Article originally published to psychologytoday.com on March 24, 2025.
Know the signs of normal aging, mild cognitive impairment, and dementia.
As a primary care physician, I often have older patients come to me worried about dementia. They tell me they’ve been forgetting names or where they put their keys, and they’re concerned that such memory lapses are a sign of something more serious. While their memory slips can be frustrating, they’re often just a normal part of aging.
Many of my patients are surprised to learn that there’s a big difference between regular age-related memory changes and dementia. So, let’s take a closer look at what’s considered normal and what might be cause for concern.
Normal Age-Related Memory Changes
As we age, it’s common to experience some decline in cognitive function. This is often called “age-associated memory impairment” and is a normal part of aging. It’s important to remember that this doesn’t mean you have dementia.
Age-related cognitive decline may include:
- Forgetting where you put things, such as your keys or glasses.
- Taking longer to learn new tasks, such as how to use a new appliance.
- Occasionally struggling to find the right word in a conversation.
- Forgetting the names of people you don’t know well.
- Needing to concentrate harder to keep up with a conversation, especially if you’re distracted or if many people are speaking at once.
These changes are generally mild and don’t significantly interfere with daily life. Despite occasional memory lapses, you are still able to function independently and pursue normal activities.
Mild Cognitive Impairment (MCI)
Between normal age-related memory changes and dementia there’s an intermediate stage called mild cognitive impairment (MCI). MCI involves a more noticeable decline in cognitive abilities, particularly memory, but it’s not severe enough to interfere with daily life.
Symptoms of MCI may include:
- Frequently losing or misplacing things.
- Frequently forgetting conversations, appointments, or events.
- Having trouble coming up with the right word or name.
- Feeling increasingly overwhelmed by making plans and decisions.
MCI can be a risk factor for developing dementia, but not everyone with MCI will progress to dementia.
Dementia: What It Is and How It Differs
Dementia is not a normal part of aging. It’s a group of symptoms caused by various diseases that damage the brain. The diseases affect cognitive function—thinking, remembering, and reasoning—to such an extent that it interferes with a person’s daily life and activities.
Dementia significantly affects daily life and the ability to complete tasks. For example, someone with dementia might:
- Forget important information, such as the names of friends and loved ones.
- Have difficulty with simple tasks, like paying bills or following a recipe.
- Get lost in familiar settings.
- Experience changes in personality and behavior.
Key differences between normal aging and dementia:
- Severity: Normal aging involves mild cognitive decline, while dementia causes significant impairment.
- Progression: Cognitive decline in normal aging is gradual and often unnoticeable, whereas dementia worsens over time and can be rapid.
- Impact on daily life: Normal aging has little to no interference with daily life, but dementia disrupts daily tasks and routines.
- Personality changes: Normal aging may cause minor personality changes, but dementia can alter personality entirely.
- Reversibility: Cognitive decline in normal aging can sometimes be improved with lifestyle changes, but dementia symptoms cannot be stopped (though they may be slowed with medication).
Early Signs and Symptoms of Dementia
While memory loss is a common symptom of dementia, it’s not the only sign. Early symptoms can be subtle and vary from person to person. Sometimes, people fail to recognize that these symptoms indicate something is wrong.
Here are some red flags that may indicate dementia:
- Memory: Forgetting recent events, names, and faces; asking questions repetitively; forgetting things more often or not remembering them at all.
- Thinking and planning: Increasing difficulty with tasks and activities that require organization and planning; becoming confused in unfamiliar environments; having trouble with all the steps involved in preparing a meal; getting lost going to familiar places.
- Language: Significant difficulty finding the right words; struggling to follow conversations; forgetting simple words or substituting inappropriate words.
- Mood and behavior: Becoming withdrawn, apathetic, or anxious; depression; rapid mood swings for no apparent reason; becoming confused, suspicious; impulsive, or more outgoing.
- Movement: Gait changes (the way we walk); difficulty with coordination; increased unsteadiness; and limb stiffness.
When to Seek Medical Evaluation
It’s time to consult a doctor when memory lapses become frequent enough or sufficiently noticeable to concern you or a family member. If you get to that point, make an appointment to talk with your primary care physician. You should also seek medical attention if you notice that memory problems affect your daily life. Don’t hesitate to discuss any concerns about memory loss with your primary care physician. They can perform an initial physical exam and administer cognitive screening tools. If the results indicate a problem, further tests can be done.
Early diagnosis is crucial for appropriate care and support. It allows for timely treatment, which may help slow down disease progression, and appropriate planning. More important, there are reversible causes of dementia rendering it curable if caught early enough.
Types of Dementia
There are many types of dementia, each with its symptoms and causes. Here are some of the most common types:
- Alzheimer’s disease: This is the most common type of dementia. It is characterized by the buildup of abnormal proteins in the brain, leading to the gradual decline of memory and other cognitive functions.
- Vascular dementia: This type of dementia is caused by damage to the blood vessels in the brain, which can reduce blood flow and oxygen to brain cells. Symptoms can vary depending on the location and extent of the damage.
- Lewy body dementia: This type of dementia is characterized by the presence of Lewy bodies, which are abnormal protein deposits in the brain. It shares symptoms with both Alzheimer’s disease and Parkinson’s disease, including memory loss, hallucinations, and movement problems.
- Frontotemporal dementia: This is a group of disorders that primarily affect the frontal and temporal lobes of the brain, which are responsible for personality, behavior, and language. Common symptoms include changes in personality, behavior, and language skills.
While occasional forgetfulness can be a normal part of aging, it’s important to be aware of the signs and symptoms of dementia. If you or someone you know is experiencing a concerning level of memory loss or other cognitive changes, don’t hesitate to seek medical evaluation. Early diagnosis is crucial for accessing appropriate care, support, and treatment options, which can help manage the disease and improve the quality of life for individuals and their families.