostic tools, such as cognitive assessments, neurological examinations, and imaging tests, to provide a comprehensive evaluation. These medical services are invaluable in helping differentiate between forgetfulness and dementia, offering reassurance, guidance, and appropriate interventions tailored to your specific needs.

A Mini-Mental State Examination (MMSE) is often the go-to when screening for dementia. The test includes a set of 11 questions that medical professionals will use to determine any cognitive impairment.

There are also a number of other cognitive screens that may be carried out, some of which include:

• The Alzheimer’s Disease Assessment Scale
• Montreal Cognitive Assessment
• Rowland Universal Dementia Assessment Scale (RUDAS),
• Addenbrooke’s Cognitive Assessment (ACE).

Zielinski suggests that “if you suspect a family member is experiencing dementia, you might ask their GP for a referral to a Memory Clinic.”

“At a memory clinic, a geriatrician will carry out a range of screening tests and possibly refer the person for a neuropsychological assessment which includes comprehensive testing of cognitive function and is helpful in providing a definitive diagnosis,” Zielinski says.

Maintaining cognitive health in your later years

As we journey through the later stages of life, preserving cognitive health becomes increasingly important. While ageing is accompanied by natural changes in our brains and cognitive abilities, there are proactive steps we can take to promote a vibrant and sharp mind as we grow older.

By adopting lifestyle modifications, engaging in intellectual stimulation, and managing underlying health conditions, we can empower ourselves to lead fulfilling lives and safeguard our cognitive well-being.

Zielinski recommends the following as effective strategies for staying sharp well into older age:

• Maintain a good social network. Varied and stimulating conversation is incredibly helpful in staving off dementia.
• Maintain an active, healthy lifestyle.
• Keep your mind active by learning new things, maintaining hobbies, reading, doing puzzles, playing a musical instrument, playing games, etc.
• Manage medical issues such as high blood pressure, high cholesterol, and diabetes.
• Be aware of and manage stress. Consider learning and practising relaxation techniques such as diaphragmatic breathing, mindfulness, meditation, etc.
• Limit consumption of alcohol and other drugs, including cigarettes.
• Eat a well-balanced diet.
• Get adequate, good-quality sleep.

While occasional memory lapses are a natural part of ageing, dementia represents a more profound and progressive decline in cognitive abilities.

By understanding the distinctions, we can gain a clearer perspective on our cognitive health and take appropriate steps to seek professional guidance when necessary. Early detection and intervention can significantly improve the management of dementia and ensure a better quality of life for ourselves and our families.

IMPORTANT LEGAL INFO This article is of a general nature and FYI only, because it doesn’t take into account your personal health requirements or existing medical conditions. That means it’s not personalised health advice and shouldn’t be relied upon as if it is. Before making a health-related decision, you should work out if the info is appropriate for your situation and get professional medical advice.